25th April 2021 data update

Team members James Beecher and Claire Biggs summarise local data on the pandemic and put it in national and international context

At the end of this week’s data update for Stroud, Gloucestershire and beyond, is a summary and link to details of current guidance. The next stage of the government’s roadmap for easing restrictions is due to take place “no earlier than 17 May.”

Key data:

  • Today, “the ZOE app recorded the lowest level of new cases since the pandemic began last March when we started our survey” (897 people). This is just one estimate of prevalence – based on a self-selected sample of people reporting symptoms, but is is very encouraging (even if if it is not entirely in line with other data sources – which suggest case numbers are falling more slowly – with 1,434 specimins submitted on 23rd April testing positive across the UK).
  • Higher numbers of people have tested positive in both Stroud district and Gloucestershire in the most recent week compared to the week before (14 in Stroud district, out of 79 across Gloucestershire). However, the estimate of the number of people with an active symptomatic infection from the ZOE/Kings College London app for Stroud district has falled by 11 (to 14).
  • Rates per 100,000 people are still low in Stroud district and Gloucestershire – indeed among the lowest rates in the UK: 9.2 per 100,000 in Stroud district 33rd lowest out of 348 ‘lower tier’ local authorities (i.e. districts), and 11.9 per 100,000 across Gloucestershire – 19th lowest of 182 ‘upper tier’ local authorities – i.e., counties).
  • There have been two weeks where no-one from Stroud district has died with Covid-19 mentioned on their death certificate in the most recent data (to 9th April), but sadly in that week one person from Gloucestershire did die with or because of Covid-19 (the Gloucestershire total is now 1,180 people). Data from the UK’s statistics agencies shows that 150,841 people living in the UK have died with their “death certificate mentioning COVID-19” as one of the causes. We send our condolences to all affected.
  • Nationally, the number of Covid-19 patients being admitted to hospital has been falling fast – 132 people were admitted on the 20th April, compared to 194 seven days previously – and 4,577 at the peak on 12th January). The total number of people with the virus in UK hospitals is 1,781 (22nd April), down from 2,872 on the 8th April (and from a peak of 39,249 on 18th January). The lowest last summer was 803 on the 2nd September, so there is still some way to go. The number of Covid-19 patients in mechanical ventilation beds is now 243 (down from 332 on the 16th April, having peaked at 4,077 patients on 24th January). The lowest last summer was 60 on 28th August. We send our best for the recovery of all Covid-19 patients in hospital.
  • Data from the NHS on vaccinations shows that there have been 456,924 Covid-19 vaccine doses delivered in Gloucestershire (27,259 doses delivered in the past week of data, compared to 17,750 doses delivered in the previous week – and a peak of 82,267 doses in the week to 21st March). Of these, 344,358 are first doses (up 3,266 in the most recent week) and 109,300 second doses (up 23,653).
  • Across the UK, as of 25th April, 46,253,754 doses have been delivered and 33,666,638 people have received at least a first dose.
  • While the number of people testing positive in the UK is reaching very low levels, across the world as a whole numbers are rising and are at their highest ever levels. The 7-day average number of people testing positive per day on April 23rd – 815,565 – is the highest daily number yet (this partly reflects increased testing but mostly is a function of the fact that the virus is rampant in many countries).
  • The number of people to be reported as dying per day (on a 7-day average basis) as rising again – to 12,485 on April 23rd, up from 10,243 on March 31st (and in the context of robust evidence that data on the number of people dying in India, to give just one example, undercounts significantly the scale of what is happening)
  • Further detail and charts on the above and more are below:

People who have tested positive

Across Gloucestershire, 79 people tested positive in the week to the 21st April (up from 64 in the previous week, and 50 in the week before that). You can view daily numbers for Gloucestershire on the government’s dashboard. These increases are slow – and could be related to wider access to testing – but also may be a function of loosening of restrictions and the start of a trend. The rate per 100,000 people for Gloucestershire is 11.9. It remains one of the lowest rates in the UK (19th of 182 ‘upper tier’ local authorities – i.e., counties).

Source: data.gov download – data and chart by Claire Biggs

14 people from Stroud district tested positive in the most recent week – to 21st April (up from 9 in the previous week). The positivity rate – the proportion of PCR tests that return positive results is still very low at 0.2% of the 2,826 tests completed in the last 7-day period for which data is available – but has fluctuated a little lately. It was lowest on the 14th April at 0.1% of 2,876 tests in the previous week. There were several days relatively recently where no specimens submitted resulted in positive tests – but this hasn’t happened since the 14th April (prior to that it also happened on the 11th, 9th, 8th, 6th, 4th and 2nd April. The rate per 100,000 people in Stroud district is for the past 7 days 9.2, and this is still one of the lowest rates around the UK (33rd out of 348 ‘lower tier’ local authorities).

Source: gov.uk dashboard – data download

If we look at the number of PCR tests being done in Stroud district – and the proportion that test positive – we can see that the number of test is broadly falling (as we’d expect if fewer people have symptoms), but that in the past week there has been a small uptick in the proportion of tests that are positive. It’s too early to read much into this – it could be that use of Lateral Flow Devices means fewer people are getting PCR tests, but that when they do in some cases this will have been preceded by an LFD test that is positive which means the PCR tests will be slightly more likely to return positive results. At low numbers of total cases it is still hopefully more the case that we are identifying more of the small number of people who have the virus as it continues to circulate – hopefully interrupting transmission chains as part of suppression, rather than seeing a rise in the number of infections and spread.

Source: gov.uk dashboard

Looking at smaller areas, the government’s map shows – for the second week – all of the Stroud district – and the vast majority of the surrounding areas across the county and beyond – with fewer than 2 positive tests in the week to 20th April (this data is “suppressed” to protext the privacy of individuals when only small numbers of people test positive – but could mean no-one has tested positive in the previous 7 days in many of these places). As we know 14 people have tested positive across Stroud district, we can assume these are distribted across the different areas of the district, rather than there being an outbreak in one area (7 households of 2 people, or a larger number of households of a mix of 1 and 2 people). The area with the highest rate of cases in Gloucestershire is Podsmead and Linden in Gloucester where 7 people testing positive gives a rate of 78.5 per 100,000 over the past 7 days – this could represent just two or three households.

Source: govt interactive map

You can enter your postcode into the government’s dashboard to get more data on your local area.

Finally on the number of people with the virus. We know that not everyone can get a test or gets one even if they can. The Kings College London/Zoe Covid-19 symptom study app reports estimates for Stroud district – based on reporting of symptoms by people using the app (of whom there are over 3,000 in Stroud district). Their latest estimate is 14 active symptomatic cases for the district – down 11 from last week by their measure. It is interesting that this is the first time the estimated number of active symptomatic people and the number of people testing positive for the first time in the past week is the same – usually the ZOE/KCL estimate is higher, because – as above – not everyone gets tested. It’s possible these are the same 14 people, but it’s also possibly the case that PCR tests include some people without symptoms (either because they are about to get symptoms, had the virus some time ago and never had symptoms – being no longer infectious but having enough virus to test positive, or because the test result is a ‘false positive’ and they don’t really have the virus). Either way, the ZOE/KCL estimate of a downward trend coupled with the low positivity rate for PCR tests suggests there isn’t too much to worry about even though the number of PCR positives per week has increased for two weeks running.

Source: Covid 19 Symptom Study app

Across the UK, the KCL/ZOE app team estimate around 19,565 people had a symptomtic infection on the 25th April, based on symptom reporting by up to 4.6 million app users. This compares to 27,499 last week and a peak of 806,000 on the 12th January. The KCL/ZOE team estimated a similar number of people with symptomatic infections on the 31th August 2020 – 19,440. Today, “the ZOE app recorded the lowest level of new cases since the pandemic began last March when we started our survey” (897 people). These estimates tend to be in-line with and often show trends in advance of other prevalence estimates – see comparison with the random-sampling done by the ONS and the REACT studies (Imperial College/Ipsos MORI).

Vaccinations

We’ve published two more videos of clips from an interview with Dr Tom Malins – a GP at Price’s Mill surgery in Nailsworth who is also a Clinical Director for the Severn Health Primary Care Network (PCN) which covers a set of local surgeries linked to the Beeches Green vaccination hub. The first video covers current work, with a focus on people who are waiting to receive their second doses, and the second video focuses on the process for people yet to receive a first dose. While the information applies to people at the surgeries in the Severn Health PCN, it is of interest and broad relevance to everyone in the district.

Please watch/share on Facebook via the link above.

Tom Malins on second doses
Tom Malins on first doses

Data from the NHS on vaccinations shows that, in total and as of the 11th April (the most recent available data) there have been 456,924 Covid-19 vaccine doses delivered in Gloucestershire (27,259 doses delivered in the past week of data, compared to 17,750 doses delivered in the previous week – and a peak of 82,267 doses in the week to 21st March). Of these, 344,358 are first doses (up 3,266 in the most recent week) and 109,300 second doses (up 23,653). The chart below shows how the rate at which second doses are being delivered is increasing while the number receiving first doses has flattened off. There are 11 weeks between the 18th April on the right and the 31st January – the third week in from the left. More people have received a second dose by 18th April (109,300) than had received a first dose 11 weeks ago (100,000) – indicating that overall people are receiving their second doses before the 12 week deadline, just as they should. The chart also shows how meeting increasing need for 2nd doses in a context of supply issues with AstraZeneca has slowed the delivery of 1st doses for now.

The chart below shows vaccination coverage for the Stroud district, as proportions of the different age bands. In theory this would show the takeup of vaccination by people, but its only an approximation – as though we know the number of people to have had first doses, we have to calculate this as a percentage of an estimate population of residents of different ages (from the Office for National Statistics 2019 estimate). The estimated number of residents in each age band won’t be quite right for various reasons – some people will have moved into an older age band, some will have moved to the area. In reality, “close to 100%” of all people aged 50 or over in Stroud district have now had at least one dose of a Covid-19 vaccine. Together they – and the 6,790 people aged 45-59 and 8,932 people aged under 45 who have already had a first dose (vaccinations are currently still being offered to people aged 40-49) – account for around 70% of the population locally aged over 16 (and around 58% of all residents of the district).

Source: NHS England

People aged 45 and over can now book to be vaccinated at one of the mass vaccination sites via this link, as can anyone who meets the criteria for other top priority groups. Making a booking at a mass vaccination site (Gloucester, Bristol, Bath, Malvern, Oxford etc) will not affect whether you receive a GP surgery invite to a local vaccination hub or site in the district. You can cancel bookings at mass vaccination sites via the link (under “manage your bookings”). Please ensure to do this with time for people to take the slot so vaccine isn’t wasted. If you are able to travel to a mass vaccination site, you free up space for people who cannot travel at the local hubs.

Check out our previous videos with Dr Jim Holmes and Practice Manager Karen Pitney from Rowcroft Medical Centre on “why you should get vaccinated“, “the process for receiving your vaccination” and “second doses“.

Prices Mill surgery update on 19th April says “21% of our registered adult population have now received two dose of vaccine (31% of Cohorts 1-9). Only a handful more patients received there first dose last week as we haven’t received the central supplies to be able to do more. Over 45s can now book to receive their first dose via the regional centres.We are forging on with second doses and will be in touch to invite you to make that booking within 12 weeks of your first. If you are over 50 and are yet to receive your first dose, please call the surgery and arrange your appointment: the next two Saturdays are already booking up!”

Minchinhampton surgery update from 23rd April reads: “Vaccination update for Minchinhampton patients:1st vaccinations to date: 49142nd vaccinations to date: 1714. The next vaccination clinics are planned for 24th & 25th April at Rowcroft Medical Centre (2nd AstraZeneca vaccinations) and 27th April at Horsfall House (1st & 2nd AstraZeneca Vaccinations).If you had a 1st AstraZeneca vaccination on or before 13th February please contact the Surgery to book in for your 2nd.”

The table below shows the vaccination hubs associated with different surgeries in the district – we include updates from Facebook pages when we have them but don’t have them for all surgeries. The above gives a rough indication of where other local surgeries are likely to be with their rollout, however.

We understand many people are keen to be vaccinated but please try to be patient, the vaccine rollout is an enormous logistical challenge. Across the UK, as of 25th April, 46,253,754 doses have been delivered and 33,666,638 people have received at least a first dose. In the time scale, this is unprecedented, and GP surgeries are doing this on top of their normal workload. If you have questions about when you’ll be vaccinated please either ask in our Facebook group or email GP surgeries rather than calling them. We will be interviewing someone next week – comment with a question on this post and we’ll do our best to ask it.

There continue to be regular updates in our Facebook group about vaccination locally – including from GP surgeries (see the Facebook group topic). If you’ve had your jab recently, please do read advice on continuing to be cautious after receiving your vaccination).

Hospitals – local, national

There were no patients in Mechanical Ventilation beds locally between 18th March and 8th April, ie, for over three weeks. Now there is one, and one other Covid-19 patient in Gloucestershire hospitals – though 10 patients were admitted in the week to 18th April (it is a good sign that most are being discharged). People in hospital now are likely to have been infected a week or more ago, but while rates are low (see below), that there are still patients receiving ventilation is a reminder that the virus has not gone away completely. We wish the two people in hospital the best with their recovery, and hope that there will be no Covid-19 patients in Gloucestershire hospitals before long.

Source: NHS hospital activity

People who have died with Covid-19

In Gloucestershire, the most recent data – up to the 9th April – shows that 1,180 people have died with Covid-19 mentioned on their death certificate (one person died with their death registered in the week ending 9th April). 197 of these people were from the Stroud district (no-one from Stroud district has died with Covid-19 mentioned on their death certificate for the last two weeks of registrations). We send our condolences to all affected.

The data is from registrations of death up to the 9th April. It is possible there will be a few further deaths, but barring dramatic mutations of the virus, and failures of policy, we should never see the weekly numbers we have seen recently again.

Data from the UK’s statistics agencies shows that 150,841 people living in the UK have died with their “death certificate mentioning COVID-19” as one of the causes. In upwards of 75% of cases, Covid-19 is the “underlying cause” – the main reason someone died.

“The number of deaths registered in the UK in the week ending 9 April 2021 was 10,397, which was 1,301 fewer than the five-year average; of deaths registered in the UK in Week 14, 422 involved COVID-19 (28 lower than in Week 13)… Of the deaths registered in Week 14 in England and Wales, 379 mentioned “novel coronavirus (COVID-19)”, a decrease of 21 deaths compared with Week 13… Of the 379 deaths involving COVID-19 in Week 14 in England and Wales, 280 had this recorded as the underlying cause of death (73.9%).”

Office for National Statistics

The data are published weekly by the ONS, NRS and NISRA and there is a lag in reporting of at least 11 days because the data are based on death registrations” (data is to the 9th April). The chart below is from the Office for National Statistics, who report based on what clinicians determine the cause of death to be for death certificates, covering England and Wales only, but shows how the number of deaths with COVID-19 mentioned as one of the causes relate to other deaths since January 2020, and push the number of people dying in some weeks well over the 5 year average. The ONS say:

“Using the most up-to-date data we have available, the number of deaths from the week ending 13 March 2020 up to 9 April 2021 was 688,950 in England and Wales. Of the deaths registered by 9 April 2021, 138,476 (20.1%) mentioned COVID-19 on the death certificate. During this period, the number of excess deaths above the five-year average was 115,608 deaths.”

We have previously included data comparing the death rate in Stroud district with other areas, incuding those that have seen more than twice as many people die compared to their local population.

The Independent SAGE weekly briefing this week includes a data presentation from Kit Yates (after a question this time rather than right at the start – due to technical difficulties) – which includes some international data on India and other countries, and is followed by a Q&A with media and public.

International context

Globally, over 3 million people have now died with their death attributed to Covid-19 at least in part (subject to different counting methods in different countries). The situation remains concerning, with Our World in Data reporting the number of people to be reported as dying per day (on a 7-day average basis) as rising again – to 12,485 on April 23rd, up from 10,243 on March 31st (and in the context of robust evidence that data on the number of people dying in India, to give just one example, undercounts significantly the scale of what is happening). This is tragically still very high – considerably higher than during Spring 2020. While things are improving in the UK, there is a long way to go globally before the pandemic is over – the 7-day average number of people testing positive per day on April 23rd – 815,565 – is the highest daily number yet (this partly reflects increased testing but mostly is a function of the fact that the virus is rampant in many countries).

While the number of people testing positive in the UK is reaching very low levels, across the world as a whole numbers are rising and are at their highest ever levels. Countries across Europe have high rates – though cases are now falling across the European Union, as they also appear to be currently in South America, and North America. Cases are rising rapidly in Asia – including particularly in India (and even the rapid rise is likely to be an undercount – the proportion of tests that are positive is very high and experts agree cases are being missed).

The United Kingdom is doing very well in terms of Covid-19 vaccine doses per 100 people (67) – behind only a few other countries like Israel (120 – ie, moving into enough doses to cover everyone, but some will be second doses) and United Arab Emirates (103), and Chile (74). Globally, the rate is 13 doses per 100 people. There is a real need to plan to improve global vaccination. You can Donate to treat, vaccinate and support people worldwide – which a few members of our Facebook group have reported doing to celebrate getting their own vaccination.

The chart above covers both first and second doses – but different countries have different strategies (the UK has maximised first doses, while other countries have pursued both first and second doses equally, which slows the first dose rate. Some other countries have used single dose vaccines – as the UK may do eventually). In terms of full vaccination, Israel has the highest proportion fully vaccinated (58%), Chile (32%), Bahrain (30%), USA (28%) and Serbia (19%) all have higher rates than the UK (18%) – though the UK’s rate is still very high in terms of global comparisons (for example India has just 1.6% of the population fully vaccinated).

Notes

The core advice remains: please book a test (see full details at the end of this page). You can now do this whether or not you have symptoms. The link will tell you which type of test to book if you have symptoms or not. Twice weekly rapid tests are available to everyone in England without symptoms. If you have symptoms, there is a permanent unit at Hempsted Meadow in Gloucester, and a walk-in unit in Stratford Park. See this link for details of testing locations in Gloucestershire. If you have symptoms (or if you are asked to by contact tracers), self-isolate until you have a negative test – or for 10 days since your symptoms appeared if you test positive or are asked to by Test and Trace. If you are struggling with self-isolating, please get in touch with us or with one of the local support groups. You may be able to receive financial support to self-isolate from Stroud District Council.

Whether or not you have symptoms, please still follow the guidelines to wear masks when appropriate (they will help prevent spread of the virus if you have it but don’t have symptoms yet, or are asymptomatic – meaning you have the virus but without ever getting any symptoms), keep distance from people, and wash your hands regularly.

The Government’s loosened restrictions on Monday 12 April:

  • “non-essential retail will be able to reopen
  • personal care premises such as hairdressers and nail salons will be able to reopen
  • public buildings such as libraries and community centres will be able to reopen
  • outdoor hospitality venues will be able to reopen, with table service only
  • most outdoor attractions including zoos, theme parks, and drive-in performances (such as cinemas and concerts) will be able to reopen
  • some smaller outdoor events such as fetes, literary fairs, and fairgrounds will be able to take place
  • indoor leisure and sports facilities will be able to reopen for individual exercise, or exercise with your household or support bubble
  • all childcare and supervised activities will be allowed indoors (as well as outdoors) for all children. Parent and child groups can take place indoors (as well as outdoors) for up to 15 people (children under 5 will not be counted in this number)
  • weddings, civil partnership ceremonies, wakes and other commemorative events will be able to take place for up to 15 people (anyone working is not included in this limit), including in indoor venues that are permitted to open or where an exemption applies. Wedding receptions can also take place for up to 15 people, but must take place outdoors, not including private gardens
  • self-contained accommodation will be able to open for overnight stays in England with your household or support bubble
  • you should continue to minimise the amount that you travel where possible
  • care home residents will be able to nominate two named individuals for regular indoor visits (following a rapid lateral flow test)”

If there is a piece of guidance you have a question about, again – please ask in our Facebook group.

These updates are designed to improve understanding of the pandemic and its impacts, with the hope this can help us to reduce those impacts locally. I appreciate they do not involve space to properly convey the full impact of the virus nor the restrictions that are making life difficult for many people.

Please remember we have a list of resources to support your emotional and mental health during this time on our website (and welcome further recommendations). The following numbers may be useful:

  • Samaritans: 116 123
  • Domestic Violence Hotline: 0808 2000 247
  • Mind: 0300 123 3393
  • Age UK: 0800 169 6565
  • Childline: 0800 1111.

Your suggestions for inclusion of data in these summaries are welcome. Please submit posts to our Facebook group.