14th June 2021 data update

Step 4 of the government’s reopening roadmap – to include the end of legal limits of contacts – was due “no earlier than 21st June”. While the situation is unclear at time of writing, it looks increasingly likely that the next step will take place later than the 21st June. Prime Minister Boris Johnson is set to make an announcement in a press conference scheduled for 6pm, to be followed by a statement to MPs by Health Secretary Matt Hancock at 9pm. Current government guidance, which is in place until the next step takes place, is available on the gov.uk website – click for full details. Please also read this additional government guidance: “Be careful: a new COVID-19 variant is spreading in some parts of England“

Key data:

• No-one from Stroud district has died with Covid-19 mentioned on their death certificate for over a month (no death certificate mentions in the six most recent weeks of data, to 28th May). No-one from Stroud district has died within 28 days of a positive test for coronavirus (SARS-COV-2) since 20th March, nor in Gloucestershire since 17th April (data to 12th June).
• The number of people testing positive by PCR or Lateral Flow Device in Gloucestershire has risen substantially and quickly – to 298 in the past week, (compared to 180 in the week before). Rates are highest in Gloucester, Tewkesbury and Cheltenham, and among people aged 20-24, but they are rising in Stroud district too. Across Gloucestershire are around 50 per 100,000 people or one in every 2,000 people testing positive in the most recent week. Across the UK, the number of people to have tested positive in the past 7 days is 50,017 – up 16,521 (49%) on the previous week
• There are 7 people in Gloucestershire hospitals with Covid-19 (as of 1st June, the most recent data). There is one patient in a mechanical ventilation bed (down from 2 last week). We wish these people well with their recovery. Admissions/diagnoses in hospital are still low locally, but the number of people in hospital with the virus nationally has been rising – albeit at relatively low numbers (1,089 on the 3rd June compared to 932 on the 3rd June). We know hospitalisations lag infections, so we may see similar rises associated with the higher numbers of people testing positive across the county recently… or we may not if these are cases among people less likely to be at risk.
• Locally, over half of the population have now received a second dose of a Covid vaccine (58% for Stroud district and 52% for Gloucestershire – compared to 46% across Englnad). In terms of those eligible for vaccination, 80% in Stroud district and 79% across Gloucestershire have now received at least one dose (78.5% across England). See below for charts breaking down vaccination rates by age band within Stroud district.
• Further detail and charts on the above and more are below:

People who have tested positive

The changes in the numbers of people testing positive across Gloucestershire is perhaps easiest to explain through monthly chart: the number of people testing positive for the first time is higher for the first 10 days of June (417), than for all of May (296) – which was already a small rise on April (256). However, while numbers are rising rapidly and we would expect them to continue to do so, they are currently well below the levels of midwinter (6,472 people tested positive in January at the peak) – and crucially almost all of those of us most at risk have now been offered a Covid-19 vaccine (and the overwhelming majority have taken up this offer and received both doses – see below).

Across the county, rates are highest – and have risen sharply – in Gloucester (77 per 100,000 or 1 in every 1,300 people), Cheltenham (57), and Tewkesbury (60). They have risen at a similar rate but are currently lower in the Forest of Dean (30), Stroud District (26 per 100,000 or 1 in every 3,500 people) and lowest in Cotswold (27 per 100,000 or 1 in every 3,700 people). Rates aren’t that dissimilar across the county and could be affected by the proportion of people who get tests, so it doesn’t really make sense to suggest they are lower in Stroud district than Cotswold (only true in a mathematically tecnical sense). You can view daily numbers for Gloucestershire on the government’s dashboard. The rate per 100,000 people for Gloucestershire is 48 (i.e., one in every 2,000-odd people has tested positive in the past week) – still lower than the UK rate of 64.7 per 100,000. The sharp rise is a reminder how quickly the virus – particularly the new variant – can spread, so please do keep being cautious: meet outdoors if you can, keep fresh air flowing if meeting indoors, maintain distance and wear masks wear appropriate, wash your hands regularly, and get tested with a PCR test if you have symptoms, and with rapid Lateral Flow Tests if you do not have symptoms. We can be hopefully that the data for the 7th and 8th June shows signs that increases might be slowing down in some areas (though it’s too early to draw strong conclusions).

On a weekly basis, 298 people tested positive across Gloucestershire in the week to the 9th June (nearly double the 180 last week, and nearly six times the 49 for the week to 19th May). This is the highest number for a week since the week to the 17th February when 352 people tested positive. Though there has been a very considerable increase, this appears to be associated mainly with younger people (particularly those aged 20-24), who we know are much less likely to be vaccinated (unless clinically vulnerable, acting as an unpaid carer for someone who is, or working in health or social care). We would expect (and the data below appears to bear out so far – though there is a lag), that these people will be less likely to need to be admitted to hospital.

The highest rate in Gloucestershire is in again in Kingsholm and Wotton, Gloucester – where 13 people have tested positive in the past week (1 more than the previous week), giving a rate of 142.2 per 100,000 (or more than 1 in every 1,000 people). The government’s map no longer shows all areas in Stroud district (as well as many in the surrounding areas across the county and beyond) – with at most 2 positive tests in the week to (as it did till 1st June). Data for some parts of the district is still “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, but we can now see cases in Frampton, Whitminster & Eastington (7), Upton St Leonards & Hardwicke (7), Rodborough & Thrupp (4), Stroud Town (4), and Ebley & Randwick (3).

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

It’s worth adding that if we look at the age of people testing positive in Gloucestershire, we can see what looks like a vaccine effect with much lower rates among those 70 and over (mainly yellow area outlined in red in the top right). Rates have been highest by far for people aged 20-24 (slightly darker blue chunk at the bottom right), at 204/100,000 (or roughly 1 in every 5000 people of this age across the county).

Though they may rise further – and rates of increase in the chart above look concerning, the rates for Gloucestershire as a whole (48 per 100,000) and the districts within it are still way below the highest in the UK: currently Blackburn with Darwen: 649 per 100,000. Seven other “Upper Tier Local Authories” have rates over 100 per 100,000:

• Bolton – 311 (though this is falling – down for two week running and from 355 last week)
• Salford (310 – up from 158 last week)
• Manchester (286 – up from 168 last week)
• Dundee City (274 – below 100 last week)
• Bury (241 – up from 162 last week)

The chart belowshows the rates in Gloucestershire (which show as dark grey for 30-60 per 100,000) in context with the areas of the country where rates have risen to 120/100,000 or higher (light and dark blue). They also given some indication of how areas that had similar rates to those locally (around North Yorkshire and the North West) have increased – or, in some cases, fallen (to light grey).

If we look at the number of PCR tests being done in Gloucestershire, we can see the rise in the number of people testing positive isn’t just about more testing being done. There has been a notable rise in the proportion of tests that return positive results (1.6% of the 18,457 people tested by PCR in the 7 days to 8th June tested positive, compared to a low of 0.2% between 24th April – 13th, and 16-21st May). That the rise has occured as the number of tests goes up is concerning, but it has perhaps levelled off in the most recent days, but it’s too early to draw any conclusions from that.

In Stroud District specifically, 28 people tested positive in the most recent week – to 9th June. This is more than double the week before (13), which was more than double the week before that (6) – but still low in context, and no higher than since the week to 17th March (when 36 people tested positive). Of course, Stroud district is not an island and people will be working and travelling to see family and friends/visit workplaces or other venues in the rest of the county (and rates may continue to rise to the levels across the other parts of the county).

The data by age from Stroud is strongly suggestive of a vaccination effect: very few people aged 55 or over have tested positive since 29th March – while there have continued to be cases among younger age groups. Rates have been highest for people aged 10-34, and are currently higher for people aged 20-24 particularly.

Another way of looking at the vaccination effect, nationally, comes via another chart from Colin Angus / Victim Of Maths on twitter. The chart below shows Covid cases per 100,000 in the past week from left to right, and the proportion of the population vaccinated from bottom to top. Rates and cases are shown for under 60s (turqouise dotes) and over 60s (orange dots). Rates of vaccination are – obviously – higher for over 60s, and covid rates are low, with some variation. Among under 60s, covid rates vary much more, are higher in more areas, and in some cases (but not all) are associated with the lower end of vaccination rates.

We do 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). This week they estimate 99 people with active symptomatic infections in the district – up 6 from last week by their measure, suggesting a flattening off after a notable rise. It’s not clear why there is a big discrepancy with the number of people testing positive, but it could be that ZOE estimates are volatile if low numbers of people are reporting at low levels. As you can see from the chart, 99 people is still low in the context of the autumn/winter peaks.

The new “Delta” variant (B.1.617.2, first identified in India) has been identified as dominant in Gloucestershire – according to the Sanger institute. 24 positive tests from Gloucester were sequenced to have the B.1.617.2 genome per week in the two weeks to 5th June (94% of all specimens sequenced), another 24 in Cheltenham (~100%), 4 in the Stroud district (90%), as well as sequenced cases and similar proportions in in Tewkesbury, the Forest of Dean, and Cotswold district. The screenshot of interactive charts below how how broadly the variant has spread around the country, you can click through to explore in more detail.

Local Hospitals

There were 7 people in Gloucestershire Hospitals with COVID-19 as of the 8th June, up from 5 the week before. 1 patient is in a Mechanical Ventilation bed, the same number as last week (it could be the same or a different person)

The chart below shows how the number of people being admitted /diagnosed over the previous 7 days period has fallen back to extremely low levels again after a brief rise (5 in the week to 6th June, compared to a recent peak of 24 in the week to 12th May – still nowhere near the peak of 202 in the week to 18th January). The increase in admissions is likely to relate to infections acquired at least a week previously, but we don’t yet seem to be seeing an increase related to the increase in infections across Gloucestershire in the last few weeks – this could be about a lag, but may also be about the younger age profile of people testing positive recently (making them, on average, much less likely to be at risk of developing severe illness).

Vaccinations

Data from the NHS on vaccinations shows that, in total and as of the 23rd May (the most recent available data) there had been 717,619 Covid-19 vaccine doses delivered in Gloucestershire (41,106 doses delivered in the week). People are receiving their second doses before the 12 week deadline, just as they should (red line linking dark blue column back to the light blue column from 11 weeks ago). There are 11 weeks between the 6th June on the right and the 21st March. Around 5,000 more people have received a second dose by 30th May (307,190) than had received a first dose 11 weeks ago (302,836). This should increase as second doses are now due to be brought forward for people in the first priority groups (lookout for a text if you are past or approaching 8 weeks since your first dose and haven’t had a second dose yet), but you can see what a challenge this is – there’s a gap of around 30,000 people to fill until people who recieved a first dose 8 weeks ago will have a second. The chart below also shows how the rate at which first doses are being delivered is picking up again after a flat April.

The charts below shows progress towards completion of the vaccination rollout locally, comparing this with the regional and England-wide progess. Stroud district continues to be ahead for both first (80% of adults, 69% of population) and second doses (63% adults, 55% population), compared to Gloucestershire (1-4% points behind), the South West (3-5% points behind) and England – where 74% of adults have had a first dose, and 52% a second (61% and 43% of the total population). This data is for 6th June, and while more doses will have been delivered since then, is closer to the proportions of people who will have built up some/maximum immunity by this point.

The chart below shows how the total population of Stroud district breaks down by age band (in the 2019 Office for National Statistics estimate). The rows below show the number of people in each age band who have been partially or fully vaccinated. The colours match down the rows, with blank/white gaps where people are yet to be invited or had not (yet) taken up an invitation as of 30th May. As you can see, essentially everyone aged 60+ is fully vaccinated (in reality a few have not been, but the number/proportion is almost too small to show up on the graph). The big difference this week is a much higher proportion of people aged 50-59 have now had their second dose. Vaccinations have only recently opened up to people aged 30-39, but already aroound two-thirds have had a first dose, and a portion a second (likely those eligible early through being an unpaid carer for someone who is clinically vulnerable/clinically vulnerable themselves/working in health or social care). People aged under 16 are not eligible for vaccination (at least, at the moment – the MHRA has approved Pfizer vaccination for 12-15 year olds, but the JCVI and government are yet to say whether people in these age groups will be vaccinated as part of the rollout).

The chart below shows progress for first and second doses, and the varying population sizes and age profiles, for different parts of the Stroud district.

Around the country, the proportion of the population to have received at least one dose varies significantly (based on eligibility of local population and takeup rates) – from as low as 25% in Stamford Hill north, to rates more similar to those in areas of Stroud district – above 75%.

People aged 25 and over can now book to be vaccinated at one of the mass vaccination sites via this link (and we expect this age to drop to 20 over the weeks to come), as can anyone who meets the criteria for other top priority groups. Making a booking at a mass vaccination site (Cainscross Pharmacy/Britannia Dance Studio, Cirencester 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.

• NHS Gloucestershire have a website where you can “Find the information you need about the COVID-19 vaccination programme in Gloucestershire in one place.Visit the site for the latest updates, info on priority groups, FAQs and more”.
• Gloucestershire County Council have a hub for information on vaccines, including “a new online form for vaccination queries from the public and stakeholders“.

We’ve published five videos of clips from an interview with Dr Tom Malins (click to watch on Youtube). Please watch/share on Facebook via the link. And 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“.

We understand many people are keen to be vaccinated but please try to be patient, the vaccine rollout is an enormous logistical challenge. GP surgeries are dealing with tens of thousands of vaccinations 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).

National context

There will no doubt be a presentation on national data by the government and chief scientific advisors, so the below is only brief. You can see a summary of the trends on the government dashboard at this link.

Across the UK, the number of people to have tested positive in the past 7 days is 50,017 – up 16,521 (49%) on the previous week (this is likely to relate both to changes in people’s behaviour since the May 17th changes, and – more significantly – to rapid spread of the new B.1.617.2 variant first identified in India).

In another sign of a vaccine effect – further to the charts above regarding rates by age group, the chart below from the Guardian shows rates highest – and rising fastes – for people aged 20-39 (over 120/100,000), then for those are 0-19 (nearly 80/100,000), lower for people aged 40-59 (nearly 50/100,000), and very low amongst those most at risk by virtue of age alone, but also most likely to be fully vaccinated – under 20/100,000 for people aged 60+

The chart below, from Colin Angus/VictimOfMaths on twitter, hopefully conveys the positive test trends well. It shows the number of new cases in the past week from left to right, with the change in the case rate compared to the previous week from top to bottom. You can see a Bolton falling, but other places continuing to follow others to higher case rates (while a lot of local authorities are still at low rates, bunched on the left of the chart)

Across the UK, the KCL/ZOE app team estimate around 161,655 people had a symptomtic infection on the 14th June, based on symptom reporting by up to 4.6 million app users. This is nearly double the 89,826 last week (7th June), but still a fraction of the peak in January (801,461).

There’s no two ways about it, it’s not good that the virus is spreading again. However, we know what to do to reduce the risks of us picking it up or passing it on:

Over 5000 cases in a day ain’t good. The virus spreads in shared air and loves close interactions and indoor spaces. If you’re meeting others keep the windows open or better still meet outdoors. We don’t want another lockdown so need to push down cases until we’re all vaccinated

— Prof Cath Noakes #Ventilate 😷 💙 (@CathNoakes) June 3, 2021

The total number of people with the virus in UK hospitals has risen considerably: 1,089 on the 3rd June compared to 932 on the 3rd June. The increase has been sustained since 28th May (notably not long after 17th May step 3) when the number reached a low of 882 (though the total is still far, far below the peak of 39,249 on 18th January).

The number of patients being admitted is also rising – 1,008 in the last 7 days compared to 869 in the week to 1st June.

The number of Covid-19 patients in mechanical ventilation beds is also rising: 158 on the 10th June compared to 134 on 3rd June, but still much lower than the peak of 4,077 people on 24th January 2021. The lowest last summer was 60 on 28th August. We send our best for the recovery of all Covid-19 patients in hospital.

The numbers of people dying are still low – 106 people had Covid-19 mentioned on their death certificate in the week to 28th May, the lowest weekly figure since the week ending 4th September 2020. However, we know it takes time for people to get sick, and certainly sick enough to die, and so these numbers do not reflect the recent rises in infections (though a rise in deaths on track with these is not certain – as most of those most at risk have now been vaccinated).

Another thread of tweets and charts from John Burn-Murdoch illustrates why the 21st June earliest possible date for step 4 now looks unlikely to go ahead until later. As the chart below shows, cases are rising steeply and hospital metrics also now show signs of climbing – “albeit at a slower rate”. In a possible sign of a vaccination effect (though we know deaths lag hospitalisations which lag cases, because it takes time for people to become sick), “Deaths so far show no sign of a sustained rise”.

Another chart from the thread shows an apparent vaccine effect in terms of hospital admissions in the North West (the currently worst affected area of England). You can see how admissions among people aged 18-64 are rising at a similar rate as in Autumn/winter 2020 (though generally at lower levels for older groups), but that for people aged 65-84 and 85+, they are flat (and at very low levels – though this is not shown on the chart)

A final chart from Colin Angus/Victim of Maths illustrates that the ratio of hospital deaths to admissions with COVID is low, having fallen considerably since January (due, we can imagine, largely due to the protective effect of vaccines – and also to a lessening of pressure in hospitals).

International context

There is a long way to go globally before the pandemic is over – the 7-day average number of people testing positive per day has been falling sharply since the high on April 25th of 826,374 (driven by falling numbers in India). However, the number of people testing positive is still very high at 385,000 daily (7-day-rolling average to June 12th).

Globally, over 3.8 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 Economist has published analysis estimating the true figure is around 10 million).

In terms of the number of confirmed COVID-19 deaths relative to the population, the United Kingdom has a fairly high rate (1,886), but lower than the worst hit countries – such as Peru (5,705 per million, or around one in every 175 people), Hungary (3,096), Bosnia and Herzegovina (2,889), and Czechia (2,822). The UK rate is lower than for the continent of South America (2,184 Covid-19 deaths per million), but slightly higher than that for the European Union as a whole (1,647), and for North America (1,505) as a whole – but broadly in line with those continents (and this may reflect differences in testing/attribution). However, there are some countries with lower deaths rates – including Germany (1,072 – not much over half the UK rate), or much lower rates – Finland and Norway have rates 10 times lower than the UK (174 and 146 per million), and South Korea, Australia, Thailand, New Zealand, Taiwan, and Vietnam have rates that barely register compared to the worst hit areas (though some of these countries have current outbreaks that may increase mortality, hopefully outbreaks can be controlled / vaccination can rollout before they reach the levels seen in other parts of the world).

In terms of vaccination, the UK has a very high proportion who have received at least one dose (60% of population) – behind only Israel (63%) and Canada (64%) among larger countries (in the chart below). The UK’s rate for full vaccination (43%) is also very high in terms of global comparisons – nearly double the European Union rate (24%), four times as high as South America (10%), and more than ten times higher the proportion across Asia (2.5%), and Africa (0.8%).

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 mark getting their own vaccination.

The chart below shows similar data, but including Stroud district and Gloucestershire in the comparison – in Stroud district 58% of people are fully vaccinated, in Gloucestershire 52%, compared to just 6% across the world.

Notes

The core advice remains: please book a test. 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 meet outside when possible, keep indoor spaces well ventilated with fresh air, 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.

A summary of key changes and similarities with the government guidance since May 17th is copied below:

• “You should continue to work from home if you can. When travelling within the UK, you should aim to do so safely and plan your journey in advance.
• You should get a test and follow the stay at home guidance if you have COVID-19 symptoms.
• Gathering limits will be eased. Outdoor gatherings will be limited to 30 people and indoor gatherings will be limited to 6 people or 2 households (each household can include a support bubble, if eligible).
• New guidance on meeting friends and family will emphasise personal responsibility rather than government rules. Instead of instructing you to stay 2m apart from anyone you don’t live with, you will be encouraged to exercise caution and consider the guidance on risks associated with COVID-19 and actions you can take to help keep you and your loved ones safe. Remember that the risks of close contact may be greater for some people than others and in some settings and circumstances, there will be specific guidance that you will need to follow even when you are with friends and family.
• Indoor entertainment and attractions such as cinemas, theatres, concert halls, bowling alleys, casinos, amusement arcades, museums and children’s indoor play areas will be permitted to open with COVID-secure measures in place.
• People will be able to attend indoor and outdoor events, including live performances, sporting events and business events. Attendance at these events will be capped according to venue type, and attendees should follow the COVID-secure measures set out by those venues.
• Indoor hospitality venues such as restaurants, pubs, bars and cafes can reopen.
• Organised indoor sport will be able to take place for all (this includes gym classes). This must be organised by a business, charity or public body and the organiser must take reasonable measures to reduce the risk of transmission.
• All holiday accommodation will be open (including hotels and B&Bs). This can be used by groups of up to 6 or 2 households (each household can include a support bubble, if eligible).
• Funeral attendance will no longer be limited to 30 people, but will be determined by how many people the COVID-secure venue can safely accommodate with social distancing. Limits at weddings, wakes and other commemorative events will be increased to 30 people. Other significant life events, such as bar/bat mitzvahs and christenings, will also be able to take place with 30 people.
• The rules for care home residents visiting out and receiving visitors will change, allowing up to five named visitors (two at any one time), provided visitors test negative for COVID-19.
• All higher education students will be able to access in-person teaching.
• Support groups and parent and child group gathering limits will increase to 30 people (not including under 5s)
• There will no longer be a legal restriction or permitted reason required to travel internationally. There will be a traffic light system for international travel, and you must follow the rules when returning to England depending on whether you return from a red, amber or green list country.”

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. We 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. We’re also volunteers with no public health expertise – collating and signposting to other sources for guidance.

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.