Step 4 of the government’s reopening roadmap – to include the end of legal limits of contacts – was due “no earlier than 21st June”, and is now due to take place on the 19th July. Current government guidance, which is in place until the next step takes place, is available on the gov.uk website – click for full details. Some restrictions have been eased, relating to weddings, civil partnerships and commemorative events; care home visits; overnight school trips; and large event pilots. There will be a review today 28th June to see if restrictions could be ended on 5th July.
In vaccination news:
- All adults aged 18 and over can now book to be vaccinated at one of the mass vaccination sites (those other than Rowcroft, Beeches Green and The Vale – which are accessed via GP invite/walk-in), as can anyone who meets the criteria for other top priority groups.
- There’s a new website that will be showing where walk-in “no appointment necessary” vaccinations can be delivered, where you can enter your postcode to find availability near you.
Key data:
- No-one from Stroud district has died with Covid-19 mentioned on their death certificate for over 8 weeks (no death certificate mentions since 16th April – to 11th June, the most recent data). No-one from Stroud district has died within 28 days of a positive test for coronavirus (SARS-COV-2) for three months – since 20th March, nor in Gloucestershire for over two months – since 17th April (data to 26th June).
- The number of people testing positive by PCR or Lateral Flow Device in Gloucestershire has risen substantially and quickly – to 979 in the past week – to 23rd June (nearly double the 575 in the week before, and more than triple the 315 in the week before that). Rates are highest in Cheltenham, Tewkesbury (both over 210 people pre 100,000 testing positive in the past week – equivalent to more than one in every 500 people) and Gloucester (180 per 100,000), and among people aged 20-24, but they are rising in Stroud district too (to 78 per 100,000). Across Gloucestershire the number of people to test positive in the most recent week is around 150 per 100,000 people or one in every 715 people.
- Across the UK, the number of people to have tested positive in the past 7 days is 100,052 – up 38,494 more people testing positive in the week than the previous week (a 59% increase).
- There are 7 people in Gloucestershire hospitals with Covid-19 (as of 22nd June, the most recent data – was four last week). There are two patients in mechanical ventilation beds (was one last week). We wish these people well with their recovery. 18 patients were admitted/diagnosed in hospital with Covid-19 in the week to the 20th June – this is low, similar to the previous week (when 17 were admitted) and it appears most people are being discharged quickly, but in the week to 2nd June just 2 patients were admitted. There’s a chart below but it’s too early to see if there is any trend.
- The number of people in hospital with the virus nationally has been rising, at an increasing rate – albeit at relatively low numbers (1,505 on 24th June, compared to 1,316 on the 17th June, and 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.
- Across Stroud district, around three-quarters of the total population have now received a first dose (doses have been delivered equivalent to 75% of the ONS 2019 population estimate). People aged 16-29 have only recently started to be invited, but already 45% have had a first dose. Over half of the local population have now received a second dose of a Covid vaccine (59% for Stroud district and 54% for Gloucestershire – compared to 48% across England). In terms of those eligible for vaccination, two-thirds in Stroud district have now had a second dose (68%), and 87% a first dose.
- Further detail and charts on the above and more are below:
People who have tested positive
Rates are highest in Gloucester, Tewkesbury and Cheltenham, and among people aged 20-24, but they are rising in Stroud district too. Across Gloucestershire the number of people to test positive in the most recent week is around 150 per 100,000 people or one in every 715 people. For the Stroud and Cotswold districts the current rate is around half this – 78 per 100,000 or one in every 1,300 people. However, these areas are following the same trend, just about two weeks later – and there’s little reason to believe they won’t keep rising – though the Forest of Dean’s rate has stopped rising, and been falling for a few days to bring it back down to the same level it was this time last week – 50 per 100,000. There’s a chance this might happen in the Stroud and Cotswold districts too – though not enough of a sign in the data to assume they won’t follow the rising trend of other parts of the county. You can view daily numbers for Gloucestershire, or districts within it, on the government’s dashboard.
The number of people testing positive by PCR or Lateral Flow Device in Gloucestershire has risen substantially and quickly – to 979 in the past week – to 23rd June (nearly double the 575 in the week before, and more than triple the 315 in the week before that). The rise has been very steep – steeper than in the autumn last year, and to a level in line with the peak in November, though still only around half the weekly peak in January. Importantly, the age profile of those testing positive in the current ‘wave’ is very different – see chart below.
Though there has been a very considerable increase, this appears to be associated mainly with younger people. The chart below shows the difference between people aged over and under 60. Those over 60 have a rate of testing positive of 15.3 per 100,000 across Gloucestershire, while those under 60 have a rate of 187.8. It’s hard to think of any explanation other than the high levels of full (both dose) vaccination among people aged 60+. Other data shows positive tests are concentrated particularly among those aged 20-24 (570 per 100,000), 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 St Paul’s, Cheltenham – where 38 people have tested positive in the past week (more than double the 18 in the previous week), giving a rate of 459.8 per 100,000 (or more than 1 in every 220 people). The government’s interactive map still shows two areas in Stroud district (as well as some others in the surrounding areas across the county and beyond) – with at most 2 positive tests in the week to (Berkeley & Sharpness; and Wotton-under-Edge). Data for these parts of the district 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 Stroud district, the area with the highest rate is Upton St Leonards and Hardwicke, with 14 people testing positive in the past week (4 more than the 10 in the previous week, giving a rate of 139 per 100,000).
You can enter your postcode into the government’s dashboard to get more data on your local area.
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 (3.9% of the 22,749 people tested by PCR in the 7 days to 22nd June tested positive, compared to a low of 0.2% between 24th April – 13th, and 16-21st May). There are a few things to say about the chart below:
- There’s been a dramatic rise in people getting PCR tests (which are mostly used when people have symptoms, or to confirm the results of ‘rapid’ Lateral Flow Device tests when they return positive results for people without symptoms. This could be a hint there might be more people with symptoms at present.
- The proportion testing positive is rising despite more tests being done – this tells us the virus is spreading.
- There are almost as many tests being done as at the peak in January (highest 7-day todtal was 25,484), but the proportion testing positive is less than half as high – 3.9% compared to 9.9%). This helps us understand that the number of positive tests isn’t driven by false positives (which seems very unlikely when recently just 0.2% of tests returned positive results), but also gives us a clear indication there are fewer people infected than at the January peak.
- The trend is clear, but as you can see from the previous peaks, it can turn very quickly. In previous instances this appears to have been primarily because of the introduction of stricter restrictions, but this time infections should eventually hit a wall of vaccinated people – and together with those with current or prior infections, should run out of ‘susceptible’ people to infect.
In Stroud District specifically, 98 people tested positive in the most recent week – to 23rd June. This is a rise on the previous week (73), and more than triple the week before that (31). It is the highest number since the week to the 3rd February when 139 people tested positive – though the age breakdown is now very different (see below).
The data by age from Stroud is strongly suggestive of a vaccination effect: far fewer people aged 50 or over have tested positive since 29th March – while there have continued to be cases among younger age groups. Rates are currently higher for people aged 20-24 particularly (367 per 100,000), though some people aged 50-59 have been testing positive recently – with a rate of 53 per 100,000 for people aged 50-55 in the most recent week. These could be among unvaccinated people, or among people who have either one or two doses and should get much milder symptoms as a result – which would also help explain the relatively low hospitalisation figures. The chart below has rows for each age band with older age groups at the top. Yellow areas show no cases, with colours going through green, to blue, to purple and black for higher numbers of cases.
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 178 people with active symptomatic infections in the district – up 81, nearly doubling, from last week by their measure. Last week there was a downward turn and I wrote “a flattening off and fall after a notable rise. Hopefully this is leading indicator of where the number of people testing positive may head – or a sign that a higher proportion of those testing positive now have minor/no symptoms”, and the difference this week is a good reminder to wait longer before identifying trends – there’s no guarantee this week’s sharp rise will be sustained either – along the medium-term trend is certainly rising.
Local Hospitals
There were 7 people in Gloucestershire Hospitals with COVID-19 as of the 22nd June, up from 4 the week before (and compared to around 800 patients in Gloucestershire Royal and Cheltenham General hospitals in total). 2 patients are in Mechanical Ventilation beds, compared to one last week.
The chart below shows how the number of people being admitted /diagnosed over the previous 7 days period (18 in the week to the 20th June) has fluctuated recently but is barely higher than last week and there’s not a clear sign of an upward trend (17 in the week to 13th 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, so it is possible we will see a rise related to the dramatic increase in infections across Gloucestershire in the last few weeks – but because the age profile of people testing positive recently is younger, and younger people are, on average, much less likely to be at risk of developing severe illness, we may not see an increase in the number of people admitted to/in hospital. While the number staying in hospital is also up a little, it’s clear most people are being discharged fairly quickly.
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 776,135 Covid-19 vaccine doses delivered in Gloucestershire. 24,097 doses were delivered in the week, making it the ‘slowest’ week for doses since 11th April – when delivery of first doses slowed due to supply issues. Roughly the same number of people have received a second dose as received a first 12 weeks ago (333,854 compared to 333,308, green line on chart). Second doses have been running ahead, and are being due to be brought forward for people in the first priority groups, so the equivalence is a concern – and probably why NHS Gloucestershire have been encouraging people who’ve had a first dose to get their second dose when invited to complete the course and ensure long-lasting protection this week. The chart below also shows how the rate at which first doses are being delivered picked up quickly in May and June after a flat April, though the need to focus on second doses means the first dose rollout is a little slower than in February and March. Because the first dose roll-out was slower in April, the number of people to have received a second dose is not that much lower than the number to receive a first dose 8 weeks ago (red line on chart).
The charts below show progress towards completion of the vaccination rollout locally, comparing this with the regional and England-wide progress. This data is for the 13th 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.
In Stroud district, two-thirds of adults have now had two doses (68%). This equates to a smaller proportion of the total population (59%) but is still much higher than for England as a whole (48%). In terms of first doses, 3 in every 4 people in Stroud district (75%) has now had a first dose (by comparison to the 2019 ONS population estimate). As with second doses, this rate is substaintially higher than for England as a whole (65%) – meaning there are districts where the rate will be much lower.
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 20th June. As you can see, essentially everyone aged 50+ is fully vaccinated (there are around 800 people aged 50-59 who had received a first, but not a second dose by 20th June). People aged 16-29 have only recently started to be invited, but already 45% have had a first dose. There are around 4,600 people aged 40-49 who have had their first but not second dose. 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 charts below show progress for first and second doses, and the varying population sizes, for different parts of the Stroud district. The total population of each area differs, from just over 6,000 in Chalford and Bussage to nearly 12,000 in Stroud Town and Ebley & Randwick. The number and proportion of people who haven’t yet received a dose or aren’t eligible differs a little because of the proportion that are under 18.
The chart below shows the same data as above but as a proportion of population, ranked by the areas with the highest proportion of population fully vaccinated – which are basically the areas with more people eligible (largely because the age profile skews older).
The chart below helps to explain that the proportion being lower in Stroud Town doesn’t appear to be because of lower takeup – rates are very high amongst the oldest groups and fairly high among younger ones (with over 60% of 25-29 year olds having received first doses already even though these have only been available to them for a few weeks). It’s more to do with having a younger demographic – with a higher proportion of people who are not eligible (because aged 16 or under) or in the younger groups only recently invited.
Public Health England are publishing weekly estimates of vaccine effectiveness based on the real-world data they have about who is testing positive, being admitted to hospital, or dying – which they combine with data on the likely impact of vaccines on transmission. Data isn’t available for some questions (ie, two doses of both vaccines, and particularly for Oxford-AstraZeneca) because it takes time to build up a sample of sufficient size to draw firm conclusions. This is also why the level of confidence is higher for some estimates of effectiveness than others. In brief, the latest data (to 24th June) shows:
- One dose of either Pfizer or AstraZeneca reduces hospitalisation by 75-85% (high confidence)
- One dose of either Pfizer or AstraZeneca reduces mortality by 75-80% (medium confidence).
- One dose of either Pfizer or AstraZeneca reduces transmission by 35-50% (low confidence).
- Two doses of either Pfizer or AstraZeneca reduces hospitalisation by 80-95% (low confidence)
People aged 18 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. There is also a new website that will be showing where walk-in “no appointment necessary” vaccinations can be delivered, where you can enter your postcode to find availability near you. 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“.
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 65,558 – up 15,541 (31%) on the previous week. The number of people testing positive in the week is higher, but the rate of increase is slowing – the previous week 16,521/49% more people tested positive than in the previous week
Across the UK, the KCL/ZOE app team estimate around 274,356 people had a symptomtic infection on the 27th June, based on symptom reporting by up to 4.6 million app users. This is a sizeable increase on 219,537 last week (20th June), but far from doubling we saw ta few weeks ago, and still around quarter of the peak in January (801,461). This implies the rate of increase is slowing.
The total number of people with the virus in UK hospitals has risen considerably: 1,505 on 24th June, compared to 1,316 on the 17th June, and 932 on the 3rd June). We know hospitalisations lag infections, but while there has been a clear increase lately, it appears vaccinations are breaking the link with cases and the rise is much slower compared to case than in previous ‘waves’. There is also half a sign the number of patients in hospital is starting to flatten – the 1,505 on the 24th June is lower than the 1,511 on the 21st June.
The number of patients being admitted also appears to be flattening – 1,557 in the last 7 days, compared to 1,413 in the previous 7 days – an increase of 144 over the week. The previous week was an increase of 405 compared to 1,008 in the previous week. The daily number of 227 on the 22nd June is the same as the daily number of patients admitted on the 15th June. We send our best wishes to all these patients, but note that least this is not suggestive of a big rise in hospitalisations.
The number of Covid-19 patients in mechanical ventilation beds, the sickest patients, is still rising: 259 on the 24th June, compared to 210 on the 17th June, and roughly double the 134 on 3rd June. However, this is 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 – 93 people had Covid-19 mentioned on their death certificate in the week to 11th June, the third lowest weekly figure since the virus reached the UK (after the week ending 4th September 2020 when 92 people died with Covid mentioned on their death certificate, and the week to 13th March when 5 people died). 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/hospitalisations (though a rise in deaths on track with these is far from certain – as most of those most at risk have now been vaccinated).
The number dying within 28 days of a positive test (a more up to date but less robust measure) has risen – to 124 in the week to 27th June , up 72% on the 72 people in the previous week. While every death is sad, it is important to see these numbers in context – at the peak in winter, 9,000 people died within 28 days of a positive test (to the 21st January).
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 stopped falling, having been in sharp decline 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 366,000 daily (7-day-rolling average to June 26th) – and rising across Africa.
Globally, over 3.9 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). South America is set to overtake Europe as the worst affected contintent in terms of numbers of deaths, having recently passed North America.
In terms of the number of confirmed COVID-19 deaths relative to the population, the United Kingdom has a fairly high rate (1,891), but lower than the worst hit countries – such as Peru (5,806 per million, or around one in every 172 people), Hungary (3,103), Bosnia and Herzegovina (2,943), and Czechia (2,829). The UK rate is lower than for the continent of South America (2,304 Covid-19 deaths per million), but slightly higher than that for the European Union as a whole (1,659), and for North America (1,520) 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 (1,083 – not much over half the UK rate), or much lower rates – Finland and Norway have rates 10 times lower than the UK (175 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 (65% of population) – behind only Canada (68%) and Chile (66%) among larger countries (in the chart below). The UK’s rate for full vaccination (48%) is also very high in terms of global comparisons: four times as high as South America (12%), and more than three times higher the proportion across Asia (7.9%). Across Africa, just 1.1% of the population are fully vaccinated.
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.
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 starting June 21st is copied below:
“The government has announced a 4-week pause at Step 3. Step 3 restrictions remain in place, and you should follow the guidance on this page, which explains what you can and cannot do.
It is expected that England will move to Step 4 on 19 July, though the data will be reviewed after 2 weeks in case the risks have reduced. The government will continue to monitor the data and the move to Step 4 will be confirmed one week in advance.
How the rules changed on 21 June
The rules on weddings and civil partnership ceremonies and wedding receptions or civil partnership celebrations changed on 21 June. See the weddings and civil partnership ceremonies and wedding receptions or civil partnership celebrations section of this guidance.
The rules on commemorative events following a death such as a wake, stone setting or ash scattering changed on 21 June. See the funerals and linked commemorative events of this guidance.
The rules on care home visits changed on 21 June. See the care home visits section of this guidance.
The rules on domestic residential visits for children changed on 21 June. See the childcare section of this guidance.
Large events pilots from 21 June
A limited series of pilot events will take place to produce additional evidence on reopening events safely. Attendees will need to show proof of vaccination or a recent negative test.
This will include some UEFA EURO 2020 matches at Wembley and a small number of other sports, arts and music performances. The full list of pilots, and further details about the events, will be announced shortly.”
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.