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12th July 2021 data update

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

Today, the Prime Minister and Health Secretary have confirmed that the government will go ahead with Step 4 of the reopening roadmap. There is information online about the new guidance, and the current government guidance, in place until the next step takes place, is available on the gov.uk website. You can watch a video recording of the press conference with the Prime Minister and the Chief Medical and Scientific Officers, which includes a data presentation and Q&A, and read the Health Secretary’s statement here. Please also read our SCCR statement – “we can still choose to act conscientiously and with compassion for others“.

In vaccination news:

Key data:

  • Sadly, two more people from Gloucestershire have died with Covid-19 mentioned on their death certificate (in the week to 25th June), bringing the total to 1,187. In the 6 weeks between 8th May – 18th June there had been no deaths with Covid-19 listed on the death certificate in the county. Our condolences to their loved ones.
  • However, we can still pass on the good news that no-one from Stroud district has died with Covid-19 mentioned on their death certificate for over 10 weeks (no death certificate mentions since 16th April – to 25th 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 nearly four months – since 20th March.
  • The number of people that tested positive by PCR or Lateral Flow Device in Stroud district and Gloucestershire was again very high in the past week – to 7th July: 249 in Stroud district, and 1,574 across Gloucestershire. However, these numbers are much closer to the previous weekly numbers than they have been (in other words, the spread appears not to be accelerating anymore). The ZOE app estimates 730 people in Stroud district have active symptomatic infections – around 1 in every 165 people in the district (roughly in line with the rate for England estimated by the ONS last week)
  • Rates are highest in Gloucester (around 350 people per 100,000 people testing positive in the week) and among people aged 20-24 (683 per 100,000), but they are rising in Stroud district too (to 208 per 100,000, with 249 people testing positive for the first time in the past week). Across Gloucestershire the number of people to test positive in the most recent week is around 247 per 100,000 people or roughly one in every 400 people. In Stroud district, the area with the highest rate is Stroud town itself, with 41 people testing positive in the past week (nearly double the 22 in the previous week), giving a rate of 351 per 100,000, or roughly one in every 285 people.
  • Across the UK, the number of people to have tested positive in the past 7 days is 228,189 – 50,061 more people testing positive in the week compared to the previous week (a 28% increase). While the number testing positive each week is still rising, it is rising at a slower rate (67% increase last week). The ONS estimate that in England in the week to 3rd July, 1 in every 160 people had the virus (compared to 1 in 250 the week before)
  • There are 15 people in Gloucestershire hospitals with Covid-19 (as of 6th July, the most recent data – very similar to the 14 last week). We wish them all well, particularly the one patient in a mechanical ventilation bed. 26 patients were admitted/diagnosed in hospital with Covid-19 in the week to the 4th June – this is the lower than the 29 in the previous week, but it does appear there is a slowly rising trend (in the week to 2nd June just 2 patients were admitted). It still seems to be the case that most people are being discharged fairly quickly, however.
  • The number of people in hospital with the virus nationally has been rising. At 2,731 on the 8th July, it is more than double the 1,344 on the 19th June (19 days later). We know hospitalisations lag infections, so this number can be expected to continue rising for at least a few weeks.
  • Across Stroud district, around 59% of the population are fully vaccinated, with a further 15% having received a first but not a second dose. People aged 18-29 have only recently started to be invited, but already 69% have had a first dose.
  • Globally, over 4 million people have now died with their death attributed to Covid-19 at least in part (if anything this is likely to be a significant undercount: The Economist has published analysis estimating the true figure is around 10 million). The number of people testing positive globally is rising and very high at 433,000 daily (7-day-rolling average to July 11th) – driven by rises in countries across Africa, Asia, and Europe.
  • Further detail and charts on the above and more are below:

People who have tested positive

Rates are highest in Gloucester (around 350 people per 100,000 people testing positive in the week). and among people aged 20-24 (683 per 100,000), but they are rising in Stroud district too (to 208 per 100,000, with 249 people testing positive for the first time in the past week). Across Gloucestershire the number of people to test positive in the most recent week is around 247 per 100,000 people or roughly one in every 400 people. There’s some sign rates are stalling or dropping in Tewkesbury, and Cheltenham – though again it’s probably too early to say for definite – as we’ve seen apparant slower growth be replaced by very fast increases previously, as you can see on the chart. You can view daily numbers for Gloucestershire, or districts within it, on the government’s dashboard, and there is more information below.

The number of people testing positive by PCR or Lateral Flow Device in Gloucestershire has risen substantially but may be slowing down – 1,574 tested positive in the week to 6th June. We’ve no expertise in predicting when the wave will peak, but the rate of increase shown in the data is 12.5% in the last 7 days, compared to nearly doubling in the week to the 18th June (an increase of 98%). The age profile of those testing positive in the current ‘wave’ is also very different – see chart below.

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

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. Over the week to the 7th July, 1,507 people aged under 60 tested positive, compared to 67 people aged 60 or over. 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 Central Gloucester and Hempsted – where 57 people have tested positive in the past week, giving a rate of 565 per 100,000 (or more than 1 in every 185 people). The government’s interactive map now shows people testing positive in every part of Stroud district – the area with the highest rate is Stroud town itself, with 41 people testing positive in the past week (nearly double the 22 in the previous week, giving a rate of 351 per 100,000, or roughly one in every 285 people).

Source: govt interactive map

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 (though more people are getting tested). There has been a notable rise in the proportion of tests that return positive results (6% of the 25,827 people tested by PCR in the 7 days to 7th July 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 implies there are more people with symptoms at present. This does seem to have fallen in the last few days – having peaked at 27,916 people being tested in the week to the 4th July – but it’s probably too early to say that this tells us anything about the numbers of people with symptoms/of contacts of people testing positive.
  • The proportion testing positive is rising independently of the number of tests being done – this tells us the virus is spreading.
  • 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. Again, the rate of increase is possibly slowing.
Source: gov.uk dashboard

In Stroud District specifically, 239 people tested positive in the most recent week – to 7th July. This is, thankfully, not another doubling since the previous week. Nonetheless, there have only been 2 weeks during the pandemic where a higher number of people tested positive – though, as for Gloucestershire as a whole, the age breakdown is now very different (see below) – and more people will have had the virus in the first wave but not been tested.

Source: gov.uk dashboard – data download

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 730 people with active symptomatic infections in the district – up 51 in the week by their measure. Again, while the rate can turn sharply, with restrictions being loosened it seems plausible rates will go to the highest ever levels in the days and weeks to come. However, for now it seems there is a possibility the increase is stalling/rates falling – see second chart below, which covers only April to July (and looks much more like the trend on the testing positive chart above).

Local Hospitals

There were 15 people in Gloucestershire Hospitals with COVID-19 as of the 29th June, up from 14 the week before (though 7 the week before that). This compares to around 800 patients in Gloucestershire Royal and Cheltenham General hospitals General and Acute beds in total. There is one patient in a mechanical ventilation bed. We wish all patients in local hospitals well.

The chart below shows how the number of people being admitted /diagnosed over the previous 7 days period (26 in the week to the 6th July) has fluctuated recently but is starting to show signs of a slowly rising trend. 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.

Source: gov.uk healthcare for Gloucestershire Hospitals NHS Foundation Trust

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 810,512 Covid-19 vaccine doses delivered in Gloucestershire. 16,805 doses were delivered in the week, making it the ‘slowest’ week for doses since 24th January – when the vaccination programme was only beginning. Roughly the same number of people have received a second dose as received a first 10 weeks ago (349,467 compared to 348,128, green line on chart).

Across Stroud district, around 59% of the population are fully vaccinated, with a further 15% having received a first but not a second dose. People aged 18-29 have only recently started to be invited, but already 69% have had a first dose.

Rates are slightly lower across Gloucestershire, the South West, and England as a whole – where 52% are fully vaccinated and 16% have had one dose (leaving 32% unvaccinated – many of whom are not eligible due to being under 16).

Rates locally and nationally are much higher than for the world as a whole – where only 12% are fully vaccinated and just 1 in 4 have received at least one dose.

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 conduct studies with samples 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 30th 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 70-85% (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 80-99% (low to medium confidence)
  • Two doses of either Pfizer or AstraZeneca reduces mortality by 75-99% (low to medium confidence)
Source: PHE weekly vaccine report.

While the above PHE data is drawn mainly from studies looking at the Alpha variant (aka B117/”Kent”), John Burn Murdoch presents a chart showing vaccine efficacy against hospital admission is barely changed for Delta (according to studies from England, Israel and Canada). Effectiveness against symptomatic infection does appear to be reduced – but even with reductins 2 doses appears to provide at least a 60% benefit.

Source: John Burn Murdoch

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. 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.

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

You can see a summary of the trends on the government dashboard at this link, and watch the government press conference in the video below:

Across the UK, the number of people to have tested positive in the past 7 days is 228,189 – 50,061 more people testing positive in the week compared to the previous week (a 28% increase). While the number testing positive each week is still rising, it is rising at a slower rate (67% increase last week).

Using a logarithmic plot to show exponential growth rates, cases are rising on trend, and if they continue to do so will hit 50,000 a day approximately next week (ie, July 19th). However, there is again a possible slightly indication the rate of increase is slowing slightly.

Chart by BristOliver on twitter

Across the UK, the KCL/ZOE app team estimate around 452,757 people had a symptomtic infection on the 12th July, based on symptom reporting by up to 4.6 million app users. This is a sizeable increase on 370,769 last week (4th July), but far from doubling we saw ta few weeks ago. Nonetheless, it is now over half the peak in January (801,461). Based on the reporting of symptoms and positive test results, Zoe estimate case numbers much higher among unvaccinated people – but this may be beginning to fall. Meanwhile cases among those vaccinated with at least one dose continue to rise – but we’d expect (and Zoe report that there are) less severe infections.

Source: Prof Tim Spector

The total number of people with the virus in UK hospitals has been rising. At 2,731 on the 8th July, it is more than double the 1,344 on the 19th June (19 days later). We know hospitalisations lag infections, but across the country and county the proportion of people testing positive who go on to stay in hospital seems much lower than it has been in the past.

Source: data.gov healthcare page

The number of patients being admitted is rising fast – 3,081 in the last 7 days, compared to 1,903 in the previous 7 days. The daily number of 563 on the 6th July is the highest daily number since 567 people were admitted on the 10rd March, and is more than double the 266 on the 26th June (doubling in 11/12 days). We send our best wishes to all these patients.

Source: Bristoliver on twitter

The number of Covid-19 patients in mechanical ventilation beds, the sickest patients, is still rising: 417 on the 8th July, around double the 208 on the 16th June (doubling in 23 days). 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 relatively low – 118 people had Covid-19 mentioned on their death certificate in the week to 25th June. 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) is rising – 200 in the week to 12th July, compared to 122 in the week to 4th July. 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).

The government’s 12th July press confernce included the following slide presented by Chris Whitty – showing that, by comparison with the Autumn wave, the number of cases is rising in a similar way (despite fewer restrictions, and a more transmissable variant – but offset by the number of people who are now vaccinated). Admissions and deaths are, however, rising much less quickly – as we’d expect thanks to vaccination reducing the level of risk.

Source: gov.uk

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). The number of people testing positive is still very high at 433,000 daily (7-day-rolling average to July 11th) – driven by rises in countries across Africa, Asia, and Europe.

Globally, over 4 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 (1,896), but lower than the worst hit countries – such as Peru (5,896 per million, or around one in every 170 people), Hungary (3,106), Bosnia and Herzegovina (2,943), and Czechia (2,832). The UK rate is lower than for the continent of South America (2,404 Covid-19 deaths per million), but slightly higher than that for the European Union as a whole (1,666), and for North America (1,534) 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 (1,089 – not much over half the UK rate), or much lower rates – Finland and Norway have rates 10 times lower than the UK (176 and 147 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 (66% of population) – behind only Canada (69%) and Chile (69%) among larger countries and UAE (76% – see the chart below). The UK’s rate for full vaccination (51%) is also very high in terms of global comparisons: more than three times as high as South America (15%), and more than 5 times higher than the proportion across Asia (9%). Across Africa, just 2.9% of the population have received any vaccination, and only 1.3% 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: 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.

Book a test via this link. 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.

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.

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.

Current government guidance and changes to it:

Read the latest announcement on changes to guidance. New “guidance will come into effect when England moves to step 4 of the roadmap. Read the current step 3 guidance on what you can and cannot do. While cases are high and rising, everybody needs to continue to act carefully and remain cautious. This is why we are keeping in place key protections:

  • testing when you have symptoms and targeted asymptomatic testing in education, high risk workplaces and to help people manage their personal risk.
  • isolating when positive or when contacted by NHS Test and Trace.
  • border quarantine: for all arriving from red list countries and for those people not fully vaccinated arriving from amber list countries.
  • cautious guidance for individuals, businesses and the vulnerable whilst prevalence is high including:
  • whilst Government is no longer instructing people to work from home if they can, Government would expect and recommend a gradual return over the summer
  • Government expects and recommends that people wear face coverings in crowded areas such as public transport;
  • being outside or letting fresh air in
  • minimising the number, proximity and duration of social contacts.
  • encouraging and supporting businesses and large events to use the NHS COVID Pass in high risk settings. The Government will work with organisations where people are likely to be in close proximity to others outside their household to encourage the use of this. If sufficient measures are not taken to limit infection, the Government will consider mandating certification in certain venues at a later date.”