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16th Oct weekly Covid-19 data summary

Team members James Beecher and Claire Biggs summarise data on Covid-19

The big news this week is that – following extensive inquiries from ourselves and others – it was revealed 400,000 people who received negative PCR results, mainly in the South West, may have received inaccurate results – around 43,000 potentially should have been positive. See the UK Health Security Agency press release: Testing at private lab suspended following Test and Trace investigation“, or our webpage “Many negative PCR test results in the South West, 8th Sept – 12th Oct, may have been inaccurate“. This will explain almost all of the instances where people tested positive on lateral flow but this was not confirmed by PCR, but can also have affected people who had symptoms or got a PCR test for another reason (e.g. as a contact of a case).

There are wide-ranging impacts. We’ve been trying to advise people to trust their lateral flow/symptoms since 29th September (and had started to do so in individual cases since 16th September), but unfortunately many people will have been told to stop isolating and go into school/work/otherwise mixed with people while infectious. We’ll say more about this in posts to come – but for this update the key point is that data in the previous week’s updates will have been affect, and still is in this update. Notes are added to some of the charts. In the coming weeks, we should start to have more robust data underpinning the updates again.

Gloucestershire – positive tests, hospital admissions, people in hospital

The first chart shows a comparison of the key data for Gloucestershire – hospital and death data shouldn’t be affected by the issues with the Immensa lab, and I have indicated on the chart where testing data has been affected (the recent ‘rise’ is in reality largely a ‘return’ to accurate data – although it also includes an increase in line with what is happening nationally, and will potentially reveal an increase associated with people mixing rather than isolating because of inaccurate results/poor guidance from 119/Test and Trace):

  • Admissions to hospital (purple line) show a slow rise – an indication of what the testing trend should really look like (those admitted to hospital are often tested in separate labs associated with the hospital). 72 people were admitted/diagnosed with COVID-19 in the week to 10th October – the most recent data. This is the second highest weekly number since February 11th (76 admissions in prior week), with 73 people having been admitted/diagnosed in the week to 25th September.
  • Numbers in hospital are fairly flat. This indicates many people are still being discharged fairly quickly. There were a total of 34 beds occupied by COVID-19 patients in Gloucester/Cheltenham hospital as of 12th October – up from 26 on the 5th October but similar to the 33 on the 28th September.
  • Four more people who lived in Gloucestershire have died with COVID-19 mentioned on their death certificate in the most recent week of data (to 1st October). We send our condolences to their loved ones. The total number of people who lived in Gloucestershire to die with COVID-19 mentioned on their death certificate is now 1,225. While it is essential not to minimise the deaths, weekly numbers are much lower than earlier this year – 71 people died with COVID-19 mentioned on their death certificate in the week to 22nd January 2021. Because we still hear people suggesting these deaths aren’t really caused by COVID-19, I continue to encourage people to read about how Covid-19 deaths are measured from the Office for Statistics Regulation.

Thanks to the Covid-19 Actuaries Response Group, we can see a comparisons of hospital admissions over the past 7 days. The South West has seen significant increase (27%), but the East of England has seen an even faster increase (48%), and other regions have also seen increases – so it’s not yet clear this is a result of the testing fiasco and people not isolating as a result… yet.

Source: Covid-19 Actuaries on twitter

People who have tested positive – districts, areas within districts, and age profile

Data on rates of people testing positive per 100,000 is still affected by the issues with the Immensa lab – as indicated on the chart. You can see how rates for Gloucestershire and the districts were in it went from being above/in-line with the England rate to diverging from it as people received false negative PCR results. The England rate will have been affected by this, but to a much lesser extent, and likely provides a guide to roughly where our local numbers ‘should’ be – though I expect our numbers will rise substantially above the England rate due to the impact of additional mixing where infectious people have not isolated.

The trend for England, shows a fairly rapid rate of increase – generally since mid-September – to 396 per 100,000 (or around one in every 250 people). However, this only covers people who have been tested. Estimates by ONS of true prevalence based on random-sampling of the population (rather than people seeking tests), find that “in the week ending 9 October 2021; we estimate that 890,000 people in England had COVID-19 (95% credible interval: 839,700 to 941,300), equating to around 1 in 60 people.” Hence, the numbers below are a clear underestimate.

Source: James Beecher analysis of data from gov.uk data dashboard – Gloucestershire

For the above chart, data is only provided for rates to the 11th October. However, more recent data on the number of people testing positive by data specimen was provided is available – up to the 15th. Normally, the most recent data is a substantial undercount because not all results have been returned. However, this week it is useful to see how the 3 most recent days, when PCR processing is working again, provide a better indication – if still incomplete – as to where rates are. There may still be results to come in, but equally specimens submitted in recent days are in part associated with people ‘re-testing’ so a portion should really be allocated a little earlier. So… don’t be alarmed by the dramatic spike but… there appears to be a fairly clear increase in the number of people testing positive. At 696 people testing positive in the 7 days to the 15th October, Stroud district has hit a new ‘record’ – even with several of those days affected by false negative results. The numbers are also particular high in Cheltenham (651 people testing positive in the week). Bear in mind that Cheltenham has a much larger population, so the rate in Stroud relative to population is much worse. However, this may in part reflect greater awareness of/interest in being ‘re-tested’, or use of postal testing in the week.

The chart has a shaded area to indicate when data is inaccurate thanks to Immensa’s failures at their PCR testing lab in Wolverhampton. That some people still tested positive on PCR is due to testing through other labs, whether through postal kits, local hospitals, or tests submitted at local test-sites that went to other labs (we still don’t have a good idea of which test sites were affected, because neither Test and Trace, the UK Health Security Agency or the Department of Heath and Social Care have made this information public).

Source: James Beecher analysis of data from gov.uk dashboard

You can view daily numbers for Gloucestershire, or districts within it, on the government’s dashboard, and there is more information below. You can also enter your postcode into the government’s dashboard to get more data on your local area.

We can maybe get a better idea of true prevalence in the South West (and hence a guide to Stroud district/Gloucestershire) through the ONS infection survey. Rather than relying on people seeking tests (and the Immensa lab reporting false negatives) this is based on sampling the population and making estimates – for the South West there has been a clear recent rise to a point where 2% of people were expected to have the virus in the week to 9th October. This diverges from many but not all other regions so may in part show the impact of many people not being told to isolate even though they were likely infectious. The North East, East Midland, South East and London all have proportions lower than 2% and falling or flat trends. However, the East of England, West Midlands, North West and Yorkshire and Humber have similar increasing trends and rates (1.6%-2%, with confidence intervals overlapping 2%).

It’s quite interesting to look at the positivity rate for Gloucestershire – this is the proportion of PCR test samples (by person) that return positive results. You can clearly see when the problem with the Immensa lab started affecting results with the dramatic drop in positivity. It’s likely that positivity will return to rates roughly where they were before September – potentially higher for a while as people who were positive get ‘re-tested’.

Anyway, in the week to 9th October (when tests were still getting false negatives at high rates), 3.7% of the 25,764 people to get tested were positive. This compares to 7.7% of the 27,548 people to get tested in the week to 7th September, before the problem arose. Essentially, we can guess that the positivity rate – and hence the numbers of people testing positive – were at least half what they likely ‘should’ be

Vaccination

Data from the NHS on Covid-19 vaccinations is now collated in a monthly vaccination update (last updated on 5th September – new update to come soon). The main headline figures are that: Across Stroud district, around 74% of the population are fully vaccinated, with a further 4% having received a first but not a second dose. These proportion are of the total population so differ from other data which considers proportions of eligible populations (eg. adults or, now, all over 12). Rates are similar for the South West as a whole, a little lower in England, considerably lower across the World on average, and just 2.7% of people in the lowest-income countries have had at least one dose.

National context

New government guidance has been out since 19th July. While many restrictions have been lifted, please see the NHS webpage on “How to avoid catching and spreading coronavirus“. Please also read our SCCR statement on the current situation where cases are very high, which underlines that “we can still choose to act conscientiously and with compassion for others“. There are people in our community who have do not have the protection granted by vaccination (including those who cannot have jabs, or do not benefit as much from them because of a health condition/treatment, as well as those who for whatever reason have not taken up the offer of vaccination yet).

You can see a summary of the trends on the government dashboard at this link, and in the image below (Described in text below the image)

Across the UK, the number of people to have tested positive in the past 7 days (to 16th October) is 289,515. This is 12.8% higher than the number that tested positive in the previous week – 32,863 more people. Deaths within 28 days of a positive test have risen slightly after a drop – 883 people died in the week to 16th October, 43 more than in the previous week (5.4% increase). Having fallen for a few weeks, sadly admissions to hospital are also rising – which means we can expect the numbers of people dying to continue to rise for some weeks too. 5,559 people were admitted to hospitals in the week to 12th October, 359 more than in the previous week (7% increase)

In terms of people aged 12+ eligible for vaccination, across the UK four-fifths (78.4%) have been fully vaccinated and 85.3% have received at least one dose.

Estimates by ONS of true prevalence based on random-sampling of the population (rather than people seeking tests), find that “in the week ending 9 October 2021; we estimate that 890,000 people in England had COVID-19 (95% credible interval: 839,700 to 941,300), equating to around 1 in 60 people.” Hence, the numbers below are a clear underestimate.

Similarly, across the UK as the whole, KCL/ZOE app team independently estimate around 976,00 people had a symptomtic infection on the 7th October (compared to 934,000 on the 7th October), based on symptom reporting by up to 4.6 million app users. This essentially confirms the ONS estimate above.

It’s important to note that the age breakdown at the moment is very distinct. The ONS esimtate that 8.1% of those in school years 7-11 would have tested positive in the week ending 9th October – but rates are much lower for other age groups: 3.1% for age 2 to school year 6, 1.1% for school year 12 to age 24, 0.6% for 25-34, 1.2% for 35-49, 0.7% for 50-69 and 0.6% for 70+.

The Covid-19 Actuaries Response Group has updated their useful chart on how modelled estimates of daily hospital admissions in England compare the reality. “Currently we are still tracking between Warwick Zeeman Institute “Green” and Centre for Mathematical Modelling of Infectious Diseases at the London School of Hygiene and Tropical Medicine Central scenarios. While it’s great that hospitals admissions have peaked in the way some models suggested they might, there is also less indication they will drop.

Source: Covid-19 Actuaries.

International context

The number of people testing positive globally each day has been falling for some time: around 405,000 (7-day-rolling average to Oct 13th) compared to around 626,000 to Sept 4th. The situation is different in different continents (and countries within them). Confirmed cases have been falling consistently for some time in South America – to the lowest levels since spring last year, and have recently been falling in North America, and Asia too. Across Europe as a whole cases are rising. While there seems to have been a fall across Africa, data is much more limited for the continent.

The numbers of people dying with their deaths attributed to Covid-19 continue to rise, particularly in Asia. Over 4.8 million people have had their death attributed to Covid-19 since the start of the pandemic. This is believed to be a significant underestimate due to limited death registration data in many countries – including India for example. The Economist estimates that excess mortality at 16.3 million (which will include deaths from causes other than Covid-19 as well as deaths caused by Covid-19 but not recorded as such).

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, or call 0808 196 3646 between 8am and 8pm, 7 days a week to self-refer or visit NHS Volunteer Responders. 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 – it’s really important you isolate and get tested if you have symptoms (fever, new cough, loss of smell/taste). 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 public health advice 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.