We’re still reeling from the announcement on 15th October that – around 43,000 potentially received false negative results between early Sept and 11th Oct – many of them locally in Stroud district and Gloucestershire. It’s since been revealed that problems began on the 2nd (rather than the 8th) of September.
There are wide-ranging impacts. This week’s data update is short as possible but still includes analysis trying to put local numbers in context – and assess the impact, particularly in terms of hospital admissions.
Before the data two points:
- Numbers of infections are very high at the moment – locally. If you have symptoms, please book a PCR test. If you test positive on either a PCR or a LFD test please isolate – and if you have symptoms and get a LFD positive but a PCR negative, please consider that the PCR could be a false negative. If you want to avoid being infected, or reduce the chances of passing the virus on to someone at risk, please take care – wear masks in crowded/indoor settings, if you want to protect yourself consider upgrading to a more protective mask, meet people outside if you can, and if meeting people indoors keep a flow of fresh air. Regular testing with lateral flow devices will help catch infections early so people can isolate and avoid passing the virus on – and you might particularly want to do them or ask others to do them before mixing indoors with large numbers of people. For those most at risk in our community, you may want to consider reducing contacts to the extent this is possible until rates are lower [for more see the NHS webpage on “How to avoid catching and spreading coronavirus” and our SCCR statement on how “we can choose to act conscientiously and with compassion for others” in a time when there are fewer restrictions on our behaviour from government.
- We’ve demanded answers on how this scandal happened and what the impact has been from the Health Secretary, Department of Health and Social Care, and the UK Health Security Agency – read our press release.
Gloucestershire – positive tests, hospital admissions, people in hospital
First, some key numbers and our standard comparison chart.
Between 12th and 24th October, the most recent two weeks of data (when PCR testing was working):
- 10,888 people living in Gloucestershire tested positive for the first time – 1.6% of the total population (roughly one in every 63 people).
- 147 people were admitted to Gloucester/Cheltenham hospital with Covid-19, or diagnosed in the hospital – with a total of 44 people with the disease still in hospital as of the 26th October – around 1/5th as many as at the worst ever point locally, but the day before hitting 51, one person shy of double the number just three weeks ago.
We’ve been using this to show how the link between the number of people testing positive and hospital admissions/deaths has been weakened since vaccination until recently. It’s no longer very useful for that – though you can see the effect. Where the blue line representing the average number of people testing positive a day used to roughly trend alongside admissions to hospital, numbers of people in hospital and – to a lesser extent – numbers of deaths, since May that hasn’t been true. Very high numbers of people have tested positive but a far smaller proportion have ended up in hospital or dying.
In the past two months the testing data has been a mess. First, the yellow dashed line shows the period where numbers were inaccurately low because of false negative results from the Immensa lab. Then, a red dotted line shows a period of adjustment where tests were working again, and some people who should have shown up during the period of the yellow line (which would have raised it) instead appear in the red-dotted period. Only in the past few days do we have accurate data that represents only new cases again. These are still very high levesl – at just below 800 people a day on average testing positive across Gloucestershire, around double the previous peak level in January 2021. By comparison, the hospital data is hard to read, so see below for a more detailed look at that
First, some more detail on the testing. The chart below looks at the issue of what we know and don’t know about case rates in recent months.
To be clear – I’m not an epidemiologist or modeller – I’ve just put a chart together of the real data and drawn on top of it to illustrate 3 approximate scenarios
We had the original darker blue line representing the average number of people to test positive in Gloucestershire over a 7 day period up to September. After that, the Immensa false negative period is shown with a dashed yellow line, the period of adjustment and re-testing shown with a dark red dotted line. We know the latter two don’t tell us what really happened – but we don’t know what did.
One possibility (A – green double line) is that cases kept rising roughly as they had been. A ‘linear’ trend line reaches roughly where the latest data is… it’s plausible, but seems unlikely that people not isolating had no impact.
Another possibility (B – light blue line) is that cases were falling, but because of the false negatives and lack of advice to isolate, rose to above the latest data (which the dotted dark red line higher because of some re-testing), and are now falling again as accurate tests help people to isolate and avoid spread.
A third broad possibility (C – red line) is that because of false negatives and lack of guidance to isolate, cases rose dramatically, peaking above a rate that has ever been reported – in this scenario even high numbers of retest positive are overtaken by cases that were missed.
What happened in reality matters – because the number of people affected over time is obviously much higher in scenario C. In the charts that follow, we turn to data about hospital admissions that isn’t affected by the problems with testing data – and shows a clear impact
The chart below shows the hospital and death data from the first chart but without tests making it hard to see what’s happening. It shows how the 7 day total has been bouncing up and down but broadly rising over the past few months, hitting a recent six-month high of 86 patients in the 7 days to the 15th of October, double the 43 in the week to the 14th September (doubling in a month). In the latest week data – to the 24th October – 74 people were admitted to Gloucestershire hospitals with Covid-19 (purple line).
The chart also shows how the number of people in hospital has been rising – hitting a recent peak of 51 on the 25th October (one short of double the 26 on the 5th October – doubling in three weeks). The number has dropped to 44 on the 26th October – but is clearly on a rising trend. With the recent high numbers of cases, we can expect it to rise. But if case numbers continue to fall, hopefully the numbers in hospital will soon too.
Two more people died with Covid-19 mentioned on their death certificate in the most recent week we have data for – to 15th October. Because it takes time for people to get sick and die, we likely haven’t seen the impact of the Immensa false negative testing scandal and recently high case rates on deaths.
Senior Research Fellow at the University of Sheffield, Colin Angus has made some charts and written a great twitter thread to put the local picture in context of the areas affected by the Immensa false negative scandal, and what’s happening in areas unaffected by it. The below charts and analysis are from him – and do a really good job of explaining the impact, which is hard to think about but essential to consider.
Colin writes: “How has the failure of the Immensa lab in Wolverhampton affected hospital admissions in the areas that saw the most incorrect test results returned? The government line is “not at all”. I beg to disagree.”
“the official government line on this is that the big spike in cases is *nothing whatsoever* to do with the lab errors. Instead they argue that cases have risen in the South West because of low levels of prior infection.”
“This feels like an obvious lie, but what does the data say? Well, if it was true, then you’d expect cases in the areas most affected by the lab errors to follow the same trajectory as other, less affected, Local Authorities in the South West. Which they, erm, don’t.”
The chart below shows the “Most Affected Areas” (including Stroud district and Gloucestershire as a whole – red line) with much lower case rates during the period affected by testing errors (grey block) and much higher than the rest of the South West (blue line), which is a little higher but not that much more than the rest of england (black line)
Colin continues:
“Maybe *actual prevalence* is the same across the SW, it’s just that more testing in the affected areas has lead to us finding a higher % of true cases? Well, we have trust-level hospital admissions data. Admissions will be *much* less biased by differences in testing behaviour, so we can use that to look at trends in hospital admissions in these areas most affected by the lab errors.”
“If we compare the 13 Local Authorities most affected by the testing errors to all other Local Authorities in England [which includes Stroud district, and Gloucestershire as a whole – red line], COVID admission rates diverged [from the black line for the Rest of England] over the period when we’d expect the testing errors to (potentially) impact on hospital admissions.”
Colin continues: “But what about the government’s claim that cases are rising across the South West for reasons unrelated to the lab errors? Well if that is true then admissions in the rest of the South West should follow the same trend as in the areas most affected by the errors. Do they?”
“Nope. The gap in COVID admission rates between the areas most affected by the Immensa scandal and other parts of the South West *increased* over the period affected by the testing errors.”
He concludes: “Now this isn’t definitive proof of causality. There could be other explanations for what’s going on here. But until somebody comes up with a convincing one… It certainly looks to me that the data supports the idea that incorrectly telling lots of people with COVID in these Local Authorities [that they did not need to isolate because they had a false negative PCR, even if they had symptoms and a lateral flow positive] has led to more people getting COVID, and more people being hospitalised as a result.”
“This also seems like pretty basic common sense, but apparently common sense is in short supply these days.”
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. However, please take into account that the reported data in terms rates per population and of increase are a mess for the period 2nd September to 25th October because of the Immensa false negative scandal.
National context
Briefer this week due to time contraints. 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 (to 29th October) is 289,718. This is 12.7% lower than the number that tested positive in the previous week – 42,185 fewer people. It’s not clear to what extent the inclusion of accurate data from the areas like our affected by the Immensa false negative scandal accounted for the recent increase, and this filtering out accounts for an apparent decrease that may not continue.
Deaths within 28 days of a positive test have risen to over 1,000 people again – 1,066 people in the past week (12.6% increase). As mentioned above – it takes time for people to get sick after they test positive so if cases are dropping it will take time before that impact is seen in numbers of people dying.
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. 6,981 people were admitted to hospitals in the week to 25th October, 381 more than in the previous week (5.8% increase)
Estimates by ONS of true prevalence based on random-sampling of the population (rather than people seeking tests), find that “In England, the percentage of people testing positive for coronavirus (COVID-19) continued to increase in the week ending 22 October 2021; we estimate that 1,102,800 people in England had COVID-19… equating to around 1 in 50 people.” Numbers of confirmed cases are much lower because not everyone gets tested.
Similarly, across the UK as the whole, KCL/ZOE app team independently estimate around 1.2 million people had an active infection on the 30th 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.
The Covid-19 Actuaries Response Group has updated their useful chart on how modelled estimates of daily hospital admissions in England compare the reality. They describe the chart as showing: “Admissions have stayed below central scenarios modelled ahead of “Freedom Day”. Last week they added “but now appear to be rising to another peak, as modelled by Centre for Mathematical Modelling of Infectious Diseases at the London School of Hygiene and Tropical Medicine. Since the summer peak was smaller than modelled, will this one be larger?!” – and that question is still open.
In terms of people aged 12+ eligible for vaccination, across the UK four-fifths (79.4%) have been fully vaccinated and 86.7% have received at least one dose – small increases on last week.
International context
The number of people testing positive globally each day has been falling for some time – but recently has an uptick: around 428,000 (7-day-rolling average to Oct 19th) compared to around 626,000 to Sept 4th, but 404,000 on October 16th.
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 quite dramatically – though this is limited to some countries, with others maintining very low rates. 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 4.9 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 16.6 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. There is a wider list of symptoms associated with the virus to look out for from the ZOE symptom study.
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.