Three key points before the data. For advice on what to do if you think you might have a SARS-COV-2 infection, please skip to the end.
- Numbers of infections are very high at the moment locally (though thankfully falling), and hospital admissions and patients in hospital with Covid-19 are rising fast. This is partly because of the Immensa false negative testing scandal that saw an estimated 43,000 people receive false negative results between 2nd Sept and 11th Oct – many of them locally in Stroud district and Gloucestershire. Please 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, and James Beecher wrote an article for openDemocracy on his experiences raising concerns with authorities.
- SCCR today published a statement on the offer of COVID-19 vaccination to 12-15 year olds – containing details of how the rollout is taking place locally, links to official guidance, and to quality sources of information in an effort to counter misinformation being circulated locally.
Gloucestershire – positive tests, hospital admissions, people in hospital
First, some key numbers. In the most recent week of complete data to 31st October:
- 4,109 people living in Gloucestershire tested positive for the first time (roughly one in every 156 people).
- 100 people were admitted to Gloucester/Cheltenham hospital with Covid-19, or diagnosed in the hospital – this is about half the level of the peak in January 2021 – when 202 people were admitted/diagnosed in a week, and is double the number around a month ago (49 admissions in the week to 4th October).
- As of 2nd November a total of 76 people that had tested positive were in Gloucester/Cheltenham hospital – a sharp jump from the 44 last week, almost double the number from approx two weeks ago (39 on 21st October) and around 1/5 of the worst point locally.
First, looking at tests – we now have data that is working as it was prior to the Immensa issues. The chart below shows that local case rates were very similar to those across England at the start of August (266 per 100,000 in Stroud, 278 in Gloucestershire, and 293 across England).
During September, and to the 11th October, rates were artificially low because of false negatives. From 15th October, they were inflated a little by people who potentially received false negatives between 3rd-11th October being asked to retest, and showing up as ‘new cases’ in the week to 20th or so of October. Now those retests have filtered out of the 7 day totals and we see that rates are still much higher than across England – 738 per 100,000 in Stroud district (1 in every 136 people testing positive for the first time), 676 across Gloucestershire (1 in every 148 people), compared to 416 across England (1 in every 240 people). Bear in mind these are the number of people testing positive and we know not everyone gets tested – true prevalence estimates are discussed below.
Another way to compare local data with national is through a ratio – the chart below from Na Sirf Musiqi on twitter, shows rates in Gloucestershire and the South West as a percentage of the rate in England excluding the South West. Rates were close to 100% (ie, the same as the rest of England) in August – the South West diverged with a bump related to the Boardmasters festival in late August, and the dropped due to false negatives in September, before correcting to around 50% higher than the rest of England rate in the most recent data.
The chart below shows how huge numbers of new cases have affected the hospital and death data for Gloucestershire. 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 100 patients in the 7 days to the 31th of October (purple line).
The chart also shows how the number of people in hospital has been rising slowly before a sharp recent rise brings the total to a new peak of 76 on the 2nd November (very similar to the position exactly one year ago). The number has potentially been inflated by transmission within the hospital referred to on an ITV Westcountry story, but admissions associated with recent high numbers of cases following the Immensa scandal are also part of this story. But if case numbers continue to fall, hopefully the numbers in hospital will soon too.
Five more people died with Covid-19 mentioned on their death certificate in the most recent week we have data for – to 22nd 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. We send our best wishes to everyone in hospital and their loved ones, and our condolences to those who have lost loved ones.
We understand from people working in the local hospital that the majority of critical care patients are unvaccinated, and that anyone who is vaccinated has less severe disease. While people are sadly still dying with Covid-19 mentioned on their death certificate, I think the chart below shows clearly how the relationship between hospital admissions and deaths is different since vaccinations became available.
A local nurse explains that in Gloucester Royal Hospital on Novemeber 3rd there were “8 Covid patients on ITU 6 of those unvaccinated“
Dr Dave Windsor, Consultant in Intensive Care and Anaesthesia, is clear in his recent tweets that “Covid has NOT gone away“, recommending that people “Stay safe, wear a mask, get your vaccine or covid will find you.”
Health care professionals really
— Dave 💙 (@drfrocester) November 4, 2021
STRUGGLING with numbers of critically unwell patients who have CHOSEN NOT to get vaccinated.
Severe Covid is now a
PREVENTABLE
illness
💉Get your vaccine
😷 Wear a mask
PLEASE help us to help you
Within Stroud district, the worst affected area in terms of people testing positive is Chalford & Bussage – with 1.2% of the population testing positive for the first time in the 7 days to 30th October (ie, more than 1 in every 100 people). Stroud Town has a rate just lower than 1 in every 100 people – 0.95%. Rates are high across the district, county, and neighbouring areas.
The vast majority of cases recently have been in younger people – particualry school-age (unvaccinated). However, cases have until recently been rising in over 60s too – to roughly the rates of the January 2021 peak.
Rates among people in their late 30s to early 60s have been high since the Immensa scandal – likely particularly among parents and teachers etc. Rates are particularly high for 40-44 year olds, with over 1% of everyone in this age group in Gloucestershire testing psotiive for the first time in the week to 28th October (not affected by re-testing of people who had false negatives between 3rd-11th October).
Again, local rates are high because of the Immensa testing scandal, not just because of re-testing following it. This is clear in the REACT/IpsosMORI prevalence estimates, which are based on 67,208 people provided a swab with a valid result from RT-PCR between 19th and 29th October.
The estimates resulting from this exercise aren’t perfect but they also aren’t affected by testing behaviour as it’s a sampling based approach – so they enable fairer comparisons across areas, and insight into prevalence of the virus among people who do not get tested. The map shows how prevalence of the virus increased since the last ’round’ last month, and the accompanying report states: “Of these 67,208 valid swabs in round 15a, 1,021 were positive giving a weighted prevalence of 1.72% (1.61%, 1.84%). The weighted prevalence in round 15a is more than two-fold higher than that estimated in round 14 at 0.83% (0.76%, 0.89%)”
The map also shows the impact of the Immensa false negative testing scandal, and the accompanying report states: “The ten LTLAs with the highest smoothed prevalence nationally (≥2.36%) in round 15a were all in South West: [with 5 of these districts of Gloucestershire, only the Forest of Dean doesn’t make the list]: Cheltenham, Stroud, Swindon, Gloucester, Cotswold, South Gloucestershire, Wiltshire, Tewkesbury, Bath and North East Somerset, and City of Bristol.” Rates in some of these areas may have been double the rate across the rest of the country, and rose approximately four-fold during the period.
” The highest weighted prevalence in round 15a by region was found in South West at 2.18% (1.84%, 2.58%) increasing almost four-fold from round 14 at 0.59%”
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 275,264. This is 6.9% lower than the number that tested positive in the previous week – 20,285 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, but the decrease appears to be being sustained, and that is a good thing.
Deaths within 28 days of a positive test have risen to over 1,000 people again – 1,190 people in the past week (12.3% 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. 7,259 people were admitted to hospitals in the week to 31st October, 204 more than in the previous week (2.9% increase). The rate of increase in admissions is falling, so hopefully falling cases will follow through into falling hospital admissions soon.
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 5th November (the same as we reported last week), based on symptom reporting and reporting of test results by up to 4.7 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 have previously described this chart as showing: “Admissions have stayed below central scenarios modelled ahead of “Freedom Day”, adding “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 (79.6%) have been fully vaccinated and 87.1% 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 434,000 (7-day-rolling average to Oct 31st) compared to around 626,000 to Sept 4th, but 404,000 on October 16th. However, it looks like this rise is slowing.
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. 5 million people have had their death attributed to Covid-19 since the start of the pandemic. This is a figure that is bad enough, but it is believed to be a significant underestimate due to limited death registration data in many countries – including India for example. The pandemic has likely had a much larger death toll. The Economist estimates that excess mortality at 17 million (which will include some 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.