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7th Jan 2022 Covid-19 update

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

Before this weeks summary of the local and national data, we wish everyone reading our Stroud Coronanvirus Community Response updates a Happy New Year. Once again, we’re trying to put a bad year behind us but the pandemic isn’t over yet. If you’ve not already read it, please keep this Open Letter from the heads of local Health and Care organisations – from which the following quote is taken in mind.

“This variant is spreading so quickly, it is likely that everyone will come into contact with an infected person in the next few weeks… The extent and impact of any Omicron COVID surge is to a large extent influenced by the choices and actions we take… Without collective action now to drive up booster vaccination rates and to embrace other preventative action this winter, the pressure on GP, community and hospital services and social care services from COVID-19 and demand for specialist emergency care will be profound. It will also have a major knock on effect on sustained efforts to bring down waiting lists for planned operations, appointments, assessments and treatments as we prioritise those with the greatest and most serious care needs.”

To underline this point – two quick notes from the national and international data (more detail below), before we get into the local picture:

We post regular updates on news around vaccination eligibility/rollout, government policy and more in our Facebook group, where you can also ask any questions you have about any aspect of the pandemic and response.

Gloucestershire – positive tests, hospital admissions, people in hospital

In the most recent data:

  • 8,130 people living in Gloucestershire tested positive for the first time in the week to the 3rd January (latest date for complete data) – this is the highest ever weekly figure by some distance – 3 and a half times the level of the peak in January 2021 (when 2,424 people tested positive for the first time in the ‘second wave’ peak week to 4th January). This is a rate of people testing positive for the first time compared to the population of around 1.3% in just that week alone (i.e, around 1 in every 80 people living in Gloucestershire testing positive for the first time, just in that week)
  • Case rates continue to be much lower for local people aged 60 and over – but have rapidly risen among over 60s recently to record highs (735 per 100,000 – approx one in every 136 people). This is still about half the level for those aged under 60 (1,492 per 100,000 – approx one in every 67 people). 1,322 people aged 60 and over have tested positive in the past week (519 in the previous week), compared to 6,872 people aged under 60 (5,135 in the previous week). That means 18% of those to test positive were aged 60 or over. This data shows how Omicron is better able to cause infections in those with immunity from vaccination – but how the age group with highest booster takeup still has lower rates compared to younger age groups.
  • 128 people were admitted to Gloucester/Cheltenham hospital with Covid-19, or diagnosed in the hospital in the week to the 2nd January. This is the highest weekly number since the week to 26th January 2021 – and is double the number in the week to the 6th December, just under one month ago. We can perhaps expect, that this number might not double again one month from now – and can at least hope not and do what we can to avoid that. The weekly number is already over halfway to the peak in January 2021 – 63% of the 202 patients admitted in the week to the 18th January. It’s far from impossible that that a similar number of patients are admitted in a week to come – though we understand that on average people are being admitted with less severe disease this year.
  • There were 112 people in Gloucester/Cheltenham hospital with Covid-19 as of 4th January 2022. Up 30% on 86 last week, and double the number on the 15th of December 2021 (i.e., doubling in under three weeks. This number is pretty much exactly half the level reached at the peak last year – 227 patients on the 20th January 2022. We don’t know when numbers will stop rising but it doesn’t seem impossible that number will be reached or exceeded around 20th January this year. However, we understand cases in hospital are less severe this wave (but high numbers of Covid-19 patients still create difficulties as they need to be on separate wards etc).
  • There were 4 Covid-19 patients in local critical care beds as of the 4th January. We cannot be complacent about critical care capacity given the hospital admission numbers above, but we can hope that we avoid the situation of January 2021 when there were at most 19 Covid-19 patients in critical care and no spare critical care capacity on several days. For comparison, on 4th January 2021 there were more than twice as many Covid-19 patients in local critical care beds: 10.
  • Seven more people died with Covid-19 mentioned on their death certificate in the most recent week we have data for – to 24th December, two of them from Stroud district. Since August 2021 a total of 120 people who had lived in Gloucestershire have died with Covid-19 mentioned on their death certificate. Across Gloucestershire, a total of 1,312 people have died with Covid-19 mentioned on their death certificate, 236 of them had been living in Stroud district. We send our best wishes to everyone in hospital and their loved ones, and our condolences to those who have lost loved ones, which we know can be particularly difficult at this time of year.

The chart below compares numbers of people testing positive, being admitted to hospital, or dying within 28 days of a positive test compared to the peak week in January. The chart shows how the number of people testing positive in a week is 361% what it was at the peak in January 2021 – but the number of people being admitted/diagnosed with Covid-19 in hospital is at 63% of the peak – though rising. The numbers of people dying are still much lower – at around 14% of the January 2021 peak (but we shouldn’t be complacent about the impact of hospitalisations, and of infections themselves which can cause long-term symptoms/impacts on health).

Chart by James Beecher and Claire Biggs using data from the excellent coronavirus.data.gov.uk site

The chart below shows how rates of people testing positive locally are just a week behind the situation across England as a whole (where approx 1 in every 56 people tested positive in the most recent week of data, compared to around 1 in every 80 locally).

We can do the same analysis for England – where the picture is similar, though cases (having been higher in January) are not yet double the January peak (but headed there fast, and past 50% more than the peak week). Hospital admissions are lower compared to the peak across England – at around a fifth of the peak.

Chart by James Beecher and Claire Biggs using data from the excellent coronavirus.data.gov.uk site

As above – we understand that on average people admitted to hospital are less likely to have severe symptoms, but in John Burn Murdoch’s words with regard to London (a few weeks ahead of the rest of the country at most): “Whilst it’s true that the number of ‘incidental’ Covid patients — people being treated primarily for another reason — has risen steeply during Omicron wave, the number with serious Covid is also now rising very quickly.”

Source: John Burn Murdoch on twitter

Returning to Gloucestershire, the chart below shows rates of people testing positive for the first time for over and under 60s, and how they have changed over the past month. As you can see, rates have recently been constently lower among those aged 60 and over (most likely to be fully vaccinated and with booster takeup over 90%), than for those under 60 (least likely to be vaccinated, and also more likely to be working, studying or attending school, in indoor environments where the virus can be easily spread). However, with cases rising to such heights among under 60s, and with Omicron better able to get past immune defences built from previous infections or vacciation, rates among over 60s have been rising fast too.

Source: gov.uk dashboard for Gloucestershire

The chart below from Gloucestershire County council helps us understand how rates among smaller age bands are related to vaccination/booster rates. The red blocks and line represent case rates – higher at the top of the graph, lower at the bottom. Along the bottom are different age groups – and there are columns showing the proportion of each age group with a booster, two doses, or 1 dose of covid-19 vaccination. Where the booster (purple bars) rates are highest, the case rates are lowest (except for those aged 0-14). Case rates are highest for 25-29 year olds, with nearly 2.3% of all those in the age group testing positive for the first time in the week to 29th December (that’s one in every 44 people in Gloucestershire)

Source: Gloucestershire County Council

The chart below shows just the hospital admission, occupancy, and data from death certification – but without test positive numbers so we can make comparisons with previous waves more easily (this chart also uses the raw numbers rather than comparisons to the January 2021 peak). You can see how the hospital admissions and occupancy numbers are rising fast to levels of previous peaks, but there is not a similar trend for deaths – though some people are still dying with COVID-19 listed on their death certificate.

Chart by James Beecher and Claire Biggs using data from the excellent coronavirus.data.gov.uk site

The chart below shows there were Critical Care bed occupancy for Gloucestershire NHS Foundation Trust (covering Gloucestershire Royal and Cheltenham General hospitals), over the past year. They key concern is pressure on beds – more Covid-19 patients means fewer beds for other patients, and we really want to avoid the situation of the 22nd and 27th January this year, where every critical care bed was occupied (with Covid-19 patients in critical care hitting a peak of 19 on the 23rd January). For some insight into how local critical care workers are finding things, watch the recent video from Gloucestershire Royal. There were 4 Covid-19 patients in local critical care beds as of the 4th January, but only 3 unoccupied beds. We can cautiously welcome this – but sadly know that the reason there are fewer patients in critical care could be because people have died, rather than because they have left the critical care unit to recuperate – and the small number of unoccupied beds means there is a fine margin to things becoming very difficult.

Source: NHS England data, chart by James Beecher and Claire Biggs

Numbers of new positive tests had been falling in Stroud town, but rose sharply in the week to 2nd January, with 140 people testing positive for the first time – up 73% on the previous week – to a rate of 1.2% of the total population (i.e. around one in every 80 people). Rates are even higher in Ebley and Randwick (1.6% of the population) and Frampton, Whitminster and Eastington (1.7% – that’s around one in every 60 people testing positive for the first time in the week to 2nd January).

Source: gov.uk interactive map

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.

National context

View a summary of the trends on the government dashboard at this link. This shows:

  • Numbers of people testing positive for the first time have risen dramatically: 1.2 million people in the 7 days to 7th January . However, % rate of increase is slowing – there’s a possibility we are nearing a peak. Nonetheless, this is a very high number and pace of increase – consistent with what we’ve expected from how Omicron has spread in other countries .
  • The number of patients admitted to hospital/diagnosed in hospital has also risen dramatically. 15,812 people were admitted/diagnosed with Covid-19 in hospital in the week to 3rd January, 58% more than the previous weekly total – and around triple the numbers of around 6 weeks ago.
  • The number of Covid-19 patients in hospital across the UK is also rising fast, more than doubling in a month from 7,413 on 6th December 2021 to 18,454 on the 6th January 2022 (3.3% rise). This is not much below the spring 2020 peak of 21,687, but still less than half the January 2021 peak of 39,254). These are considerable numbers for an NHS that has been under considerable additional pressure due to the pandemic for the past 18 months.
  • It takes time for people to get sick enough to need hospital, and deaths come later – so numbers do not yet reflect the impact of recent rises in cases. The numbers of people dying within 28 days of a positive test has now started to rise, however. 1,120 people died within 28 days of a positive test in the week to the 7th January. Numbers of deaths are being confirmed in the more robust but delayed measure which counts deaths where Covid-19 is mentioned on a death certificate, however because it takes time for death certificates to be processed this data is less up to date: across the UK 591 people died with Covid-19 mentioned on their death certificate in the week to the 24th December (the lowest weekly total since the week to the 30th July 2021). These numbers are around 10 times lower than in the worst weeks of the pandemic when over 9,000 people died in a single week, but we should not minimise these numbers. Over 16,000 people have died with Covid-19 mentioned on their death certificates since the 30th July.

Not everyone gets tested – but we can get a better idea of the number of people with infections from the ONS infection survey – which estimates an astonishing 1 in 15 people would have tested positive in the week to 31st December (up from 1 in 45 the previous week). “In England, the percentage of people testing positive for COVID-19 continued to increase in the week ending 31 December 2021; we estimate that 3,270,800 people in England had COVID-19 (95% credible interval: 3,163,500 to 3,377,500)”

Across the UK as the whole, KCL/ZOE app team independently estimate around 2.7 million people had an active infection on the 7th January, based on symptom reporting and reporting of test results by up to 4.7 million app users. This is up from around 1.6 million a couple of weeks ago – but is potentially peaking. It equates to around 200,000 people being newly infected every day.

International

Whether people have access to testing strongly influences confirmed case numbers by continent, but across the world as a whole cases are rising rapidly again – to levels far beyond what has been seen before – 1.89 million people tested positive in the week to the 5th January.

The map below shows how Europe, Australia, the USA, Canada, and Argentine are the worst affected countries at the moment in terms of confirmed cases relative to population (again, bear in mind that some countries have low numbers of confirmed cases because people are not able to access testing even when they do have infections).

The UK is far from the only country in Europe to have experience rapid rises in the number of people testing positive – compared to population size France, Denmark, Greece and Ireland all have higher current case rates. Spain, Portugal and Italy – as well as – outside Europe – Australia – all have cases rising at similar rates to the UK, just some weeks behind. For now, Germany seems to have been able to keep case rates lower – but they are starting to rise and we should not assume the country won’t be affected in similar ways to others.

While deaths are lower in the UK as a proportion of cases thanks to high levels of vaccination and a rapid booster campaign, the situation globally is very different – as John Burn Murdoch points out: “Covid deaths have passed 25% of their Delta peak in Mozambique and Angola, and are still rising. In wealthy, well-boosted countries like the UK, deaths this wave may peak at 10-15% of the previous record. In others they may hit 50%.”

Notes

Read the latest government rules and guidance. Some key, locally focused, information and links below.

The core advice remains: If you have symptoms (or if you are asked to by contact tracers), self-isolate until you have a negative PCR 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 – people who are vaccinated are particularly like to experience cold-like symptoms including headache, runny nose, sore throat etc.

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.

Rapid tests for people without symptoms are available to everyone in England – and the government is recommending people take them either twice a week, or before mixing with others (which could be more often), and daily if identified as a contact of someone with a confirmed infection, but not required to isolated (if fully vaccinated or under 18).

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 are now legally required in some indoor settings again – and 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.