Blogs > Coronavirus (COVID-19) epidemic weekly update for Malvern SeniorsClick to read our observations on politics and world events 2nd October 2022 START OF WINTER WAVE - HOSPITAL ADMISSIONS RISING Those aged 65+ years can book Autumn booster vaccinations PreambleFor more than two years we have been keeping an eye on the published government figures and monitoring the media to asses the likely level of risk for Seniors in the Malvern Hills district and providing links to where further information could be found. During the epidemic Public Health England was split into the UK Health Security Agency and Office for Health Improvements and Disparities. However for simplicity, in this blog, we have continued to refer to this as PHE data. Testing has been run down and the public can no longer record the result of Lateral Flow tests so the daily cases reported on the Coronavirus Dashboard greatly underestimate the actual situation, and we have deleted our section on testing; this can however be found on archived pages. The only remaining sources of data indicating direction of travel are:
Now the epidemic seems largely over in the UK the numbers are of less importance, but we'll carry on with our blog for a little while longer. As sections become no longer relevant we are deleting them, but you can always refer back to archived pages. This page will continue to be updated each weekend using Friday's data, nominally with Sunday's date. ContentsSummaryFor most people COVID no longer represents a critical threat to health in Worcestershire - at present relatively few people are being admitted to hospital and only a handful a week are dying in a population of approximately 600,000. The COVID death rate in England and Wales seems to have levelled off at about 300 deaths per week but could ramp up towards 1,200 deaths per week during the winter. That's a lot but nothing for most people to be overly concerned about. Winter wave of COVID-19The UK is now on the gentle upside of the expected Winter Wave of COVID-19. Both ONS and the Zoe Health Study suggest the prevalence of COVID-19 is rising and this has already begun to show in increased hospital bed occupancy. The situation is likely to gradually worsen during October and November. Autumn booster jabsAutumn booster vaccinations are currently on offer to those aged 65+ years. Seniors are advised to get both the COVID booster and flu jabs to reduce the likelyhood of severe illness and hospitalisation. See Booster shots section below. What happens if you get sickBecause the vaccines rarely stop people catching COVID and prevalence is rising do not be surprised if you catch COVID despite being fully vaccinated. Infection 12 months ago rarely stops people getting sick for a second time. Some may either show no symptoms or have a mild fever, sore throat, general aches and pains, and quickly get over it; while others could feel quite poorly and spend between two and five days in bed, with it taking five to ten days or so to recover. Many of those who have caught COVID report either getting easily tired or suffering from shortness of breath for some weeks afterwards; if so patients are advised to take it easy until fully recovered. PrecautionsAny precautions to take are now a personal decision. The bookmark below will take you to the Worcestershire County Council webpage links at the end - there is little new to see. Click for Worcestershire Dashboard and associated links Booster shotsSpring Boosters are no longer available; instead an Autumn booster jab is being offered to those aged 50+ starting with the most elderly. For more information click this link:- NHS invites more than four million people for Autumn booster as care homes set to get first jabs From 12th September those aged 65+ years can book an Autumn Booster. However you should not book if it is less than 3 months since your last vaccination or you have had COVID within the last 2 weeks. Either the NHS or your GP Surgery (or both) should contact you when it is your turn to book; either by email, text message or letter. You should not need to contact them. The arrangements for getting vaccinated have changed slightly with the rollout of Autumn boosters. According to SW Healthcare, representing GP Surgeries, the centre at the Three Counties Showground has closed and vaccinations will either be at GP Surgeries, or at walk-in 'Pop-Up' Clinics, else roving 'Vaccine Vans' which are otherwise known as 'Jab-Vans'. That is not the complete picture as some pharmacies such as Claremont House in Barnards Green and Evans in Malvern Link will also be offering walk-in and timed appointments. To book an Autumn Booster on-line:- Click for NHS National Booking Service Note: you may sometimes have to travel out of town to get an Autumn booster appointment, depending on vaccine availability. Alternatively you can wait to be contacted by your GP Surgery and in due course get your Flu vaccine at the same time. Don't forget to check the mobile phone you have registered with your GP surgery for text messages. If you think you have been forgotten or don't have a mobile phone, phone your GP surgery to book an appointment. Our email from the NHS included a link for finding walk-in centres: Click this NHS link to find a walk-in coronavirus (COVID-19) vaccination site Depending on availability you could be offered either of the original Pfizer and Moderna vaccines, or the new Pfizer and Moderna bivalent vaccines which protect against both the original Wuhan strain and Omicron BA.1. The SW Healthcare website explains the Worcestershire arrangements that are gradually being put in place by GPs in conjunction with NHS Herefordshire and Worcestershire. Click for SW Healthcare information about where to get your vaccination in Worcestershire Hint: click Vaccine Rollout on the navigation bar at the top of the page and then Vaccine Van for pop-ups. There were no pop-ups in Malvern the last time we looked. In summary, if you want to get your Autumn booster you can either book an on-line appointment, possibly having to travel out of town, look for a local walk-in centre such as Claremont House and Evans Pharmacies, look for a pop-up, or perhaps easiest contact your GP Surgery and book your flu jab at the same time. Vaccination SitesThe NHS England website has a spreadsheet updated 14th September 2022 listing vaccination centres under the categories:
Note: this does not mention plans for pop-ups or vaccination-vans. Click for NHS England Vaccination Sites Two pharmacies in Malvern are listed Evans in Malvern Link, and Claremont House in Barnards Green. Prospect View is the only GP Health centre listed in Malvern. Upton Surgery is used by some residents. The Malvern Showground remains listed as a Vaccination Centre despite SW Healthcare saying it has closed. No hospital hubs are listed for Worcestershire. Note: for historical information about how to get vaccinated, which may be out of date, select an archived report eg Go to 'How to Get Vaccinated' section of the 7th August 2022 blog Number of casesThere are now three sources reporting the prevalence of COVID-19 in the UK.
ONS infection surveyONS estimated that 857,400 people in England had COVID-19 in the week ending 17th September 2022; an increase of 12% since the previous report. Note that this information is almost two weeks out of date and cases are likely to have risen since. Click for latest Coronavirus (COVID-19) Infection Survey, UK
Prevalence of COVID-19 in England estimated by ONS Prevalence is currently higher in Scotland (1:45) and Wales (1:50); and lower in Northern Ireland (1:80) Infections in the West Midlands seem particularly on the rise. Zoe Health StudyThe ZOE Health Study estimates are shown in the following table.
Prevalence of COVID-19 in UK estimated by the Zoe Health Study Even after accounting for Scotland, Wales and Northern Ireland, prevalence estimated by the Zoe Health Study is almost double that estimated by the ONS. However both show the incidence of COVID is continuing to increase. According to the later Zoe figures estimated prevalence rose by 18% in the UK last week suggesting about 1:31 people would test positive for COVID, while daily cases have risen by 24%. Hospital bed occupancy is rising sharply mirroring the increase in cases. Numbers testing COVID positive in Worcestershire (PHE)Note: this section has been deleted due to COVID testing being run down in the UK; figures can still be found on the Worcestershire Coronavirus dashboard, but these greatly underestimate the true number of infections. The direction of travel in Malvern is down. Click for Worcestershire Coronavirus Dashboard Number of deathsStatistics on COVID deaths are published by Public Health England, The Office of National Statistics, and NHS England. These can't be directly compared as they cover different periods, but together the figures paint a picture of the direction of travel - which is that COVID weekly deaths are levelling off and can be expected to rise between now and Christmas. PHE figuresThe Dashboard chart of COVID (28) deaths, following a positive test, by date of death shows that the 7 day average peaked in England at 183 per day about 18th July, then steadily falling to 43 per day by 13th September before rising to 51 deaths per day on 19th September. Note 1: given that testing has been greatly reduced this can no longer be considered a reliable indicator. Note 2: some of the deaths reported by PHE will be people who die with COVID but not from it. Click to view the UK government Coronavirus Dashboard ONS figuresThe Office of National Statistics (ONS) reports registered deaths in England and Wales where COVID-19 is mentioned somewhere on the death certificate. The ONS figures lag the PHE figures by 10 - 14 days and do not include Northern Ireland and Scotland. Note: the figures include cases where COVID may have been a secondary cause of death. Click for national ONS data on deaths (Excel spreadsheet) The ONS figures are broken down by District providing a glimpse of where deaths are occurring. The provisional cumulative total of COVID related deaths in Worcestershire reported by the ONS up to 16th September (week 37 of 2022) is shown below. Note: normally the numbers are from summation of rows 9 to 339 of the ONS Death Registrations-Pivot table, which gives the provisional total of deaths reported in any week, which can be distorted by delayed reporting over public holidays. This week (37) there is no pivot table, so picking out the numbers using the spreadsheet filters has been more tedious. Deaths by 'date of death' is a more accurate metric but takes longer to be confirmed.
Provisional cumulative COVID-19 deaths in Worcestershire registered by ONS to 16th September 2022. There was just 1 COVID death at home in Bromsgrove; and 1 death in hospital in Worcester. In England and Wales 300 COVID-19 related deaths were reported in the week to 16th September, roughly as forecast last week. Of these 37 were in care homes, 31 at home, 6 in a hospice, 222 in hospital and 4 elsewhere. So far this year in England and Wales 26,454 people have died with COVID mentioned on their death certificate. Correction: the figure reported last week should have been 26,154.
ONS provisional deaths 'by week reported' in England and Wales 2022 Note: the steps in the chart above in weeks 18, 22, and 36 were probably due to delayed reporting over the Easter, Mayday, Jubilee and Autumn Bank Holidays. Similarly HM Queen's funeral could further distort the figures. Following the upturn in hospital admissions it's likely deaths have reached a minimum and could rise a little in the next week or two. The figures on the Coronavirus Dashboard of ONS deaths by date on the death certificate show ONS England deaths peaked at 120 deaths per day on 18th July; since gradually falling to a 7 day average of 36 deaths per day by 2nd September. This is the most reliable measure of deaths. In comparison averaged over recent years 1,700 people die daily from all causes in the UK. Click for ONS Coronavirus (COVID-19) latest insights: Deaths NHS England figures for WorcestershireThe table below shows the latest COVID deaths in Worcestershire hospitals reported by NHS England on 22nd September 2022.
Excludes deaths in care homes, deaths at home and deaths in hospices. Two less than last week. Click for NHS COVID-19 total announced deaths Look for COVID Total announced deaths file, then select tab Deaths by Trust. Note: NHS say all deaths are recorded against the date of death rather than the date the deaths were announced. As from 1st July 2022 reporting has moved to publication once per week on a Thursday, rather than every weekday. Trend in Worcestershire COVID deaths this yearSince 1st January 2022 there has been a baseline level of up to 1 COVID death per day in NHS Worcester acute hospitals. A peak of typically up to 3 deaths per day occurred either side of 1st April, with a more recent upturn of up to 2 deaths per day during July 2022. On some days no deaths were reported. With a Worcestershire population of roughly 600,000 and assuming one COVID death per day that equates to 0.06% COVID deaths per year. Taking into account that most deaths are of the elderly the risk of Seniors dying of COVID this year will probably be less than 0.5%. Worcestershire represents about 1% of the population of England, so all other factors being equal, one might expect the Worcestershire death rate to be one hundredth of the figure for England. England peaked at about 800 (ONS) deaths per week at the end of July but now only about 300, so for Worcestershire assume a pro rata average of no more than 3 deaths per week. To get things in perspective, at the present time, Seniors are 40 times more likely to die of something else, for example cancer, heart attack, stroke, and old age. For that reason most people now seem to be taking the view that COVID is no longer a critical threat to their health. Risk of COVID-19 death by age bandNHS England provides an analysis of COVID-19 deaths in hospital in England and Wales by age band. Shown below is a snapshot of 2,898 recent deaths for the period 6th May 2022 to 6th July 2022 when most of these deaths will have been from the Omicron variants.
Relative risk of COVID-19 death by age band May - July 2022 The main point to note is those aged 60+ still account for 93% of deaths despite young people being more likely to catch COVID-19. The risk profile for Omicron appears to be the same as for Delta. Age is the greatest risk factor; perhaps reflecting that older people have more health problems. Healthcare numbersThe UK government Coronavirus Dashboard includes information about healthcare statistics and NHS bed occupancy. COVID bed occupancy has shot up in the last week.
Headline summary of patients in hospital reported on 29th September 2022 Note: 'Patients admitted daily' is the weekly total divided by 7. This number includes both patients admitted to hospital with COVID-19 from the community, and those diagnosed with COVID-19 in hospital. See charts on the Coronavirus Dashboard and below. Bed numbers by region in EnglandTabulated figures for COVID bed occupancy in England can be found on the NHS England website and are another indicator of the prevalence of COVID. Click for NHS England COVID-19 Hospital bed Activity statistics Note: see the latest Daily Admissions and Beds spreadsheets, then look for all COVID beds.
Comparison of All beds COVID data for England, London and Midlands In the last week the number of COVID-19 General and Acute beds rose by 30% in England, 15% in London and 40% in the Midlands. For comparison, the number of beds occupied during the peak of the epidemic in January 2021 is shown in red in the right hand column of the table. The chart below shows how COVID bed occupancy peaked in England about 18th July and is once again rising. The peak in beds is about one week delayed on the peak in daily admissions and deaths lag beds by a further week.
COVID bed occupancy in England from 1st July to 28th September 2022 Hospital bed occupancy has been rising for the last ten days. Worcestershire hospital bedsBetween 20 September 2022 and 26 September 2022, 52 patients went into hospital with coronavirus. This shows an increase of 200% compared to the previous 7 days. There were 58 patients in hospital with coronavirus on 28 September 2022, 22 more than the week before; one on a ventilator. Click for Summary of Malvern numbers on the Coronavirus dashboard This link also reports deaths. Deaths in Malvern HillsBetween 18 September 2022 and 24 September 2022, there were no deaths within 28 days of a positive coronavirus test. Forecast for the week aheadWe expect between 300 and 350 COVID related deaths to be registered in England and Wales (as registered by the ONS) in week 38 ending 23rd September, to be reported on 4th October. In the county of Worcestershire, based on 58 new hospital cases last week and assuming the ratio of all deaths (including those in care homes and at home) to be 1:11 of admissions, then there should be no more than 5 COVID deaths per week in the first half of October. NHS COVID bed occupancy in England could rise by a further 20% next week based on the upward trend already established, and the Zoe Health Study estimate of the increase in cases. Longer term outlookCurrently there are few signs of a new variant of concern so infections ought to fall during September - except for the fact:
The Zoe Health Study numbers suggest COVID infections are slowly accelerating, which is confirmed by an increase in hospital bed occupancy. In due course the COVID death rate will rise proportionally. Based on the past dip in COVID bed occupancy we hazard a guess the ONS death rate has bottomed out at about 280 deaths per week or about 40 deaths per day in England and Wales and it will slowly ramp up during October and November. Given that COVID hospital bed occupancy fell to 4,000 beds in England, and has already risen to 7,000 it looks fairly certain the death rate will rise from 280 deaths per week towards 450 in England and Wales during the next fortnight or so. Assuming that hospital bed occupancy were to rise at about 25% per week for the next 6 weeks, then COVID bed occupancy could reach that during the worst of the epidemic by the middle of November BUT because of vaccinations and natural immunity far fewer would be on ventilators and in ICU. The NHS should be able to cope with this, but at the expense of cancelling many elective operations such as hip replacements.. To counter the expected surge in demand for NHS beds, Autumn booster shots are being offered to those aged 50+ years to protect the most vulnerable from severe illness and hospitalisation, starting with the oldest; this should dampen the peak of the winter wave, but we'll just have to wait and see by how much. UCL modelling charts have been suggesting the COVID death rate could fall to a minimum of 35 deaths per day, that is 245 certified deaths per week by the end of September which is more or less what has happened; but concerningly the charts also hint at the Winter Wave peaking at about 180 deaths per day or 1,260 deaths per week towards the end of November 2022. Click for UCL Long-term forecasting of the COVID-19 epidemic Exactly what happens will depend on the uptake and effectiveness of the Autumn booster shots, human behaviour such as mask wearing, improvements to ventilation, and the effect of inflation and energy pricing on the public's health. Additional deaths due to the Winter WaveThe UK COVID-19 death rate is going to rise this winter, but by how much is uncertain. However we are fairly sure the rise should be nothing (for most) to worry about. It has been our opinion that while the death rate remained below 700 deaths per week neither the public nor the government would be concerned. Now this threshold may be exceeded in the second half of October because of the winter wave. However, we doubt many will be concerned by a 'blip' - possibly of the order of 10,000 additional UK COVID deaths amongst OAPs this winter. To put things in perspective, Worcestershire's share of this might only turn out of the order of 100 COVID related deaths this winter. In a population of 600,000 few are likely to be concerned about that as the vast majority (we estimate 99.98%) can be expected to survive any sickness due to COVID-19 this winter. This projection assumes people can afford to eat and heat their homes and by implication a relatively mild winter, and this is by no means certain. Advice for SeniorsWe expect the risk of exposure to COVID-19 to rise towards HIGH in the UK as winter approaches. See our riskometer opposite. Despite this many, perhaps most, people will take the view that COVID is no longer a critical threat to their health. For the more cautious the simple safeguards to remember are to:
Notes: 1) Wash your hands thoroughly before touching your face to avoid transferring virus from contaminated surfaces to your mouth, eyes and nose. If outdoors, wash hands with an alcohol based hand gel. 2) Two metres is further than you think - roughly an arm and a walking stick away. 3) If you are 'clinically vulnerable' consult your GP or specialist; you may need to take a test and consider anti viral drugs if testing positive. 4) However careful you are, don't be too surprised if you catch COVID as the Omicron variants are highly infectious and the Wuhan vaccines give little protection against transmission and infection (although they do reduce the severity of symptoms). 5) You may still have to take a test and wear a facemask when travelling to some overseas countries. AnnexCommentaryAs expected cases of COVID are rising following children's return to school, increased mingling and the dropping of precautions. This is being reflected by rising NHS COVID hospital bed occupancy but thankfully for whatever reason most people are less seriously ill than they were when the Wuhan virus first struck. Nevertheless we anticipate 'bed blocking' by the elderly awaiting care placements and severely ill COVID patients to place increasing pressure on the NHS this winter causing many elective operations such as hip and knee replacements to be either cancelled or delayed. Fully vaccinated Seniors should not be too concerned about the COVID death rate rising this winter as the risk will probably be no greater than that from seasonal flu. COVID video updatesLinks to updates by Professor Tim Spector of the Zoe Health Study, Independent SAGE and pundit Dr John Campbell can be found here:- Click to watch Zoe Health Study fortnightly update on 22nd September 2022 presented by Tim Spector. Tim Spector says cases are highest in young children but have begun to rise in all age groups. Click to watch Independent SAGE weekly update on 30th September 2022 Join Independent SAGE for a discussion on Covid and Long-Covid in children; with guests Sammie Mcfarland and Mr Steve Lowe, chaired by Dr Stephen Griffin, hosted by Dr Helen Salisbury, and Prof Christina Pagel on numbers. List of vaccinesAutumn bivalent boostersA second bivalent vaccine has been approved 3rd September 2022 as a booster by the Medicines and Healthcare products Regulatory Agency (MHRA) after it was found to meet the UK regulator’s standards of safety, quality and effectiveness. The updated booster vaccine made by Pfizer/BioNTech, targeting the Wuhan virus and Omicron BA.1 variant, has been approved for use in individuals aged 12 years and above. An updated version of the COVID-19 vaccine made by Moderna that targets two coronavirus variants (known as a bivalent vaccine) has been approved for adult booster doses by the Medicines and Healthcare products Regulatory Agency (MHRA) after it was found to meet the UK regulator’s standards of safety, quality and effectiveness. The earlier vaccine storyHere is the updated list of COVID-19 vaccines ordered by the UK. It looks as though the government has settled on the use of Pfizer and Moderna with Astrazeneca now held in reserve. Moderna has been offered for Spring Boosters at the Three Counties Showground. The order for Valneva has been cancelled, but nevertheless it has now been approved for use by MHRA. Click for BBC report - Valneva Covid vaccine approved for use in UK Nuvaxoid (Novavax) was approved in February. The government has signed deals to buy 114 million additional doses of the Pfizer (54M) and Moderna (60M) vaccines to use in 2022 and 2023. The press announcement goes on to say that 60M doses of Novavax vaccine are expected to be delivered in 2022 and 7.5M doses of GSK/Sanofi, so there seems no intention to cancel these late arrivals. Click for Guardian report - Novavax expected to be become fourth Covid vaccine available in UK
Table of vaccines ordered by the UK government
Summary of LinksSome of this information is now out of date but provides a historical context to the epidemic. Information about Coronavirus can be found on the NHS website: https://www.nhs.uk/coronavirus
SymptomsNote: the list of symptoms was updated on 1st April 2022 Article about the effects of Wuhan Coronavirus on the human body
Reporting and how to obtain a testHow to get a test https://www.nhs.uk/coronavirus About joining the Zoe COVID Symptom Study:
GuidanceUK government Coronavirus guidance See also - government sets out next steps for living with COVID COVID-19 Response: Autumn and Winter Plan 2021 for England UK Health and Security Agency (UKHSA) website
COVID Alert statesGuidance on UK COVID-19 alert level methodology: an overview COVID-19 Alert Level lowered to 3 on 10th May 2021
TiersGuidance on tiers: what you need to know Government postcode checker to find tier for other areas
StatisticsUK government COVID-19: Omicron daily overview UK government Coronavirus Dashboard Coronavirus Dashboard Interactive Map ONS data on deaths in England and Wales (Excel spreadsheet) NHS England COVID-19 Daily Deaths NHS England COVID-19 Hospital Admissions NHS England vaccination statistics Worcestershire Coronavirus Dashboard Worcestershire COVID-19 Vaccinations Dashboard
HSA COVID-19 vaccine weekly surveillance reports Information about NHS hospital bed numbers: past, present, future
A glimpse of the worldwide vaccination situation can be found on the Our World in Data website. Click for chart showing % vaccinated
ModellingA forecast of the progression of the COVID-19 epidemic can be found on a University College London (UCL) website. Click for UCL Long-term forecasting of the COVID-19 epidemic A projection of the future COVID-19 death toll and daily deaths can be found on The Institute for Health Metrics and Evaluation website. Click for IHME projection of COVID-19 deaths
ReportsCoronavirus (COVID-19) latest insights by ONS A live roundup of the latest data and trends about the coronavirus (COVID-19) pandemic from the ONS and other sources. MedRxiv is a US preprint server for Health Sciences. A depository for reports which have still to be peer reviewed. COVID-19 rapid guideline: managing the long-term effects of COVID-19 NICE guidance on managing Long COVID
The bigger pictureWorldometer summary of coronavirus cases worldwide European Centre for Disease Prevention and Control info https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases World Health Organisation info
Window on the USACentre for Disease Control (CDC) Find maps and charts tracking cases, deaths, and trends of COVID-19 in the United States. American Association of Retired People (AARP)
WorcestershireA local summary of COVID data can be found on the Worcestershire Coronavirus Dashboard. Note 1: use the arrow <> buttons at the bottom of the Dashboard screen to move between pages. Note 2: the figures for COVID cases are becoming meaningless as testing is run down. Note 3: deaths are on page 7, and hospital beds on page 9. Click for Worcestershire County Council COVID-19 news There is a colourful webpage offering advice on learning to live with COVID for those aged under 30 years. 'Rona' is slang for Coronavirus. Click for The Worcestershire 'Rona' Hub Click for Simple Summary of Malvern numbers on the Coronavirus dashboard
MiscellaneousSpanish Flu Dr Jeff Kildea's commentary about the 1919 outbreak of Spanish Flu in Australia
Views of Martin McKee, Professor of European Public Health Follow Martin McKee on Twitter Views of Prof Christina Pagel, a member of Independent SAGE Follow Christina Pagel on Twitter
SAGE membership Scientific Advisory Group for Emergencies (SAGE)
Scottish government: Link to Scottish Government website Link to Postcode checker for COVID restrictions by protection level in areas of Scotland
Welsh Government: Guidance on COVID alert levels in Wales
The interpretations and opinions expressed are our own |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Last updated 2nd October 2022 |