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Coronavirus (COVID-19) epidemic weekly update for Malvern Seniors

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29th January 2023

COVID TURNS OUT TO BE JUST ANOTHER WINTER VIRUS

Fall in new daily cases and hospital admissions slowing

COVID booster campaign ends on 12th February 2023

Preamble

For nearly three 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.

For most people, COVID is no longer a critical threat to health so this a shortened version of our weekly update which will continue to be updated weekly, nominally with Sunday's date, for a few weeks more.

Contents

Summary

What happens if you get sick

Booster shots

Number of cases

Number of deaths

Healthcare numbers

Forecast for the week ahead

Longer term outlook

Advice for seniors

Annex/commentary

Summary of links

Bibliography

Menu of archived pages

Summary

In the last week, NHS COVID bed occupancy and daily hospital admissions have begun to fall more slowly in England, while daily deaths, although reported higher, remain 'acceptably' low.

NHS England has issued a final call to come forward for a COVID booster which means that Sunday 12th February will be the last chance for anyone who has been invited for a COVID booster to take up the present offer.

Don't worry too much as further vaccinations for the most vulnerable are likely in the Spring and/or Autumn.

Jump to forecast

What happens if you get sick with COVID

If you are feeling poorly there is now a fair chance it won't be COVID-19 but some other winter respiratory illness; 'bugs and lurgi' of the unknown variety have recently left friends feeling very poorly, sometimes for two to three weeks.

If you have a stash of Lateral Flow Tests you could test yourself at home. However be aware that a negative test does not guarantee you don't have COVID. Whatever the virus best stay at home until you feel better, and wear a face mask to protect others if you do have to go out.

Do not be surprised if you catch COVID because prevalence is still quite high and vaccination, while protecting from severe illness, is unlikely to prevent infection.

The lucky 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.

Some 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.

A small number of patients report debilitating symptoms for months after so-called recovery. For example see Dez Medinger and Danny Altmann's book The Long COVID Handbook in bibliography.

Precautions

Nowadays few people are taking precautions - for many months that has been a personal decision. A few people can still be seen wearing facemasks.

Click to view our advice

Booster shots

In 2022 an Autumn booster shot was offered to all those aged 50+ years and patients designated Clinically Extremely Vulnerable, such as those with a severely weakened immune system. The last chance to be vaccinated in England under this campaign is Sunday 12th February 2023.

JCVI will advise if further boosters are advisable for persons at higher risk of serious illness in 2023.

See Health Secretary's Twitter:

https://twitter.com/SteveBarclay/status/1618336060395626524

Vaccination Sites

Section deleted; if necessary refer to 2022 archived blogs (see menu of archived pages).

Number of cases

The main sources reporting the prevalence of COVID-19 in the UK are:

• The ONS which conducts a weekly random survey by collecting nose and throat swabs from the public for PCR tests, and analysis for variants.

• The ZOE Health Study, whereby participating members of the public log their symptoms, tests and vaccines.

ONS infection survey

ONS estimates that 906,300 people in England tested positive for COVID-19 in the week ending 17th January 2023; a significant fall of 38% on the previous week.

Click for latest Coronavirus (COVID-19) Infection Survey, UK

Prevalence of COVID-19 in England estimated by ONS

Prevalence is estimated 1:55 in Wales; 1:55 in Scotland; and 1:30 in Northern Ireland.

Zoe Health Study

The ZOE Health Study estimates are shown in the following table.

Prevalence of COVID-19 in UK estimated by the Zoe Health Study

According to the more recent Zoe figures, estimated prevalence has fallen by 25% while daily cases may have risen 10% during the last week.

The increase in daily cases correlates with Hospital bed occupancy levelling off in recent days.

Number of deaths

Statistics 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 the daily death rate in real-time probably peaked about 1st January 2023, whereas the delayed ONS figures are still rising.

Note: part of the upturn in ONS deaths this week could be a statistical blip caused by delayed reporting over Christmas and New Year.

PHE figures

The Dashboard chart of COVID (28) deaths, following a positive test, by date of death shows that the 7 day average peaked in England at 164 deaths per day on 30th December before falling to 116 deaths per day on 16th January 2023 (add a further 4 deaths per day for Wales).

The Coronavirus Dashboard chart suggest 30th December marked the peak of Winter Wave deaths.

The PHE figures include people who die with COVID but not from it so are higher than the ONS numbers.

Click to view the UK government Coronavirus Dashboard

ONS figures

The 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 real time by 10 - 14 days due to the administrative delay in submitting and processing reports, 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 ONS data on deaths (Excel spreadsheet)

The ONS figures are broken down by Local Authority providing a glimpse of where deaths are occurring. The provisional cumulative total of COVID related deaths in Worcestershire reported by the ONS up to 13th January (week 2 of 2023) is shown below.

Note: the numbers are now derived from  Table 1 of the ONS Death Registrations spreadsheet using the in-built filters. This gives the provisional total of deaths registered in any week, which can be distorted by delayed reporting, for example, due to public holidays.

Deaths by Welsh Health Boards are excluded to avoid duplication as these are totals of Local authorities.

Death occurrences by 'date of death' is the most accurate metric but takes longer to be confirmed.

Provisional cumulative COVID-19 deaths in Worcestershire registered by ONS to 13th January 2023.

There was 1 death in a care home and 3 in hospital in Bromsgrove; 1 death in a care home and 1 in hospital in the Malvern Hills; 1 death in a hospice in Redditch; 1 death in hospital in Worcester; 1 death at home in Wychavon; and 1 death at home in Wyre Forest.

The general picture has been of a continuing handful of deaths per week in Worcestershire but deaths are up a bit this week.

In England and Wales 919 COVID-19 related deaths were reported in the week to 13th January, 183 more than the week before and a rise of 25%. Of these 159 were in care homes, 55 at home, 25 in a hospice, 676 in hospital and 4 elsewhere.

ONS provisional deaths 'by week reported' in England and Wales since the start of 2022 (so week 53 is week 1 of 2023)

Note: deaths registered during the last two weeks are higher than anticipated and we are not sure why; likely some delayed registrations due to the New Year holiday and nurses strikes; possibly higher mortality due to nurses strikes and colder weather; possibly the average gap between hospital admission and death is longer than we thought.

The figures on the Coronavirus Dashboard of ONS deaths by date on the death certificate show ONS England deaths rose to 714 per week as of 30th December (add 64 for Wales).

That makes about 778 weekly deaths in England and Wales which could represent the peak of the Winter Wave.

In comparison averaged over recent years roughly 1,700 people die daily from all causes in the UK, so currently COVID deaths account for 5% of all deaths.

Many of these are said to be people who die a few months earlier than they would otherwise do so.

Click for ONS Coronavirus (COVID-19) latest insights: Deaths

NHS England figures

Daily COVID hospital death figures in England show some scatter, but charting them suggests the daily death rate peaked about 1st January 2023 and that the daily death rate has since fallen by about 35%.

NHS England figures for Worcestershire

The table below shows the latest COVID deaths in Worcestershire hospitals reported by NHS England on 26th January 2022.

Excludes deaths in care homes, deaths at home and deaths in hospices.

Note: the increase is the difference between this week's cumulative total and that last reported.

The same number of deaths as 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.

Risk of COVID-19 death by age band

NHS 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 still the greatest risk factor; perhaps reflecting that older people have more health problems.

According to the Coronavirus Dashboard sex is an additional risk factor - males are roughly 50% more likely to die than women; possibly because women have a stronger immune system

Healthcare numbers

The UK government Coronavirus Dashboard includes information about healthcare statistics and NHS bed occupancy.

Headline summary of patients in hospital reported on 26th January 2023

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.

Daily admissions had peaked at 992 on the 3rd January 2023 and might just be beginning to level off at around 500 daily admissions.

Possibly this has something to do with either the protection of vaccines wearing off, or new variants in circulation.

See charts on the Coronavirus Dashboard and below.

Bed numbers by region in England

Tabulated figures for COVID bed occupancy in England can be found on the NHS England website providing 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 fell by 6% in England, 9% in London and 9% in the Midlands; a slower fall than previously.

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 had been falling for about 3 weeks but is now showing signs of levelling off.

Note: the peak in beds is usually one week delayed on the peak in daily admissions, and deaths roughly lag beds by a further week.

COVID bed occupancy in England from 1st October to 25th January 2023

Worcestershire hospital beds

Between 17 January and 23 January 2023, 27 patients went into hospital with coronavirus. This shows a decrease of 41% compared to the previous 7 days. There were 49 patients in hospital with coronavirus on 25 January 2023, 27 less 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 Hills

Between 15 January and 21 January 2023, there has been 1 death within 28 days of a positive coronavirus test.

Forecast for the week ahead

We expect COVID related deaths registered in England and Wales to have begun falling from a peak of 780 towards 625 weekly deaths  in week 3 of 2023 to be reported by the ONS on 31st January.

In the county of Worcestershire, based on 27 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 3 COVID deaths per week at the start of February 2023.

NHS COVID bed occupancy in England could level off at about 5,000 beds next week.

Longer term outlook

As far as we can make out the weekly COVID ONS death rate in England and Wales peaked at about 780 on 1st January 2023 roughly coinciding with a peak in hospital bed occupancy.

Since then hospital bed occupancy has almost halved which suggests the weekly death rate could fall towards 450 by early February.

UCL modelling

The latest UCL projection (likely to be updated tomorrow) is that the 7-day average of daily (certified) deaths per day may rise slowly, peaking in late January at around 140 per day or 980 deaths per week.

On present evidence, it looks like the peak in deaths may have come earlier than predicted and, allowing for deaths in Scotland and Northern Ireland, the projection could be about 15% higher than the final figure.

Click for UCL Long-term forecasting of the COVID-19 epidemic

Advice for Seniors

We judge the risk of exposure to COVID-19 has fallen to MODERATE in England, but remember there are many other respiratory viruses circulating that could make you feel just as sick.

See our riskometer opposite.

Many, perhaps most, healthy people are taking the view that COVID is no longer a critical threat to their health.

For the more cautious the simple safeguards to protect against all respiratory infections, are to:

• make sure your COVID and FLU vaccinations are fully up to date (noting the present booster offer expires on 12th February);

• wash your HANDS thoroughly, using soap and hot water, for 20 seconds, including after handling deliveries to your home, to kill virus picked up from contaminated surfaces (see note 1);

• ideally wear either a well fitting FACE covering,  or better still an FFP2 (N95) face mask when in crowded settings for example when in shops, theatres, health-care settings, and when using public transport;

• SPACE at least 2 metres from people you don't feel safe with (see note 2);

• preferably socialise with friends and other households outdoors in the FRESH AIR else, if you are indoors, either ventilate by keeping windows open as far as is practicable or consider putting a HEPA air purifier in the room;

• avoid crowded indoor settings and friends and colleagues with cold and flu like symptoms;

• stay at home to protect others if you yourself feel unwell with cold or flu like symptoms;

• respect others and give them space;

 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, for example filling the car up with fuel, either wash hands with an alcohol based hand gel after touching suspect surfaces or wear gloves.

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 it's highly infectious and vaccines only prevent severe illness.

Annex

Commentary

NHS COVID bed occupancy had been falling quite quickly since the New Year but there are now signs it is levelling off suggesting daily cases may have stopped falling.

Perhaps that's due to an endemic level of residual infection linked to declining protection from vaccines, emergence of new variants, and well vaccinated older people dying being replaced by younger people who have had fewer or no jabs.

 The NHS won't be helped if COVID patients continue to occupy 5,000 hospital beds.

Deaths reported by ONS in the first two weeks of January were higher than expected but we are hoping that was mostly due to delayed registrations over Christmas and New Year.

The offer of Autumn booster vaccinations is being withdrawn after 12th February, but other vaccinations may be offered to those considered especially vulnerable later in the year.

This week's Independent SAGE update (see below) takes a look at mortality statistics. It's worth watching if you are interested in actuarial statistics!

We attended an interesting Malvern Museum talk about Saxon and Norman Malvern last Thursday which was very well attended with many people packed into the hall. Potentially a good test of whether COVID has 'gone away' we thought!

Currently we have seen no evidence COVID remains a problem in Malvern, but do tell us if you think different.

COVID video updates

Links to updates by Professor Tim Spector of the Zoe Health Study, Independent SAGE  and pundit Dr John Campbell can sometimes be found here:-

There have been no recent COVID updates from the Zoe Health Study. Prof Tim Spector seems to have moved on to monitoring other health issues and food science.

Click to watch Independent SAGE weekly update on 27th January 2023

Join Independent SAGE for a discussion on excess deaths, with special guest Stuart McDonald. Prof Christina Pagel and Dr Duncan Robertson will be hosting the session, Prof Anthony Costello chairing and Dr Duncan Robertson also on numbers.

Independent SAGE briefings will be happening every two weeks from now on.

Dr John Campbell raises the question of excess deaths (higher than the average in past years) and asks why no-one is investigating the cause.

Click for video - Excess deaths in 30 countries

List of vaccines

Section deleted. Refer to archived pages for historical information about vaccines.

Summary of Links

Some 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

Symptoms

About COVID symptoms

Note: 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 test

How to get a test

https://www.nhs.uk/coronavirus

About joining the Zoe COVID Symptom Study:

 https://covid19.joinzoe.com

Guidance

UK 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 states

Guidance on UK COVID-19 alert level methodology: an overview

COVID-19 Alert Level lowered to 3 on 10th May 2021

Tiers

Guidance on tiers: what you need to know

Government postcode checker to find tier for other areas

Statistics

UK 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

Reports on COVID intensive care beds - see intensive care national audit and research centre (ICNARC) website

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

A video with Dr John Campbell and mathematician Professor Fenton explaining the various ways in which RISK can be specified.

Risks and benefits with Professor Fenton

Modelling

A 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

Reports

Coronavirus (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.

https://www.medrxiv.org/

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 picture

Worldometer 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

https://covid19.who.int/

Window on the USA

Centre for Disease Control (CDC)

CDC COVID Data Tracker

Find maps and charts tracking cases, deaths, and trends of COVID-19 in the United States.

American Association of Retired People (AARP)

Worcestershire

A 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

COVID Outbreak Control Plan

Click for Simple Summary of Malvern numbers on the Coronavirus dashboard

Miscellaneous

Spanish 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

Bibliography

Woolhouse, Professor Mark, The Year the World went Mad, published 2022 by Sandstone Press Ltd, ISBN: 978-1-913207-94-3

Medinger Dez, Altmann Danny, The Long Covid Handbook, Penguin Books, 2022. Kindle version available.

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The interpretations and opinions expressed are our own