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

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12th February 2023

COVID JUST ANOTHER WINTER VIRUS

Daily cases only slightly higher

Preamble

For almost 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

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

Last week we wondered if another wave of COVID-19 caused by the Kraken variant might roll through the community during February but, so far, this has not proved to be the case.

In the last week, NHS COVID bed occupancy rose only a little, while daily deaths continued to remain 'acceptably' low.

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 temperature/fever it's more likely Flu.

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.

Nowadays, you might not know it's COVID and brush it off as just another cold. The top six symptoms reported through the Zoe app are, sore throat, runny nose, blocked nose, sneezing, headache, and cough.

A few 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 especially women. For example see Dez Medinger and Danny Altmann's book The Long COVID Handbook in bibliography.

Precautions

Nowadays few people are taking precautions - but that may change were the Kraken variant to start spreading rapidly. Keep that facemask handy during February just in case.

Click to view our advice

Vaccination Sites

Section deleted as the Autumn 2022 booster campaign ends on 12th February; if necessary refer to 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 estimated that 874,700 people in England tested positive for COVID-19 in the week ending 31st January 2023; a rise of just 9% on the previous week.

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

Prevalence of COVID-19 in England estimated by ONS

Prevalence was estimated 1:85 in Wales; 1:65 in Scotland; and 1:70 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 risen by 11%, while daily cases have risen 10% in the last 5 days possibly due to the new Kraken variant.

The increase in daily cases detected by Zoe correlates with Hospital bed occupancy rising slightly.

Note: the Zoe numbers were rebased on 3rd February 2023 to better align with ONS figures.

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 Winter Wave death rate peaked around 1st January 2023 and is now falling.

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 around 30th December before falling to 84 deaths per day on 30th January 2023 (add 1 death per day for Wales).

The Coronavirus Dashboard chart suggests 30th December roughly 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 27th January (week 4 of 2023) is shown in the table 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' which can be found in Table 2 of the ONS spreadsheet is a more accurate metric but it takes longer for all the data to be collected.

Provisional cumulative COVID-19 deaths in Worcestershire registered by ONS to 27th January 2023.

There were 2 deaths in hospital in Bromsgrove; 1 death in hospital in Redditch; 1 death at home and 1 in hospital in Wychavon; and 2 deaths in hospital in Wyre Forest.

The general picture has been of a continuing handful of weekly deaths in Worcestershire.

In England and Wales 611 COVID-19 related deaths were reported in the week to 27th January, 169 less than the week before and a fall of 22%. Of these 75 were in care homes, 31 at home, 17 in a hospice, 484 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)

Table 2 of the ONS spreadsheet gives England and Wales figures by date of death. Deaths in week 1 of 2023 registered so far are 788; and 671 in week 2 (incomplete).

Note: assuming 788 deaths per week marks the peak of the Winter Wave then the explanation for 919 provisional deaths reported in the week ending 13th January is likely that the total included 131 reports delayed by the Christmas and New Year holiday.

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

Many of these are said to be people who die a few months earlier than they might otherwise do. COVID is perhaps an extra burden which pushes the very frail over the edge.

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 confirms the daily death rate peaked about 1st January 2023 and that the daily death rate has since fallen by roughly 50%.

NHS England figures for Worcestershire

The table below shows the latest COVID deaths in Worcestershire hospitals reported by NHS England on 9th February 2023.

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.

Worcestershire COVID deaths continue to be a little higher than our projection.

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 9th February 2023

The number of COVID patients in hospital in England has risen a little, while the number of patients on a ventilator fell slightly.

NHS England daily admissions show considerable scatter, but fell to a minimum of about 550 patients per day in the middle of January, since heading upwards towards 750 patients per day. This could be due to the Kraken virus, a sub-variant of Omicron, exported from the USA, which is rumoured to have been replacing BA.5.

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 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 rose by just 5% in England, 5% in London and 6% in the Midlands; slower than might have been expected were the Kraken variant spreading rapidly.

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 COVID bed occupancy rising a little in the last week and then 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 9th February 2023

Worcestershire hospital beds

Between 31 January 2023 and 6 February 2023, 25 patients went into hospital with coronavirus. This shows a decrease of 22% compared to the previous 7 days. There were 41 patients in hospital with coronavirus on 8 February 2023 twelve less than the week before. None on a ventilator.

Click for Summary of Malvern numbers on the Coronavirus dashboard

This link also reports deaths.

Deaths in Malvern Hills

Between 29 January 2023 and 4 February 2023, there were no deaths within 28 days of a positive coronavirus test. 

Forecast for the week ahead

We expect COVID related weekly deaths registered in England and Wales to fall in the range 500 to 600  in week 5 of 2023 to be reported by the ONS on 14th February.

In the county of Worcestershire, based on 25 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 one might expect no more than 2 COVID deaths per week in the second half of February 2023.

NHS COVID bed occupancy in England is expected to remain level 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 788 deaths per week around 1st January 2023 roughly coinciding with a peak in hospital bed occupancy of 9,500.

Hospital bed occupancy is now around 6,382 beds which suggests the ONS could be reporting 525 deaths per week in the second half of February 2023.

UCL modelling

The latest UCL projection is that the 7-day average of daily (certified) deaths per day could fall further to about 50 per day by early March. That is 350 deaths per week.

If we read the charts right, deaths might then slowly rise briefly peaking in late April at 100 deaths per day, or 700 deaths per week.

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

This could suggest an on-going death rate 'involving' endemic COVID-19 of the order of 20,000 deaths per year broadly comparable to deaths linked to Flu.

Note: if the Kraken variant causes daily cases to rise substantially these projections might need to be be revised, but at the present time this has not happened.

Advice for Seniors

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

See our riskometer opposite.

The emergence of the Kraken variant could cause the risk to rise during February, but so far there has been little evidence of this.

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 vaccinations are up to date;

• 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, when using public transport, and travelling by air;

• 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.

Annex

Commentary

In the last week new daily cases have crept up just a little and hospital bed occupancy shows signs of levelling off; so one wonders if the postulated Kraken Wave could be another damp squib. Currently we have seen no evidence COVID is a problem in Malvern, but please do tell us if you think otherwise.

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:-

Prof Tim Spector seems to have moved on to monitoring other health issues, food science and writing books. However last week Tim was back on the air with a short update on COVID.

Click to watch Zoe Health Study video: COVID update + eating plants increases energy by 10%

Else,

Click to watch Independent SAGE update on 3rd February 2023

Join Independent SAGE for a dedicated Public Question and Answer session on all things Covid; mitigation, vaccines, long Covid, immunity, variants, pressure on healthcare and more. With Prof Anthony Costello as chair and Dr Kit Yates on numbers.

Independent SAGE highlights the fact that the Zoe COVID numbers have been rebased to bring them more into line with ONS figures. That is reflected by today's Zoe figures being roughly half those yesterday. However the shape of the charts is the same.

Independent SAGE briefings will be happening every two weeks from now on, but could return to weekly if COVID were to hot up.

Note: crowd funder link deleted - Independent SAGE has reached its fund raising target.

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