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

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12th March 2023

COVID JUST ANOTHER WINTER VIRUS

Daily cases and deaths no longer of great concern

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

The incidence of COVID remains high with about 2% of the population infected at any one time. Hospital admissions appear to be oscillating around 800 patients per day, while NHS England COVID bed occupancy remains around 7,500 beds.

The COVID death rate in England and Wales, which has settled at about 400 deaths per week, remains relatively LOW. During March deaths may rise briefly towards 675 per week, tracking the most recent wave of cases, before lowering.

 Vaccination and natural immunity, following infection, now protect the majority of the population from severe illness and death; while the Wuhan virus has mutated to a less deadly form - the Omicron variant.

Consequently, despite the high prevalence, few people are suffering severe illness, and for most it seems as though the threat from COVID-19 has gone away.

Click to 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 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 closed 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 1,333,400 people in England tested positive for COVID-19 in the week ending 28th February 2023; a rise of just 2% 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 1:45 in Wales; 1:40 in Scotland; and 1:75 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 4% and daily cases by 7% in the last eight days.

Hospital bed occupancy has remained fairly level over the last fortnight broadly reflecting little change in prevalence.

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, has now reached a minimum, following which the death rate could climb a little during March.

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 167 deaths per day around 30th December; marking the peak of the Winter Wave.

Since then deaths fell, and flat-lined at about 90 deaths per day in the fortnight ending 13th February before rising slightly to about 100 deaths per day in the fortnight ending 27th February.

There was little change in the COVID death rate during most of February.

Click to view the UK government Coronavirus Dashboard

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

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)

ONS figures for Worcestershire by date reported

The ONS figures can be filtered 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 24th February (week 8 of 2023) is shown in the table below.

Note: these numbers are 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.

Provisional cumulative COVID-19 deaths in Worcestershire registered by ONS to 24th February 2023.

There was just 1 death in hospital in Wychavon;  and 1 death in hospital in Wyre Forest.

The general picture continues to be of a 'handful' of weekly deaths in Worcestershire.

ONS figures for England and Wales by date reported

In England and Wales 419 COVID-19 related deaths were reported in the week to 24th February, 5 more than the week before and a rise of 1%. Of these 60 were in care homes, 24 at home, 10 in a hospice, 323 in hospital and 2 elsewhere.

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

The cumulative total of 2023 COVID deaths registered by ONS in England and Wales to 24th February is 4,790.

ONS figures for England and Wales by date of death

Table 2 of the ONS spreadsheet gives England and Wales figures by date of death. This is a more accurate metric but it takes an additional two to three weeks for most of the registrations  to flow in; see extract in the table below.

ONS weekly deaths in England and Wales - 'by date of death'

The peak of the Winter Wave appears to be settling at about 811 deaths per week.

Of the 419 deaths reported in week 8, only 328 deaths were in that week. The latter figure will rise as reports of deaths in that week continue to  flow in. Once the total this week is close to the total the previous week, the number 'by date of death' can be considered fairly stable.

Deaths in weeks 7 and 8 look like ending up about 400.

Comparison with deaths from all causes

ONS registered 12,348 deaths from all causes in week 8 in England and Wales so currently COVID deaths are about 3% 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

Averaged over recent years roughly 1,700 people die daily from all causes in the UK.

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 since then the daily death rate has 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 March 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.

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 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 March 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.

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 2% in England, 10% in London, and fell by 3% in the Midlands.

The general picture is that COVID Bed Occupancy has remained fairly static over the last fortnight.

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.

Although COVID bed occupancy is only 25% of that at the peak of the epidemic, it continues to be a significant drain on NHS resources.

The chart below shows how COVID bed occupancy has flat-lined recently.

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

COVID bed occupancy in England from 1st October to 8th March 2023

Worcestershire hospital beds

Between 28 February 2023 and 6 March 2023, 39 patients went into hospital with coronavirus. This shows an increase of 11% compared to the previous 7 days. There were 50 patients in hospital with coronavirus on 8 March 2023 one more than the week before; one on a ventilator.

Broadly there is no great change.

 Click for Summary of Malvern numbers on the Coronavirus dashboard

Forecast for the week ahead

COVID related weekly deaths registered in England and Wales could rise towards 500 in week 9 of 2023 to be reported by the ONS on 14th March.

In the county of Worcestershire, based on 39 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 4 COVID deaths per week in the second half of March 2023.

NHS COVID bed occupancy in England has remained level for a fortnight but could fall a little next week.

Longer term outlook

The weekly COVID ONS death rate (by date of death) in England and Wales peaked at about 811 deaths per week around 1st January 2023 roughly coinciding with a peak in hospital bed occupancy of 9,500.

NHS hospital bed occupancy in England is currently remaining level at about 7,655 beds. Historic cases suggest that during March the ONS death rate may creep up from 400 peaking at about 675 deaths per week before falling back slightly.

The present wave of cases appears to have peaked so hospital bed occupancy should begin falling, but by how much and how fast is impossible to say.

There seems a fair chance that the COVID death rate will remain 'acceptably low' (which we define as below 100 COVID deaths per day) until at least Autumn 2023.

UCL modelling

The latest UCL projection is that the 7-day average of daily (certified) deaths should fall to about 50 per day (350 per week) and peak at around 100 per day (700 per week) about 6th April 2023.

Based upon present trends, that projection looks credible.

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

Advice for Seniors

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

We see no evidence that COVID is currently causing alarming numbers of people in Worcestershire to fall severely ill; so for most, the risk might perhaps now be considered LOW.

Consequently we have taken the plunge and moved our riskometer to LOW for the first time since the pandemic started (see opposite).

Many, perhaps most, healthy people continue to take 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

According to Independent SAGE there was a burst of Flu infections in December which went away as rapidly as it came, whereas COVID-19 continues to circulate with about one million people (roughly 2% of the population) infected at any one time.

We are now hearing of people, fortunately suffering mild illness, who have caught COVID for a second time within 9 months.

Daily hospital admissions in England have been oscillating around 800, roughly within the range 700 to 950, for the last 3 weeks with no clear downward trend.

NHS England hospital COVID bed occupancy has been fairly static at around 7,500 beds over the same period.

Assuming the death rate is proportional to hospital bed occupancy, it's possible the death rate will rise from 400 to about 675 deaths per week in England and Wales, tracking historic cases, and then begin to fall towards the end of March.

There are currently no more than a handful of deaths per week in the whole of Worcestershire, so little to be concerned about.

It is rumoured Spring Boosters may be offered to those aged over 75 years and the very vulnerable, provided it is at least 6 months since their last jab.

Click for government guide to the COVID-19 spring booster 2023

Last Tuesday we watched a documentary about the Spanish Flu of 1918/1919 which was re-broadcast on Freeview PBS America (channel 84).

Click to watch video - The Flu that Killed 50 Million

That was an H1N1 bird flu pandemic that originated in the USA with a mortality rate of about 4%. Very fortunately for us the mortality rate from the COVD-19 pandemic has been an order of magnitude less. Bad yes, but things could have been a lot worse.

The media is now speculating whether a hard lockdown in the UK was necessary. Sweden was an outlier with the government trusting the population to act sensibly - were that the case here possibly Boris Johnson might still be Prime Minister and borrowing considerably reduced!

COVID video updates

Nothing new this week.

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 has moved on to new pastures, monitoring other health issues, food science and writing books, so his work supporting us through the COVID pandemic looks done - thank you Tim, and your team, for all your hard work.

The last Independent SAGE update was on 3rd March and the next one is expected to be delayed to 24th due to pay-related strikes of college staff.

Click to watch Independent SAGE update on 3rd March 2023

Join Independent SAGE for a session on disinformation and how it spreads, with guests Prof Deborah Lupton and Prof Stephan Lewandowsky, hosted by Prof Trish Greenhalgh, Dr Stephen Griffin and Prof Martin McKee, chaired by Prof Anthony Costello; starting with trends and numbers by Prof Christina Pagel.

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