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

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19th March 2023

COVID JUST ANOTHER VIRUS

The numbers are once again trending upwards, so don't be too surprised if you catch a mild dose - much of the population has some form of immunity, either through vaccination or previous infection, protecting from severe illness and death.

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.

Government reporting of COVID figures is being cutback at the end of March 2023 so our blog, which is updated every Sunday, may shrink during coming weeks as data dries up.

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-19 remains quite high with about 2% of the population infected at any one time; there is little indication prevalence is going to falll much below 1 - 2% in the foreseeable future.

In recent days hospital admissions and bed occupancy have begun creeping up. Unsure why, but possibly due to the XBB.1.5 and similar new variants.

By the end of March, the COVID death rate in England and Wales may increase from 500 to 720 deaths per week, which is nothing to be alarmed about. These deaths are baked in - relating to people already infected.

Vaccination and natural immunity, following infection, are protecting most of the population from severe illness and death.

If you catch COVID for a second or even a third time it is likely to be a mild illness, though you might feel quite poorly and be left feeling very tired.

(Definitions: mild = treatable at home; severe = treated in hospital).

Click to jump to forecast

What happens if you get sick with COVID

If you are feeling poorly there is a fair chance it won't be COVID-19 but some other respiratory illness.

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 last reported through the Zoe app were, sore throat, runny nose, blocked nose, sneezing, headache, and cough.

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

Precautions

Click to view our advice

Vaccination Sites

Waiting for information about the Spring Booster Campaign; if necessary you can refer to archived blogs (see menu of archived pages).

Number of cases

The main sources currently 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. This may be paused at the end of March 2023

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

ONS infection survey

ONS estimated that 1,322,000 people in England tested positive for COVID-19 in the week ending 7th March 2023; an insignificant fall of just 1% 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; 1:50 in Scotland; and 1:70 in Northern Ireland.

ONS say:

We will be pausing Coronavirus (COVID-19) Infection Survey data collection from mid-March, and as a result the final weekly publication will be published on 24 March 2023. As the UK Health Security Agency (UKHSA) works to confirm its approach to surveillance, the Office for National Statistics (ONS) plans to work with existing participants to continue gathering valuable insight into the experiences of COVID-19, long COVID and other respiratory infections, details of which will be announced in due course.

This probably translates to - the government plans to cutback and spend less on health surveillance.

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 9% while daily cases leapt by 56% in the last week.

The uptick in daily cases is confirmed by a rise in Hospital bed occupancy.

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 COVID-19 death rate has begun to rise, though not to a level to be concerned about.

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 to about 110 deaths per day in week ending 6th March 2023.

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 3rd March (week 9 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 3rd March 2023.

There was just 1 death in a care home and 1 in hospital in Worcester; and 1 death in hospital in Wychavon.

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 513 COVID-19 related deaths were reported in the week to 3rd March, 94 more than the week before and a rise of 22%. Of these 67 were in care homes, 27 at home, 15 in a hospice, 403 in hospital and 1 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 3rd March is 5,303.

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 have settled at about 812 deaths per week.

Of the 513 deaths reported in week 9, only 296 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 week 8 look like ending up about 450.

Comparison with deaths from all causes

ONS registered 12,539 deaths from all causes in week 9 in England and Wales so currently COVID deaths are about 4% 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

So far there have been 129,470 deaths from all causes in England and Wales in the first 9 weeks equating to 14,385 per week.

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

NHS England figures for deaths

NHS England say the reporting of COVID deaths on the NHS website will cease at the end of the month. Quote:

At the end of March 2023, publication of COVID-19 deaths information on the NHS England website will cease, with the last publication on Thursday 30th March covering data up to 29th March 2023. Similar information on COVID-19 deaths will continue to be published and made available on the Coronavirus Dashboard.

One wonders why the NHS will no longer be directly reporting this data which will find its way into the ONS Dataset - 'Death registrations and occurrences by local authority and health board' (Excel spreadsheet); see above.

NHS England figures for Worcestershire

The table below shows the latest COVID deaths in Worcestershire hospitals reported by NHS England on 16th 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.

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.

Daily hospital admissions in England

This chart of daily COVID hospital admissions and diagnoses shows a long term upward trend since the middle of January 2023.

Daily admissions from 1st October to 15th March 2023

It's possible that daily admissions are near their peak and could soon begin to fall.

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 10% in England, 3% in London, and 10% 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 has unexpectedly crept up in the last week.

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 15th March 2023

Note: the small downward step in the data about day 145 may have been due to correction of over-reporting of COVID cases.

Worcestershire hospital beds

Between 7 March 2023 and 13 March 2023, 41 patients went into hospital with coronavirus. This shows an increase of 5% compared to the previous 7 days. There were 60 patients in hospital with coronavirus on 15 March 2023 ten more than the week before; one on a ventilator.

 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 to somewhere in the range 500 to 600 in week 10 of 2023 to be reported by the ONS on 21st March.

In the county of Worcestershire, based on 41 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 towards the end of March 2023.

NHS COVID bed occupancy in England is uncertain but could rise a tad next week.

Longer term outlook

The weekly COVID ONS death rate (by date of death) in England and Wales peaked at about 812 deaths per week around 1st January 2023 roughly coinciding with a peak in hospital bed occupancy of 9,500.

After dipping, NHS hospital bed occupancy in England has crept back up to 8,434 and could possibly either go higher or reach a plateau close to the present level and then fall.

Historic cases suggest that during March the ONS death rate may creep up towards 720 deaths per week in the next week or two. These deaths are baked in - relating to people already infected.

UCL modelling

The latest UCL projection is that the 7-day average of daily (certified) deaths may peak at over 100 per day (700 per week) about 7th April 2023 and then fall to less than 50 per day for the remainder of the year.

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 remains quite high in England, while there are many other seasonal respiratory viruses circulating that could make you feel just as sick.

There is 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 moved our riskometer to LOW (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

Thursday 23rd March 2023 will be the third anniversary of the first UK COVID Lockdown.

The UK government is no doubt 'tiring' of spending money on health surveillance and will be using this occasion to declare the pandemic well and truly over.

At the end of March reporting of COVID Prevalence will be paused, and NHS England will stop reporting COVID hospital deaths on their website, just at a time when COVID seems to be increasing in the community - it will be interesting to see what Independent SAGE have to say next Friday.

COVID-19 continues to circulate with about 1.3M people (roughly 2% of the population) infected at any one time.

We are currently hearing of local people, suffering mild illness, who have caught COVID for a second time within 9 months, and are left feeling very tired afterwards. Charts show daily hospital admissions in England have been oscillating about a line, trending slightly upwards for the last 6 weeks, which might possibly be linked to the Omicron XBB.1.5. variant nicknamed Kraken.

NHS England hospital COVID bed occupancy, which had been fairly static at around 7,500 beds, has risen a little.

Assuming that the death rate is proportional to hospital bed occupancy, it's possible the death rate could rise towards 720 deaths per week in England and Wales towards the end of March. However, because there are no more than a handful of deaths per week in the whole of Worcestershire, there is little for Malvern Hills residents to be concerned about.

The government has announced Spring Boosters are to be be offered to those aged over 75 years and the very vulnerable; ideally this will be at least 6 months after their last jab.

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

To date we have had 5 jabs roughly spaced at 6 month intervals, which seems rather a lot, and are not particularly keen to have another - as we felt quite poorly after our last booster which was combined with a Flu jab.

Andrew Bridger MP has made himself unpopular by speaking, in the Commons on 17th March, about vaccine side effects and asking about the tradeoff between harm from the vaccines (eg as notified in Yellow Card reports) versus harm from COVID-19.

Dr John Campbell talks on his Youtube channel about MPs walking out when Bridgen gave his speech.

Click for video - Vaccination problems, UK Parliament

You will have to make your own mind up whether or not he is talking any sense.

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