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

11th April 2021

COVID LOCKDOWN in ENGLAND

EXIT STEP 2 on Monday,  CASES DECLINING

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Preamble

We keep an eye on the published government figures and monitor the media to asses the level of risk for Seniors in the Malvern Hills district.

This page is currently updated every Sunday between 1800 and 2400 hours GMT.

Information about Coronavirus can be found on the NHS website:

https://www.nhs.uk/coronavirus

How to request a COVID test (updated)

In order to protect others it is important to book a test and self isolate if you feel unwell with COVID symptoms.

There are now two types of test you can get. The accurate PCR test involving a throat and nose swab which is sent off to a laboratory for analysis and the quicker Lateral Flow test.

Click for government guidance on types of tests

Getting a PCR test

Click the link below for information on how to get a free NHS PCR test if you think you have Coronavirus:

https://www.gov.uk/get-coronavirus-test

In case of difficulty you can try phoning the Coronavirus contact centre by dialing 119.

There is a 'walk through' COVID testing station at County Hall next to the Countrywide Centre; one has been set up at the Worcester Arena car park on the University of Worcester site in Hylton Road to serve the residents of St Johns; and there is also a drive through pod at the Worcester Royal Hospital.

The nearest COVID testing station is on the upper level of the car park below Great Malvern library on the corner of Victoria Road and Como Road.

These are not drop-ins and you will need to book - but there is said to be good availability and you should get the result back in about 24 hours.

Getting a Lateral Flow test (new)

Lateral Flow tests can now be obtained at Great Malvern Library. This test is chiefly intended to screen working people who may be infected but show no symptoms and can either be pre-booked or you can walk in.

Click for WCC info about Lateral Flow Tests

Click for report in Malvern Gazette

About the COVID Symptom Study app (Zoe)

Please consider helping others by downloading the COVID Symptom Study app onto your smart phone or Ipad and reporting how you feel either daily, or as you are able. Note that currently there is no desktop PC version for Windows.

For further details click this link: https://covid19.joinzoe.com

The Zoe app, which is easy to use, allows you to report whether or not you are feeling well and if you have had a test for COVID. This helps Kings College London monitor the spread and symptoms of the disease and give advice to government.

If you have had a jab there are new questions allowing you to enter the vaccine type and any side effects. If you do not see these questions you will need to update the app.

There is also a new mental health questionnaire.

NHS COVID-19 contact tracing app (England)

Release of the NHS COVID-19 contact tracing app for Apple and Android smartphones was announced on 24th September.

Click this link for NHS Coronavirus app information

The app provides a means for warning people who have unknowingly been in the presence of someone who has tested COVID positive

11th April 2021

Summary

Unlike France, it is beginning to feel as though we have turned a corner and the end is in sight. The vaccination programme is on track, the COVID death rate has fallen to a low level, and daily hospital admissions are continuing to fall.

In the last week the incidence of new cases of COVID-19 in the Malvern Hills has fallen to one case per day, so currently the district is almost virus free.

Some of our friends have expressed anxiety about not yet having had their second jab but we have advised them to be patient and wait to be called by their GP surgery. Priority has been switched to giving second jabs to Seniors aged 70+ during April.

STEP 2 out of lockdown begins tomorrow, on 12th April. Then for example you will be able to:-

• eat and drink outdoors such as in a pub garden

• get a haircut

• visit the gym

• visit the library

• go shopping (non essential retail opens)

subject to social distancing and wearing a face-covering when necessary.

Click for BBC article - Countdown to freedom

Click for Easy Read Road Map out of Lockdown

For those interested, a local summary of COVID cases can be found on the Worcestershire Coronavirus Dashboard.

Note: use the arrow <> buttons at the bottom of the Dashboard screen to move between pages.

Click for Worcestershire County Council COVID-19 news

Click to skip to our commentary

Vaccinations

You can see at a glance the percentage of people vaccinated by age group on the Worcestershire COVID-19 Vaccinations Dashboard - the county has been doing very well and a high percentage of those aged 50+ have now had a jab.

Click to view Worcestershire COVID-19 Vaccinations Dashboard

The COVID vaccination programme stepped up a gear with the opening of the mass vaccination centre at The Three Counties Showground.

All those aged 50+ years should have been able to book a jab on-line without having to wait for a call from their GP surgery.  Here is the link:

Click to book a Coronavirus vaccination - NHS (www.nhs.uk)

The target is to vaccinate all those aged 50+ with a first jab by next Thursday (15th April).

If you are housebound and cannot get out you should contact your GP surgery to ask for a home visit.

If you are 50+ and have not had your first jab contact either the NHS or your GP surgery to book an appointment.

If it is 12 weeks since your first jab, and you haven't been offered an appointment for your second jab, contact your GP surgery.

According to the Zoe Symptom Study the vaccine offers no protection for the first two weeks but after 3 weeks most vaccinated individuals have some immunity. Remember that a first jab only offers about 80% protection so you may still become ill though in most cases not seriously.

The bar chart below shows the population of the UK by age band (1), and the number of first (2) and second jabs (3) given, so that you can see overall progress of the vaccination programme in the UK.

Vaccinometer as of 11th April 2021

Total first jabs are reported 32,121,353 to the 11th April. Second jabs are reported 7,466,540.

Priority is now being given to second jabs, and we expect the number of second jabs given to rise towards 15 million by the end of April, which should be enough to cover those aged 70+ and frontline health workers.

You will find information summarised on the Vaccination tab of the Coronavirus Dashboard.

Number of cases

This week the average rate of people testing COVID positive in the UK reported by PHE on the 'Coronavirus Dashboard'  has fallen from 3,764 to 2,629 new cases per day. The chart below shows how the daily rate has varied since 1st September.

UK daily confirmed COVID cases 1st September to 11th April 2021

During the last week the cumulative total of confirmed UK COVID cases reported by PHE rose by about 19,000 to 4,369,775 after a deduction of 8,010 'false positive' Lateral Flow Tests.

In Worcestershire there have now been 33,119 confirmed cases of COVID-19, an increase of 118 on the week.

The breakdown by Worcestershire Lower Tier Local Authorities (LTLA) is shown in the following table, together with comparisons for Herefordshire, a more sparsely populated county, and the city of Leicester.

Note: this week the cumulative cases are copied from the 'Cases by area' (whole pandemic) data set of the Coronavirus Dashboard, while the weekly increase is taken from the Cases by area (last 7 days) data set.

Cumulative cases reported by PHE  in Worcestershire to 11th April 2021

Note: the number of cases has been adjusted for Lateral Flow Test false positives.

Interactive map

At the bottom of the Coronavirus Dashboard (daily update) page there is an Interactive Map which is coloured to show the variation in infection rate across the country. The light green and yellow areas show how the rate of infection has fallen across the UK since the start of the third lockdown.

Click for Interactive Map of COVID cases

Note: the Interactive Map works on desktop PCs but it's possible you may encounter difficulties using a tablet or smartphone.

Weekly cases to 6th April are: North Malvern <3; Malvern Link <3; Pickersleigh <3; Barnards Green <3; Malvern Wells and Priory <3; Callow End and Hanley <3; Upton and Welland <3.

Number of deaths

Statistics on COVID deaths are published by Public Health England, The Office of National Statistics, and NHS England.

PHE figures

Public Health England reports that the cumulative total of COVID (28) deaths in UK hospitals and care homes has risen by 251 in the last week to 127,087 while the daily average appears to have flat-lined at about 35 deaths per day; see chart below which shows the actual daily death rate in red, and our forecast to 16th April in blue.

Daily UK death rate from 7th February to 11th April 2021 in red

Forecast to 16th April in blue

We had expected the daily death rate to fall to 25 so there remains some doubt whether deaths have truly flat-lined or the apparent levelling off has been caused by delayed reporting over Easter.

Click to view the UK government Coronavirus Dashboard

In comparison averaged over recent years 1,700 people die daily from all causes so COVID deaths are now less than 2%.

ONS figures

The Office of National Statistics (ONS) separately reports registered deaths in England and Wales where COVID-19 is mentioned on the death certificate. The ONS figures lag the PHE figures by 10 - 14 days and do not include NI and Scotland.

The ONS figures are broken down by District providing a glimpse of where deaths are occurring. The provisional cumulative total of COVID related deaths in Worcestershire reported by the ONS up to 26th March 2021 (week 12 of 2021) is shown below.

Note: the numbers are from the ONS Death Registrations Pivot Table

Provisional cumulative COVID deaths registered by ONS to 26th March 2021

In England and Wales 719 COVID related deaths were reported by the ONS in the week to 26th March, one third lower than the week before. Of these 128 were in a care home, 71 at home, 18 in a hospice, 492 in hospital and 10 elsewhere.

Note: the more recent PHE numbers suggest the death rate has more than halved since these figures were compiled.

The provisional COVID death toll for all weeks of the epidemic is shown in the following table for England and Wales. (The UK total is about 10% higher as deaths for Scotland and Northern Ireland have to be added).

COVID death toll in England and Wales to 26th March 2021 (source: ONS)

Note 1: based on ONS Registrations pivot table, rather than Occurrences which gives a lower result.

Note 2: in previous weeks we had double counted deaths in Wales by summing rows 9 to 351 of the ONS spreadsheet, which included both LA and Health Board data, rather than 9 - 344 only.

Click for national ONS data on deaths (Excel spreadsheet)

NHS England figures

The table below shows latest COVID deaths in Worcestershire hospitals reported by NHS England to 10th April.

Click for NHS COVID-19 Daily Deaths

The main point to note is the COVID death rate has fallen a long way from its peak and there are currently few deaths in Worcestershire.

Healthcare numbers

The UK government Coronavirus Dashboard includes important information about healthcare statistics.

Headline summary of patients in hospital as reported 11th April 2021

These headline figures show the number of COVID patients in hospital has continued to fall and is now 7% of the peak.

Daily admissions are also falling. In the past, the steady state number of COVID patients in hospital has been roughly ten time the number of patients admitted daily, suggesting a fall to 2,200 patients is on the way.

Last year roughly 10% of new cases were admitted to hospital and of those at least 1 in 5 died.

The latest figures suggest almost 10% of new cases are still being admitted to hospital.

If it is assumed that due to vaccination just 1 in 15 now dies then 220 hospital admissions per day may suggest 15 UK deaths per day by the end of April.

Note: these ratios are very rough and ready and will certainly change as more of the population is vaccinated.

Tabulated figures for  bed occupancy in Worcestershire Acute and Care hospitals can be found on the NHS England website.

It had been quicker to look at a graph at the bottom of the Worcestershire Coronavirus Dashboard homepage which showed at a glance the number of beds occupied by COVID patients in Worcestershire Acute hospitals. This graph was missing this morning so has either been been removed or is being updated.

The main point to note is that the number of Worcestershire COVID beds occupied has fallen steeply.

Click for Worcestershire Coronavirus Dashboard

Click for NHS England COVID-19 Hospital bed Activity

Forecast for the week ahead

Trends suggest that during the next seven days (up to 18th April) the cumulative total of new UK COVID-19 cases reported by PHE on the Coronavirus Dashboard could increase by about  14,000 towards 4,384,000.

In Worcestershire there may be up to 100 new cases of COVID-19, and possibly up to 10 cases in the Malvern Hills district.

We estimate the number of COVID (28) deaths will increase by about 200 nationally towards 127,300 during the 7 days ending 18th April 2021.

In the county of Worcestershire, assuming a 0.7% death rate, the 118 new cases this week should translate to no more than one COVID death per week towards the end of April.

Longer term forecast

It's impossible to provide a longer term forecast due to uncertainty about how much the STEPS out of lockdown and the behaviour of the public will affect the Effective Reproduction Rate of the virus, and how effective the vaccines will be at reducing the transmission of COVID-19.

So far, rapid rollout of the vaccine, frequent testing of school children and their families, hand washing, masks, and physical distancing seems to have kept COVID under control, in most areas.

STEP 2 permits either two households, or groups of up to 6 people to meet outdoors while keeping 2 metres apart, plus allows shopping and eating in outdoor settings - this should be safe providing people do not flout the rules.

COVID rule of six

Pundits are not expecting STEP 2 to make much difference, but are more concerned what will happen after restrictions are eased on 17th May allowing mixing in indoor settings (STEP 3).

However, the vaccine is breaking the link between new cases and both hospitalizations and deaths, so new cases should not be of concern as long as they are not allowed to spiral out of control.

COVID deaths have fallen to a trickle so it is anticipated that the (PHE) UK death toll by the end of April 2021 will be approximately 127,600; see commentary.

Advice for Seniors

The daily number of new  cases of Coronavirus has fallen a long way from the peak so we judge the risk to be LOW for most Seniors in the Malvern Hills district who have been vaccinated more than 3 weeks ago; see our annex and riskometer opposite.

But remember, if you are elderly, have not been vaccinated, and catch COVID there is a significant chance that you will either die or your long term health may be seriously damaged, so continue to take care to protect yourself and those you love. 90% of COVID deaths are in those aged over 60 years according to NHS England statistics.

Click for our risk of death table (for those who have not been vaccinated)

It's possible, despite a first jab, for up to 20% of Seniors to become ill with COVID, though not seriously in most cases, so it makes sense to continue taking reasonable precautions until the epidemic fizzles out.

The simple safeguards to remember are to:

• 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;

• wear a FACE mask when unavoidably near other people for example when shopping, visiting hospital or the chemist, and using public transport;

• SPACE at least 2 metres from people outside your bubble see note 2;

• meet friends and other households outdoors in the FRESH AIR;

• keep TIME near strangers as short as possible, see note 3;

• self-isolate and book a test if you have COVID-19 symptoms (new continuous cough, fever or loss of, or change in, sense of smell or taste).

Hence the PMs new mantra:-

 HANDS, FACE, SPACE, FRESH AIR

Pulse Oximeter

A doctor in Bournemouth speaking on the evening news suggested that if you were sick with COVID at home it would be a good idea to have a little device known as a Pulse Oximeter handy (see photo on right). This measures the oxygen saturation in the blood and pulse rate by clipping the device on a finger and pressing a button; the reading should normally be at least 97%.

If the reading falls to about 93% you should call your doctor for advice, and if the reading is consistently below 92% you should consider calling an ambulance or visiting A&E.

Pulse Oximeters can be purchased from Amazon for £18 to £25; alternatively your doctor's surgery might loan you one if you are unwell and have tested COVID positive.

Hopefully you will have been vaccinated and won't need one now!

Remember, if you have symptoms of COVID-19 at home and can't count from one to ten out loud due to shortness of breath, you should immediately call your GP, 111 or 999 for advice.

Click for UK government Coronavirus guidance on what you can and cannot do

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 use hand gel.

2) Two metres is further than you think - roughly an arm and a walking stick away.

3) During lockdown STEPS 1 and 2 you should not mix with other households indoors.

Minimise exposure time if you unavoidably find yourself mixing in a confined setting - an invisible mist of virus can build up in the air if the space is shared with an infectious person; imagine people exhaling cigarette smoke. Unless you wear a well fitting FFP3 hospital grade face mask you can breath this in; a face covering will offer little protection. The likelihood and extent you get sick will depend on both the density of the airborne virus, which can be reduced by opening windows, and the duration of your exposure.

This advice is mirrored by Japanese advice to avoid the three Cs, see poster below:

• Crowded spaces with poor ventilation

• Crowded places with many people nearby

• Close-contact settings such as close range conversations

COVID advice in Japan

Night clubs, crowded pubs and (student) parties are high risk.

Annex to 11th April update

Commentary

On Monday 5th April the PM gave a press briefing confirming England would move to STEP 2 of the exit from lockdown on 12th April.

Click for press release on further easing of Covid restrictions

Froth in the media about vaccination passports continues. There should be a government statement next week about prospects for overseas travel.

On Tuesday it was announced the trial of the Astrazeneca vaccine on children would be paused while data on blood clots was reviewed.

Initial estimates suggest the vaccine reduces person to person transmission by about 60%.

On Wednesday the delivery of 5,000 Moderna vaccine to Wales was announced; the vaccine has also been used in Glasgow.

The EU Medicines Agency held a press conference to say that the Astrazeneca vaccine was safe but that blood clots should be listed as a rare side effect.

PHE and MHRA held a UK press conference, drawing a similar conclusion. In consequence, based on balance of risk versus reward, the JCVI recommends the Pfizer and Moderna vaccines should be offered as an alternative to those aged under 30 years.

Click for press release on new advice

On Friday the media turned their attention to the death of Prince Philip, Duke of Edinburgh.

The Zoe COVID Symptom Study people assess the daily infection rate has fallen to about 1,700 new cases per day.

It appears to us, in many areas, COVID is fizzling out while 'warm spots' remain in parts of the Midlands, the North and Scotland which is making it difficult for SAGE to quote a figure for the Reproduction Rate of the virus. It doesn't matter - the authorities just need to 'work on' those areas where the virus is still present.

Vaccines (from last week)

Getting vaccinated

Colin related his experience of getting vaccinated at The Three Counties Showground:

I was in and out of the showground facilities in just 12 minutes - and that included them checking my name and booking number four times! Most people arrive by car, but it's equally easy to arrive by bicycle or walk in.

Afterwards they ask you to wait in the car park for 15 minutes to make sure there is no immediate adverse reaction.

To make it more comfortable they have thoughtfully provided benches, a coffee truck and a little mobile van decked out as a corner shop!

They use the Oxford Astra-Zeneca vaccine there. The needle itself was inconsequentially tiny and I barely felt it. But I'm generally a bit susceptible to anything that's going around, and I had to take the next day off as I collected the full set of common side effects - I was tired, feverish and unable to think clearly; Paracetomol didn't really help this.

The next day I was pretty much back to my normal self. But I'm the only person I know who has had this reaction - my friends were unaffected other than a sore arm; I suppose it shows that my immune system is working.

And now I feel like I've joined everyone else on our journey out of this strange world. Although we've been suffering comfortably here in Malvern, it has prompted me to think about where we want to visit (in the UK) when the leash loosens. I should write a list!

Colin's experience is not unusual, friends have also mentioned feverishness, headaches, aches and pains, and nausea, whilst we just felt very tired.

Advice: be prepared to take the next day off following your jab.

Volunteering

Another friend has written in the Guarlford and Madresfield Parish Magazine, 'The Grapevine' about volunteering for vaccination clinics. Click on the link below and then go to page 6.

A day in the life of a volunteer

We found the remarks about 'herding' the elderly amusing.

List of vaccines

Here is the list of vaccines ordered by the UK -  you will see there is plenty of vaccine in the pipeline for delivery later in the year.

Table of vaccines ordered by the UK government

Present rate of new cases

This week, the average rate of infection per 100,000 population per week in England fell from 47 to 29. In comparison the figure for Worcestershire is 20, and that in the Malvern Hills 6.

The probability of catching Coronavirus in the Malvern Hills district is now low, and as most Seniors have been vaccinated we judge the risk LOW.

The risk of death from Coronavirus for unvaccinated healthy teenagers is small so for them the risk is also LOW. The middle aged can suffer from debilitating Long COVID so for those that have not been vaccinated and live in an area where rates are not falling the risk might be judged LOW to MODERATE.

Forecast of death toll to the end of April

The rolling 7 day average death rate was 36 deaths per day on 11th April. Assuming the death rate falls linearly to 15 deaths per day by the end of April, another 484 deaths can be expected which suggests the UK COVID-19 death toll could be heading towards 127,600 by the end of the month.

Forecast UK COVID-19 epidemic death toll by the end April 2021

Another 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

The latest projection is for 150,000 deaths by the end of April which is likely to be similar to the figure reported by the ONS.

At the start of the epidemic in March the Chief Scientific Adviser, Sir Patrick Valance, suggested a death toll of 20,000 would be a good outcome; on the other hand, Professor Neil Ferguson of Imperial College warned in some scenarios the death toll might be as high as 250,000; while we thought, in the very worst case assuming up to 1% of the UK population died the outcome might have been nearer 400,000 taking into account some build up of herd immunity.

So how well will the UK have done? When Sir Patrick Valance spoke off the top of his head there had been few deaths and he clearly did not want to 'scare the horses'. Professor Neil Ferguson was nearest the mark. A few might consider an outcome of 127,600 deaths a fair result compared to a greater number of people dying in a very short space of time, more being permanently disabled by Long COVID, and temporary collapse of the NHS. Members of the Labour Party and others will no doubt say the UK has done very poorly compared to the best performing countries such as Australia, New Zealand and Singapore where deaths have been much lower, not to mention the enormous expense of supporting those out of work and huge damage to the economy. But, worldwide, this pandemic is not played out and it could be a further 1 to 2 years before the 'dust' finally settles.

At the appropriate time there will no doubt be a full inquiry to learn lessons for the future.

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Summary of Links

Symptoms

About COVID symptoms

Article about the effects of 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

Tiers

Guidance on tiers: what you need to know

Government postcode checker to find tier for other areas

Statistics

UK government Coronavirus Dashboard

Coronavirus Dashboard Interactive Map

ONS data on deaths in England and Wales (Excel spreadsheet)

NHS England COVID-19 Daily Deaths

NHS England COVID-19 Hospital Admissions

NHS England vaccination statistics

Worcestershire Coronavirus Dashboard

Worcestershire COVID-19 Vaccinations Dashboard

Reports

ONS Coronavirus (COVID-19) Roundup

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)

American Association of Retired People (AARP)

Worcestershire

Help:

http://www.worcestershire.gov.uk/here2help

Worcestershire County Council COVID-19 information:

http://www.worcestershire.gov.uk/coronavirus

Here you will find a useful link,

'Website: Number of new cases by date in Worcestershire'

which displays interesting COVID charts and statistics for Worcestershire

COVID Outbreak Control Plan

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

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

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The interpretations and opinions expressed are our own