Angus and Rosemary's Miscellany

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

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.

There is talk of updating the app to show vaccination status.

9th May 2021

Summary

Little has changed in the last four weeks. The vaccination programme is on track, and the COVID death rate has fallen to a low level, as has daily hospital admissions.

There is increasing optimism that things will soon get back to near normal in the UK, whereas in other parts of the world, such as India, things are going to get a lot worse before they get better.

England continues in STEP 2 out of lockdown permitting for example:

two households to meet outdoors
groups of up to six to meet outdoors
eating and drinking outdoors such as in a pub garden
getting a haircut
visiting the gym
visiting the library
going to the zoo
going shopping (non essential retail opens).

Subject of course to social distancing and wearing a face-covering when necessary.

The Prime Minister is expected to give a press briefing on Monday announcing the move into STEP 3 on 17th May

Click for BBC article - Countdown to freedom

Click for Easy Read Road Map out of Lockdown

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.

Click to view Worcestershire COVID-19 Vaccinations Dashboard

There is a mass vaccination centre at The Three Counties Showground.

The next target is to vaccinate all those aged 18+ with a first jab by the end of July.

Those aged 40+ years can now 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)

Alternatively you can wait to be contacted by your GP surgery - this may either be by a phone call, or a text message on your mobile.

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

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.

COVID vaccination bar chart

Vaccinometer as of 9th May 2021

Total first jabs are reported 35,371,669 to the 9th May. Second jabs are reported 17,669,379.

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

Vaccinations Worldwide

A glimpse of the worldwide vaccination situation can be found on the Our World in Data website.

Click for worldwide statistics

There are many charts which some may find confusing, but look for the chart showing share of people who have received at least one dose of COVID-vaccine.

Click for chart showing % vaccinated

Recent figures were UK 51%, Germany 28%, France 23%, while surprisingly India and Russia are only 9% vaccinated.

Number of cases

This week the average rate of people testing COVID positive in the UK reported by PHE on the 'Coronavirus Dashboard' has roughly flat-lined at 2,000 cases per day. The chart below shows how the daily rate has varied since 1st September.

COVID daily new cases

UK daily confirmed COVID cases 1st September to 9th May 2021

The chart below shows in more detail how daily cases have varied between 1st March and the 9th May.

Daily COVID cases to 2nd May 2021

The chart suggests cases could rise a tad next week.

During the last week the cumulative total of confirmed UK COVID cases reported by PHE rose by 14,659 to 4,434,860.

In Worcestershire there have now been 33,424 confirmed cases of COVID-19 an increase of just 50 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: the cumulative cases are copied from the 'Cases by area' (whole pandemic) data set of the Coronavirus Dashboard. The weekly increase is calculated by subtracting last week's total from this week's.

Districts of Worcs	Cases	Weekly increase	Population
Bromsgrove	6,259	+6	98,529
Malvern Hills	2,797	+4	77,545
Redditch	6,236	+11	85,317
Worcester	6,110	+11	103,542
Wychavon	6,442	+9	126,240
Wyre Forest	5,580	+9	100,957
TOTAL	33,424	+50	592,130
COMPARE WITH
County of Hereford	7,089	+52	195,000
Leicester (city of)	36,890	+130	400,000

Cumulative cases reported by PHE in Worcestershire to 9th May 2021

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.

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.

New cases in Worcestershire are currently too low to register on the map.

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 67 in the last week to 127,605 while the daily average has fallen from 16 to 10 deaths per day.

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 1%.

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 23rd April 2021 (week 16 of 2021) is shown below.

Note: the numbers are from the ONS Death Registrations-Pivot table

Districts of Worcs	Deaths 2020	Deaths 2021	Week 16	Population
Bromsgrove	164	101	1	98,529
Malvern Hills	61	83	0	77,545
Redditch	108	84	0	85,317
Worcester	87	114	0	103,542
Wychavon	157	118	1	126,240
Wyre Forest	171	104	2	100,957
TOTAL	748	604	4	592,130

Provisional cumulative COVID deaths registered by ONS to 23rd April 2021

In England and Wales 258 COVID related deaths were reported by the ONS in the week to 23rd April; 102 lower than the week before, a fall of 28%. Of these 46 were in a care home, 39 at home, 6 in a hospice, 164 in hospital and 3 elsewhere.

The provisional COVID death toll for all weeks of the epidemic is shown in the following table for England and Wales.

Year	Provisional COVID UK death toll in England and Wales
2020	80,741
2021	56,746
TOTAL	137,487

COVID death toll in England and Wales to 23rd April 2021 (source: ONS)

Note: summation of rows 9-344 of ONS Registrations-Pivot Table spreadsheet tab.

The UK death toll is about 10% higher as deaths for Scotland and Northern Ireland have to be added.

Click for national ONS data on deaths (Excel spreadsheet)

The death toll based on death certificates is about 20% higher than deaths within 28 days reported by PHE.

NHS England figures

The table below shows latest COVID deaths in Worcestershire hospitals reported by NHS England to 8th May.

Worcestershire	Cumulative deaths	Weekly increase
Acute hospitals	806	+1
Care hospitals	63	0
TOTAL	869	+1

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 if any weekly deaths in Worcestershire.

Healthcare numbers

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

Hospital cases (UK)	Number	Weekly change
Patients currently in hospital	1,152	-299
Patients on ventilation	163	-22
Patients admitted daily	101	-59

Headline summary of patients in hospital as reported 9th May 2021

In the past, the steady state number of COVID patients in hospital has been roughly ten time the number of patients admitted daily, suggesting the number of COVID patients in hospital could drop to 1,000.

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

The latest figures suggest about 7% of new cases are being admitted to hospital.

If it is assumed that due to vaccination just 1 in 10 now dies then 101 hospital admissions per day may suggest up to 10 UK deaths per day towards the end of May.

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.

Click for NHS England COVID-19 Hospital bed Activity

You can also obtain a snapshot of bed occupancy from the Coronavirus Dashboard daily update page, by entering your postcode at the bottom of the page, which will show data for Worcestershire; then find and click All Health Data to see bed occupancy. This information has returned to the Worcestershire Coronavirus Dashboard.

Click to view Worcestershire Coronavirus Dashboard.

Recently there have been 5 COVID patients in Worcestershire Acute Hospitals of which none were on ventilators.

The main point to note is that the number of Worcestershire COVID beds occupied has fallen steeply from the peak of about 300.

Forecast for the week ahead

Trends suggest that during the next seven days (up to 16th May) the cumulative total of new UK COVID-19 cases reported by PHE on the Coronavirus Dashboard could increase by about 14,500 towards 4,449,500.

In Worcestershire there could be 50 new cases of COVID-19, and possibly up to 8 cases in the Malvern Hills district.

We estimate the number of COVID (28) deaths will increase by about 50 nationally towards 127,655 during the 7 days ending 16th May 2021.

In the county of Worcestershire, assuming a 0.7% death rate, the 50 new cases this week should translate to no more than one COVID death per week in the second half of May.

Longer term forecast

Commentators suggest that the UK is approaching herd immunity due to both the success of the vaccination programme and immunity of those who have already been infected by COVID-19. Infections are therefore likely to continue at a low level with occasional localised flare ups. But remember many of those aged under 50 years have yet to be vaccinated so the public should remain cautious until towards the end of June.

The only potential threat is of foreign 'new variants of concern' against which the present vaccines are less effective, and scientists are working on booster jabs to guard against that threat.

Advice for Seniors

COVID risk high 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 were to 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 second jab, for a small percentage Seniors to become ill with COVID, though not seriously in most cases.

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

The three Cs - Covid advice in Japan

COVID advice in Japan

Annex to 9th May update

Commentary

For a fourth week there has been little of significance to report concerning the situation in the UK. Hospital admissions and the COVID death rate are at a low level, and pundits are not expecting a fourth wave of any significance.

On Friday morning Prof Van Tam gave a press briefing on the vaccination programme. Those aged under 40 will now be offered an alternative to the Astrazeneca jab, eg Pfizer or Moderna, where available, providing the vaccination programme is not slowed.

On Friday afternoon Grant Shapps gave a press briefing about the easing of travel restrictions after 17th May. There did not appear much to celebrate. Telve countries were expected to be on the green list including Portugal, Gibraltar and Irael; he did not name the others. Turkey, the Maldives and Nepal had been moved to the red list. Spain, Italy and France are on the amber list requiring quarantine on return to the UK.

Australia, New Zealand and Singapore may be on the green list but if you are able to go there you will probably have to quarantine on arrival.

Overseas travel

It is currently illegal to travel abroad for holidays but after 17th May 2021 you should be able to visit countries on the green list without having to quarantine on return.

Click for present guidance on travel during the COVID pandemic

The PM said a report by a task force would be produced by 12th April outlining prospects for overseas travel in the summer. Progress to date was outlined by Grant Chapps MP and the Department of Transport on 9th April.

Click for press statement - Global Travel Taskforce sets out framework to safely reopen international travel

Click for Report of the Global Travel Taskforce - The Safe Return of International Travel

It's all rather complicated but in essence you will need to get a COVID test before return to the UK and following arrival. If you return from a green list country you are free to circulate if the tests are clear. If you return from an amber list country you must quarantine for ten days and take two COVID tests. If you arrive from a red list country you must quarantine for ten days in an approved government hotel.

The countries allocated to the red, amber and green lists should be published next week.

Click for BBC report on countries likely to be on green list

The cost of getting tests could yet be a significant burden on holiday-makers, who may also have to provide evidence of vaccination for example by either providing a vaccination certificate or by means of an app on their smartphone.

Essential business travel remains possible subject to quarantine regulations.

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.

COVID-19 vaccine	Doses ordered (million)	Status
Pfizer BioNTech, two dose, -70 deg C	40+60	Approved, deliveries continuing, made in Belgium (EU). An additional 60M doses have been ordered for booster shots for the most vulnerable in the autumn.
Astrazeneca, two dose, fridge	100	Approved for those aged 30+ years; deliveries continuing. Batches made in UK, Belgium and India.
Moderna, two dose, -20 deg C	7+10	Approved. First deliveries to Wales and Scotland 7th April 2021 then England 13th April; mainly for those aged under 50 years awaiting vaccination.
Valneva, two dose	60+40	A jab from French company Valneva will be made in Livingston, West Lothian, Scotland. Delivery to start in second half of 2021.
Janssen, single dose	30	A jab from Belgian firm Janssen, owned by Johnson and Johnson; phase III trials complete. Approved for use in the USA and EU; possibly available in UK from May.
Novavax	60	A jab manufactured by US firm Novavax is being made in Stockton-on-Tees UK; phase III trials complete, awaiting approval. Should be available later this year. Glaxo Smith Kline (GSK) has been contracted to fill and package vials.
GSK Sanoft	60	Some delay due to adjusting the formula to give better protection to the elderly; possible availability late 2021.
Curevac	50	Contract placed with German company Feb 2021. Possible source of new variant vaccine later in 2021

Table of vaccines ordered by the UK government

Present rate of new cases and risk

This week, the average rate of infection per 100,000 population per week in England fell from 23 to 21. In comparison the figure for Worcestershire is now 12, and that in the Malvern Hills 10.

The probability of catching Coronavirus in the Malvern Hills district is now very 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 areas where rates are falling more slowly the risk might be judged LOW to MODERATE.

About the final UK COVID-19 death toll

At the start of the epidemic on 17th March 2020 the Chief Scientific Adviser, Sir Patrick Valance, questioned by the Health Select Committee, did not disagree with Jeremy Hunt's suggestion that a death toll of 20,000 might be a reasonable outcome.

Click for Youtube video of Coronavirus: Health Committee questions Government Chief Scientific Adviser and NHS England 17 March 2020

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 Jeremy Hunt and Sir Patrick Valance spoke there had been few deaths and they clearly underestimated what was to come. Professor Neil Ferguson was nearer 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, temporary collapse of the NHS and patients dying at home or queued in ambulances outside hospitals. You have only to look at the situation in India to imagine what could have happened.

Members of the Labour Party and others will no doubt say the UK has done 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.

With hindsight, deaths might have been much lower if the second lockdown had been continued into December and January, but that would have meant cancelling Christmas, and who knows to what extent the public would have complied.

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.