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.

NHS app

You will need the NHS app installed on your smartphone and be registered with the NHS in order to display your vaccination status.

Note: this is not the NHS COVID-19 app

20th June 2021

Summary

The PM has announced that exit from Lockdown in England will be postponed to 19th July to allow more of the population to be vaccinated in order to reduce transmission of the Delta variant of COVID-19.

The surge of the fourth wave of COVID-19 cases, which began about 14th May, has slowed in the last week and we predict the rolling average of daily cases in the UK will follow a bell shaped curve reaching a maximum of 11,000 new cases per day, within the next ten days, and then falling, see long term forecast.

For the time being life appears very much back to normal in the rural Malvern Hills, despite new cases beginning to rise in Worcestershire.

Click for guidance on what you can and cannot do

Remember that, though we are being offered new freedoms, it is our decision how cautious to be.

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 for Simple Summary of Malvern numbers on the Coronavirus dashboard

Click to go to our annex/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

Adults aged 18+ can now book a jab on-line without having to wait for a call from their GP surgery.

Note: there is a mass vaccination centre at The Three Counties Showground.

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.

Extension of vaccination to children aged 12+ may follow in the summer, but no decision has yet been made.

Two jabs are thought necessary to protect against the Delta variant of COVID-19.

Protection is not 100% so some vaccinated Seniors may become ill, though not seriously in most cases.

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 20th June 2021

Total first jabs are reported 42,964,013 to the 20th June. Second jabs are reported 31,340,507.

In comparison the population of the UK, including children, is about 66,000,000

You can find this 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

Hint: click TABLE tab to see more countries.

Vaccination programmes in the EU are ramping up. The share of people who have received at least one dose to 17th June are Germany 50%, Belgium 53%, Spain 48%, Italy 51% and France 46%. In comparison 62% of the UK population (including children) has received at least one dose.

India 16%, Russia 13% and Japan, 16% are lagging behind, whilst in Africa few have been vaccinated.

Number of cases

During the last week the average rate of people testing COVID positive in the UK reported by PHE on the 'Coronavirus Dashboard' rose from 7,145 new cases per day to 9,248. The chart below shows broadly how the daily rate has varied since 1st September.

COVID daily new cases

UK daily confirmed COVID cases 1st September to 20th June 2021

The chart below shows in more detail how daily cases have varied between 1st March and the 20th June. Most cases now are in those aged under 30 years.

Daily COVID cases to 2nd May 2021

UK daily new confirmed COVID cases 1st March to 20th June 2021

It is reassuring that the acceleration in daily cases has slowed over the past ten days suggesting measures to contain the virus are working.

During the last week the cumulative total of confirmed UK COVID-19 cases reported by PHE rose by 64,227 to 4,630,040.

In Worcestershire there have now been 34,170 confirmed cases of COVID-19 an increase of 219 on last week. The number of daily cases has risen from 21 to 31.

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 the difference between this week and last week's total.

Districts of Worcs	Cases	Weekly increase	Population
Bromsgrove	6,417	+64	98,529
Malvern Hills	2,876	+28	77,545
Redditch	6,361	+21	85,317
Worcester	6,307	+38	103,542
Wychavon	6,540	+37	126,240
Wyre Forest	5,669	+31	100,957
TOTAL	34,170	+219	592,130
COMPARE WITH
County of Hereford	7,341	+79	195,000
Leicester (city of)	38,786	+426	400,000

Cumulative cases reported by PHE in Worcestershire to 20th June 2021

The weekly increase is indicative; the seven day average by area, which varies day to day, is an alternative metric that can be found on the Coronavirus dashboard.

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 map shows that, in addition to hot spots, infection rates have been creeping up across the UK.

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.

While new cases in Malvern are currently too low to register on the map, except Pickersleigh, it just seems a matter of time before 'ripples of the fourth wave' are imported from outside Worcestershire. However this should be nothing to worry about as vaccination levels are high, apart from children and teenagers.

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 72 in the last week to 127,976 while the daily average has increased only slightly from 9 to 10 deaths per day.

UK COVID death rate

COVID-19 death rate 1st April to 20th June 2021

Click to view the UK government Coronavirus Dashboard

In comparison averaged over recent years 1,700 people die daily from all causes.

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 Northern Ireland and Scotland.

Click for national ONS data on deaths (Excel spreadsheet)

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 4th June 2021 (week 22 of 2021) is shown below.

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

Districts of Worcs	Deaths 2020	Deaths 2021	Week 22	Population
Bromsgrove	164	101	0	98,529
Malvern Hills	61	83	0	77,545
Redditch	108	85	0	85,317
Worcester	87	116	0	103,542
Wychavon	157	119	0	126,240
Wyre Forest	171	106	1	100,957
TOTAL	748	610	1	592,130

Provisional cumulative COVID-19 deaths registered by ONS to 4th June 2021

In the last week reported there has been only one COVID-19 death, in hospital in Wyre Forest.

In England and Wales 98 COVID-19 related deaths were reported by the ONS in the week to 4th June; 3 more than last week, suggesting the COVID death rate may be beginning to turn up slightly. Of these 9 were in a care home, 19 at home, 1 in a hospice, 66 in hospital and 3 elsewhere.

Note: summation of rows 9 to 339 of the ONS deaths Registrations-Pivot table.

The provisional UK COVID-19 death toll (as reported by PHE and ONS) for all weeks of the epidemic can be found on the Deaths tab of the Coronavirus Dashboard.

NHS England figures

The table below shows latest COVID deaths in Worcestershire hospitals reported by NHS England to 19th June.

Worcestershire	Cumulative deaths	Past week
Acute hospitals	808	0
Care hospitals	63	0
TOTAL	871	0

Click for NHS COVID-19 Daily Deaths

Healthcare numbers

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

Hospital cases (UK)	Number	Change since last week
Patients currently in hospital	1,316	+227
Patients on ventilation	210	+56
Patients admitted daily	226	+39

Headline summary of patients in hospital as reported 20th June 2021

The daily number of hospital admissions expressed as a 7 day average fell to 100 about 20th May but has crept up to 206 and can be expected to increase further in proportion to the rise in daily cases. If roughly 2,000 case per day last month led to 100 daily admissions, then the recent 10,000 cases per day could see daily admissions rising towards 500.

In the past, the steady state number of COVID patients in hospital has been roughly ten time the number of patients admitted daily, so we could see the number of COVID patients in hospital rising towards 5,000 and then falling as the fourth wave is suppressed.

If it is assumed that due to vaccination just 1 in 15 of those admitted to hospital now dies then 206 hospital admissions per day suggests the COVID daily death rate could rise to 14 in July and then fall as the fourth wave is suppressed.

Note: these ratios are very rough and ready and should 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

An easy to read summary can be found on the Worcestershirfe Coronavirus Dashboard.

Click to view Worcestershire Coronavirus Dashboard.

Recently there have been 6 COVID patients in Worcestershire Acute Hospitals of which one was on a ventilator.

The main point to note is that the number of Worcestershire COVID-19 beds occupied is very much lower than the peak of about 300 beds.

Forecast for the week ahead

Trends suggest that during the next seven days (up to 27th June) the cumulative total of new UK COVID-19 cases reported by PHE on the Coronavirus Dashboard could increase by up to 70,000 towards 4,700,000.

In Worcestershire about 250 new cases of COVID-19 can be expected, and possibly 30 cases in the Malvern Hills district.

We estimate the number of COVID (28) deaths will increase by about 77 nationally towards 128,050 during the 7 days ending 27th June 2021.

In the county of Worcestershire, assuming a 0.3% death rate, the 219 new cases this week should translate to no more than three COVID deaths per month in July.

Longer term forecast

When the Alpha (Kent) variant was predominant commentators suggested that the UK could be approaching herd immunity due to both the success of the vaccination programme, and immunity of those who had already been infected by COVID-19.

The flare up of cases in the north, caused by the more transmissible Delta variant, indicates a higher level of vaccination is needed to counter a Reproduction Rate of 6 to 7.

The bell shaped chart below, based on a logistic function, shows how future UK daily cases might vary as surge testing and the ramping up of vaccinations dampens the fourth wave of the virus during the remainder of June and July.

COVID cases forecast

Actual and projected UK daily cases to 31st July 2021

A ripple of cases amongst unvaccinated children and teenagers in early August cannot be ruled out once restrictions cease.

Advice for Seniors

COVID risk high The daily number of new cases of Coronavirus in the Malvern Hills district remains fairly low and as most Seniors should have had 2 jabs we judge the risk for most to be LOW; 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 get both doses of your vaccine and continue to take care of yourself and those you love. Last year, 90% of COVID deaths were 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 some Seniors to become ill with COVID-19 though for most, except the frail, this is likely to be a mild illness with symptoms akin to Hay Fever.

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;
preferably meet friends and other households outdoors in the FRESH AIR, else keep the windows open if you are indoors;
minimise TIME near strangers;
self-isolate and book a test if you have COVID-19 symptoms (the top five symptoms amongst the vaccinated are now said to be headache, runny nose, sore throat, sneezing and persistent cough).
keep away from areas where the infection rate is known to be high.

Hence the PMs mantra:-

HANDS, FACE, SPACE, FRESH AIR

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) If possible keep windows and doors open to improve ventilation when meeting others.

Annex to 20th June update

Commentary

On Monday the PM announced that Step 3 of the exit from lockdown in England would be extended by 4 weeks to 19th July.

Click for PM statement at coronavirus press conference: 14 June 2021

During this time the plan is to finish double jabbing around two thirds of the adult population which would mean increasing the number double jabbed from 30M to 35M; we estimate this could be accomplished with only 132,000 jabs per day, half the present number.

Also to offer a first vaccination to all those aged 18+ by 19th July rather than the end of July. 42M are single jabbed to date and 54M are 18+, so in theory first vaccinations may need to be increased to 300,000 jabs per day (nearly double the present number).

The Welsh Health Minister said all adults in Wales had already been offered a first jab. We think this has been done by using all the vaccine allocated, whereas in England some vaccine is held in reserve for deployment to hot spots etc.

On Wednesday the BBC reported that Covid vaccination could become compulsory for care home staff looking after the elderly in England.

There was speculation in the media that the government has 50M Astrazeneca doses stockpiled and is receiving deliveries of 1.5M doses of Pfizer and Moderna vaccine per week. This suggests to us a proportion of younger age groups may need to be vaccinated with Astrazeneca if targets are to be met.

On Thursday Italy announced visitors from the UK would have to quarantine for 5 days and pass a COVID test from next Monday irrespective of vaccination status in order to keep out the Delta variant.

Click to watch Tim Spector's weekly Zoe COVID update on YouTube

Overseas travel

The situation is becoming increasingly confused as both the UK and other nations change the rules.

If you are worried about having to change plans or getting on a busy flight it might be best to take your holiday in the UK this year.

List of vaccines

Here is the list of vaccines ordered by the UK - a shortage of vaccine has been limiting the vaccination rate in the UK, while plenty of vaccine is on order 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	20	Approved, a jab from Belgian firm Janssen, owned by Johnson and Johnson; UK approval 28th May. Order reduced from 30 to 20M.
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

The average rate of infection per 100,000 population per week in England has risen from 64 to 85 while in comparison the figure for Worcestershire has risen to 30 and the Malvern Hills from 5 to 21.

As a yardstick we suggest a figure of below 10 can be considered LOW.

Areas of high infection (mostly now falling) include Blackburn 543, Ribble Valley 422, Rossendale 323, Bolton 296, and Salford 340.

The probability of catching Coronavirus within the Malvern Hills district remains fairly low, and as most Seniors have been vaccinated with 2 jabs we judge the risk LOW for all except the 'frail'.

The risk of death from Coronavirus for unvaccinated children and healthy teenagers is said to be 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 may be visiting areas where rates are high the risk might be judged MODERATE to HIGH.

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 about 128,000 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 recent 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. The PM has promised an independent inquiry in Spring 2022 to learn lessons for the future.