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

14th November 2021

GET VACCINATED AND TAKE CARE AS VIRUS STILL WIDESPREAD

Skip preamble and go to summary

Skip to advice

Skip to links at end

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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. We also provide links to where further information can be found.

This page is normally 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 get vaccinated

The most important thing everyone can do now is get vaccinated. Most Seniors should have been double jabbed months ago, but if not get your vaccine, and encourage your friends and loved ones to get theirs.

The effectiveness of the vaccines falls over time so remember to get your booster shot six months after your second jab.

You should get a reminder either from the NHS or your GP surgery; this could be by letter, or a text message if you have registered a mobile phone number.

Boosters can now be had without an appointment at the Three Counties Show Ground.

See the NHS website for opening times and vaccine availability:

www.nhs.uk/grab-a-jab

Alternatively try booking an appointment at your GP surgery.

Note: the immuno-suppressed may be offered a third jab as part of their primary course, followed by a booster later.

How to request a COVID test

In order to protect others it is important to get a test and self isolate if you feel unwell with either classic COVID symptoms, or cold and flu like symptoms which can be caused by the Delta variant.

There are now two types of test you can get. The more accurate PCR test involving a throat and nose swab which is sent to a laboratory for analysis and the Lateral Flow Device 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 may have Coronavirus:

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

We feel the website discourages people from seeking a PCR test who don't have all the classic symptoms. If you feel strongly enough, press on answering the questions so as to get your PCR test.

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

Alternatively settle for a 'Nasal swab' Lateral Flow Device test in the comfort of your own home (see below).

According to Google there is a 'drive through' COVID testing station at County Hall near the Countrywide Centre, and a 'walk through' at Pershore.

There is also a COVID testing station at the Worcester Royal Hospital for screening patients before admission.

If you cannot get to these you can order a home PCR test kit.

If you test COVID positive you should self-isolate for 10 days.

Getting a Lateral Flow Device test (updated)

Lateral Flow Device tests (LFD) can either be taken at Claremont Pharmacy in Barnards Green, Evans Pharmacy in Malvern Link, or at home.

The test is intended to screen those who do not show the classic symptoms of COVID-19 and provides a means to test yourself at home either before visiting an elderly person, or going to work, or if feeling poorly with cold and flu like symptoms.

COVID Lateral Flow Device You can collect home test kits, for example packaged as the COVID-19 Self-Test (Rapid Antigen Test) in boxes of 7 tests, from Malvern library, the Co-op, and most pharmacies such as Boots and Murrays in Church Street, Claremont House and Lloyds in Barnards Green, Murrays at Prospect View, Evans and Murrays in Malvern Link, and Boots and Morrisons on the Enigma Retail Park.

If collecting from a pharmacy you need to know that from October 2021 you have to go on-line and get a collection code to present to the pharmacy in order to obtain a pack of 7 tests. This involves giving NHS Test and Trace your email and/or mobile phone number and address.

http://www.gov.uk/get-collect-code

The LFD now comes in two versions.

The Throat and Nose Swab kit;
The Nose Swab only kit (Orient Gene, Acon Flowflex and MP Biomedicals).

(Lateral Flow Device cassette shown on the right).

ACON Flowflex comes in a blue and white pack.

Orient Gene comes in a green and white pack.

MP Biomedicals come in a blue, white and grey pack.

Click for instructions for using the LFD test kits

COVID lateral flow test leaflet

Leaflet at Boots the Chemist

The new Nasal only test kit which only requires a nose swab is the easiest to use and the best one to get but it is not yet widely available. On 10th November we found Boots in Church Street and Malvern Library were still supplying the old Throat and Nose kit; Murrays in Church Street said they had the new kits and Malvern library thought the library in St John's Worcester might have the new kits.

Click for NHS information on Rapid Lateral Flow Test sites and collection sites in Malvern

Hint: to see the list, click on 'filter' and then 'pick up sites for test kits' checkbox.

Click for WCC info about Lateral Flow Tests

In our opinion, many Seniors will find the classic Throat and Nose Swab home test kit difficult to use as you need to rub the tonsils or thereabouts with the swab-stick without touching the tongue, teeth, cheeks, gums or any other surface before swabbing the nose. Doing this standing in front of a mirror on your own without gagging while holding a torch in the other hand, won't be easy unless you have a steady hand and good eyesight.

The Nose Swab kit is the best one for testing yourself at home.

If you test COVID positive you should isolate and take a more accurate PCR test to confirm the result.

NHS Test and Trace want people to report the result of their home LFD tests at:

www.gov.uk/report-covid19-result

especially if it is positive. This helps NHS Test and Trace monitor where the issue of the free LFD tests is proving most effective and the spread of the disease.

COVID LFD box

Throat and Nose home test kit obtained from Prospect View

About the COVID Symptom Study app (Zoe)

You can help 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 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. This is an important source of data as we progress through the EXIT wave.

There are questions allowing you to enter your vaccine type and whether any side effects; this now includes boosters and flu jabs.

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 2020.

Click this link for NHS Coronavirus app information

If you have been close to someone who has tested COVID positive, your smart-phone will be pinged and you will be advised to self-isolate

From 16th August fully vaccinated individuals don't need to self-isolate. However if you are feeling poorly and get pinged it is recommended you take a COVID test, and self-isolate if the result is positive.

Bear in mind fully vaccinated individuals can still catch the Delta variant of COVID and pass it on to others.

NHS app and Covid Pass

You will need the NHS app installed on your smartphone and be registered with the NHS in order to display your vaccination status, for example when travelling abroad.

Note: this is not the NHS COVID-19 app

If you don't have a smartphone you may be able to login from a PC to obtain a printed copy.

You can use your NHS login when signing in to report the result of Lateral Flow Device tests taken at home.

14th November 2021

Summary

The recent fall in new daily cases bottomed out this week. Cases remain very high and could remain so for some weeks until boosters sufficiently bolster resistance. It looks as though the hoped for dip in COVID cases by Christmas won't now occur until January.

Hospital admissions are not falling much and COVID patients remain a significant burden on the NHS.

Unlike last year, cases are not expected to rise steeply this Christmas and could even fall.

'Baked in' UK daily deaths appear to have peaked and should fall slightly during the next two weeks.

Seniors can use the new Lateral Flow Device kit which only requires a nose swab to test for COVID at home. This is much easier to use than the previous version as only a nose swab needs to be taken and you don't have to poke the swab far up your nostrils. You will need a code to collect the LFD kits from pharmacies (see above).

While cases remain high, Seniors are advised to continue taking precautions to reduce the risk of catching the virus; such as regular hand-washing, wearing a face covering where recommended, continuing with sensible distancing, and avoiding crowded situations.

Click to view our advice

We notice the elderly getting out more, and life seems very much back to normal in the rural Malvern Hills. People are not sanitising and wearing masks as much as they did, and friends are not distancing when they chat either assuming or hoping their circle does not have COVID.

Like us you may feel 'fireproof' after being fully vaccinated; but the present vaccines are not a magic bullet so don't be too surprised if you or some of your friends become poorly. Fully vaccinated individuals can catch the Delta variant of COVID and pass it on to others - some may feel very poorly but thankfully most should not need treatment in hospital though sadly a minority particularly the elderly and frail with underlying conditions may die of COVID despite being fully vaccinated.

In Malvern, booster jabs are being rolled out for the most elderly and others such as NHS staff who received their second jab more than 6 months ago and we expect most of those aged 70+ years will have received their booster by Christmas, by which time everyone will be hoping the 'emergency' is all but over.

Don't forget to get your flu jab as it is expected there could be a greater chance of dying if you are unfortunate and catch flu and COVID at the same time.

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 the percentage of local people vaccinated by age group on the Worcestershire COVID-19 Vaccinations Dashboard.

Click to view Worcestershire COVID-19 Vaccinations Dashboard

Two jabs followed by a booster 6 months later are needed to fully protect adults from the Delta variant of COVID-19.

Those aged 12 - 15 years can now grab a first jab, and those aged 50+ can get a booster jab without an appointment at the Three Counties Showground. For details click this link:

www.nhs.uk/grab-a-jab

You can also book on-line or with your GP surgery - see the NHS website for eligibility criteria.

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

The bar chart below shows the population of the UK by age band (1), extended to include 12 year olds, 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 14th November 2021

Apart from boosters, the vaccination rate has slowed considerably since the summer and again you will see little change to last week's chart so, without a more effective public health campaign, the situation is about as good as it's going to get. Total first jabs are reported 50,557,065 to the 14th November while second jabs are reported 46,009463.

Probably the stage has been reached where as many are now achieving future 'immunity' through infection as vaccination - particularly schoolchildren.

The population of the UK aged 12+ is about 58M, so were everyone to be vaccinated the lower blue line would reach 58M; currently it is 8M short.

Most of those aged 12 to 17 years are currently only eligible for a single dose so the upper blue line would reach 52M at best; currently it is 7M short.

For comparison, if younger children are included, the total population of the UK is about 66M.

England is still behind Wales and Scotland in the vaccination of children, particularly those aged 12 - 15 years.

Country	12-15 years	16-17 years
England	27%	62%
Wales	53%	78%
Scotland	55%	76%

Percentage of children vaccinated as of 5th November

source: Independent SAGE

Let's hope the situation will rapidly improve now parents with cars can get children aged 12 -15 years vaccinated at the Three Counties Showground.

The ONS says about 90% of adults have antibodies either through infection or vaccination but achieving herd immunity is somewhat doubtful as somewhere between 6 and 30% of the double vaccinated can catch the Delta variant of COVID-19; nevertheless vaccination is most important to protect as many people as possible from debilitating long term loss of smell and taste, Long COVID, serious illness, and death.

Click for NHS video warning young people of the dangers of the virus for the unvaccinated.

Vaccination statistics can be found on the Vaccination tab of the Coronavirus Dashboard.

Booster jabs

By now those aged 70+ years should either have received a letter or text message from their GP surgery or a letter from the NHS asking people to book an appointment for their booster. You may have to wait a week or two, but it should not be difficult to get a booster jab in Great Malvern and surrounds.

The number of booster jabs given in England can be found in a spreadsheet on the NHS England website. Look in the data section for the COVID-19 daily announced vaccinations Excel file which gives a breakdown of jabs by region and age.

Click for NHS COVID-19 vaccinations

As of 13th November 10,188,021 booster jabs and third doses were said to have been given in England.

The Coronavirus Dashboard reports on 13th November a total of 12,164,586 booster and third jabs had been given in the UK with the daily average being about 300,000 jabs per day which is pretty good bearing in mind many volunteers have been stood down.

There are said to be about 28M who will be due for a booster by the New Year. Assuming 2M jabs per week, we expect all those aged 70+ years will have had their booster shot before Christmas; but the youngest of those aged 50+ might have to wait until towards the end of January.

Vaccinations Worldwide

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

Click for worldwide statistics

Note: click the country list on the left hand side of the screen to add or remove countries from the chart.

The UK did well to start with but has fallen behind many other countries. For example Portugal has fully vaccinated 87% of its population compared to 67% in the UK.

Australia has overtaken the UK with 69% fully vaccinated.

Number of cases

The steady fall in daily cases over the last three weeks slowed this week with signs of a small upturn in the last few days.

During the last week the average rate of people testing COVID positive in the UK reported by PHE on the 'Coronavirus Dashboard' rose slightly from 35,362 to 37,488 cases per day.

The ZOE COVID Study estimates there are more likely 65,000 cases per day compared to 81,000 last week.

The chart below shows broadly how the daily rate reported by PHE has varied since 1st September.

COVID daily new cases

UK daily confirmed COVID cases 1st September 2020 to 14th November 2021

Zooming in, the next chart shows in more detail how daily UK cases have tipped up in the last few days.

Daily COVID cases to 2nd May 2021

UK daily new confirmed COVID cases 1st August to 14th November 2021

During the last week the cumulative total of confirmed UK COVID-19 cases reported by PHE rose by 259,190 to 9,561,099.

In Worcestershire there have now been 76,072 confirmed cases of COVID-19 an increase of 2,129 on last week.

The next chart shows how daily cases in Worcestershire have fallen in the last few days.

COVID cases in Worcestershire

Daily cases in Worcestershire from 1st August to 14th November 2021

The rolling average of daily cases fell slightly from 338 levelling off at 304.

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	14,997	+422	98,529
Malvern Hills	7,064	+255	77,545
Redditch	13,081	+348	85,317
Worcester	13,054	+370	103,542
Wychavon	14,725	+449	126,240
Wyre Forest	13,151	+285	100,957
TOTAL	76,072	+2,129	592,130
COMPARE WITH
County of Hereford	20,303	+781	195,000
Leicester (city of)	63,922	+1,310	400,000

Cumulative cases reported by PHE in Worcestershire to 14th November 2021

Cases are mostly down a bit, except for Redditch and the City of Leicester where cases rose slightly.

Note: 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 maps

At the bottom of the Coronavirus Dashboard (daily update) page there is an Interactive Map which is coloured to show infection rates across the country.

This week the map has changed from mostly purple to mostly blue suggesting cases have diminished across England, including the Malvern Hills..

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.

Recent weekly cases to 8th November are: North Malvern 32; Malvern Link 15; Pickersleigh 16; Barnards Green 9; Malvern Wells and Priory 10; Callow End and Hanley 23; Upton and Welland 24.

Another map can be found on the Zoe COVID Study website indicating extrapolated cases based on reports from those using the Zoe app.

Click for People with COVID (estimated from the Zoe app)

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 rose by 1,093 in the last week to 142,898 while the daily average fell slightly from 170 to 156 deaths per day.

UK COVID death rate

COVID-19 death rate 1st July to 14th November 2021

Click to view the UK government Coronavirus Dashboard

Since England emerged from lockdown on 19th July about 14,000 people have died of COVID-19; mostly the elderly.

In comparison averaged over recent years 1,700 people die daily from all causes, so COVID deaths now make up 9%.

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 29th October 2021 (week 43 of 2021) is shown below.

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

Districts of Worcs	Deaths 2020	Deaths 2021	Week 43	Population
Bromsgrove	164	120	3	98,529
Malvern Hills	61	90	0	77,545
Redditch	108	96	0	85,317
Worcester	87	126	0	103,542
Wychavon	157	141	4	126,240
Wyre Forest	171	123	0	100,957
TOTAL	748	696	7	592,130

Provisional cumulative COVID-19 deaths registered by ONS to 29th October 2021

In week 43 there was 1 death in a care home plus 1 death at home and 1 death in hospital in Bromsgrove; and 4 deaths in hospital in Wychavon.

In England and Wales 858 COVID-19 related deaths were reported in the week to 29th October, 69 more than the week before. Of these 85 were in a care home, 65 at home, 9 in a hospice, 692 in hospital and 7 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 for Worcestershire

The table below shows latest COVID deaths in Worcestershire hospitals reported by NHS England on 12th November 2021.

Worcestershire	Cumulative deaths	Past week
Acute hospitals	875	2
Care hospitals	64	0
TOTAL	939	2

Click for NHS COVID-19 total announced deaths

More recently, on 13th November, the Coronavirus Dashboard reported 3 deaths in the Malvern Hills in the last 7 days, one of whom is rumoured to have been a 69 year old unvaccinated male.

Click for Summary of Malvern numbers on the Coronavirus dashboard

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 breakdown of deaths for the period 1st August 2021 to 20th October 2021 when, despite much of the population being protected by the vaccines, particularly the elderly, the death rate rose to about 130 deaths per day.

Age band	Number of deaths	% of deaths
0 - 19	17	0.3
20 - 39	116	2
40 - 59	708	12
60 - 79	2,470	42
80+	2,565	43

Relative risk of COVID-19 death by age band

Those aged 60+ years continue to account for about 85% of deaths, not far from the figure of 92% last year, but remember that due to vaccination the death rate as a proportion of new cases is five to ten times lower than in 2020.

The majority of these deaths are likely to be of the vaccine-hesitant, those with underlying conditions such as Diabetes, the frail, and those that are immuno-compromised. Pregnant mothers, the overweight and deprived individuals with a poor diet are also said to be at increased risk.

An NHS leaflet offered to patients being admitted to hospital suggests we are at higher risk of complications from COVID-19 infection if we have one or more of the following conditions:

Age over 70 or Male over 50;
Lung problems (including asthma, COPD, emphysema, bronchitis, bronchiectasis;
Heart disease
Diabetes
Chronic kidney disease
Liver disease (eg hepatitis, cirrhosis)
Brain or nerve problems (eg Parkinson's disease, motor neurone disease, multiple sclerosis, cerebral palsy)
You have a condition that increases the risk of infection
Take medication that affects the immune system, (eg steroids)
Very obese (BMI over 40)
Pregnancy

Many COVID deaths are now rumoured to be of the fully vaccinated elderly, but remember that broadly speaking we are ten times more likely to die of something else, so don't be over-concerned.

Healthcare numbers

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

Hospital COVID cases (UK)	Number	Change since last week
Patients currently in hospital	8,652	-508
Patients on ventilation	999	-35
Patients admitted daily	968	-87

Headline summary of patients in hospital reported on 14th November 2021

The number of hospital beds occupied by COVID patients is about 22% of the peak last January.

Worcestershire hospital beds

Despite hospital bed occupancy remaining fairly flat nationally, COVID bed occupancy has gone up significantly in Worcestershire during the last three weeks.

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

A summary can be found on the UK government Coronavirus Dashboard which reports on 9th November there were 64 COVID-19 patients occupying Worcestershire Acute Hospital beds, of which 5 were ventilated beds; roughly 24% of the peak experienced last January.

61 patients have been admitted to hospital with coronavirus in the last 7 days.

Note: Healthcare statistics can be found on the Healthcare tab of the UK Coronavirus Dashboard. At the top of the page where it says Healthcare in United Kingdom, click the drop down arrow to select Area Type as NHS Trusts, and Area Name as Worcester Acute Hospitals.

Click to view Worcester healthcare figures

Alternatively,

Click for Summary of Malvern numbers on the Coronavirus dashboard

Forecast for the week ahead

Trends suggest that during the next seven days (up to 21st November) the cumulative total of UK COVID-19 cases reported by PHE on the Coronavirus Dashboard could increase by 260,000 towards 9,825,000 with the 7 day rolling average of daily new cases hovering around 37,000.

In Worcestershire up to 2,200 new cases of COVID-19 can be expected, and 250 cases in the Malvern Hills district.

We estimate the number of UK COVID (28) deaths will increase by about 1,000 towards 144,000 during the 7 days ending 21st November 2021, with the average daily death rate falling to about 145 deaths per day. The daily death rate will probably remain around 140 into early December. These are 'baked in' deaths of those already infected which cannot be avoided.

In the county of Worcestershire, assuming a 0.2% death rate, the 2,129 new cases this week may translate to 4 COVID deaths per week by the first week in December.

We imagine the daily number of patients admitted to hospital will reach 1,000 next week tracking daily cases.

Longer term outlook

We must all be hoping to see a significant downturn in daily hospital admissions and deaths as those aged 50+ years receive booster jabs, and schoolchildren are either vaccinated or gain immunity following infection by COVID-19.

The timing of this is uncertain and will depend on the speed of vaccine rollout; tag on a week or so for the vaccine to take effect, a further week for the increased resistance to infection to impact hospital admissions, and a further two weeks for this to be reflected in the number of daily deaths, then it could be another 4 to 6 weeks before a marked improvement in the figures is seen.

Many commentators had been hoping the epidemic would be 'all but over' by Christmas, but some are now wondering if the tail could extend a further two to three months.

Updated modelling from University College London now suggests the seven day average of daily deaths will remain at about 150 per day for the next two weeks and then decline slowly, reaching a minimum of about 25 per day in the New Year (a month later than originally predicted).

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

SPIM models do not rule out a further wave of the epidemic next March as the effectiveness of the vaccines wanes and the behaviour of the public returns to 'normal'.

For a fixed level of vaccination, daily cases are a signpost to whether daily hospital admissions and deaths are going to go up or down. Based on our heuristic 'rules of thumb' - recent hospital admissions, cases of Long COVID and deaths were expected to follow daily cases roughly in the ratio:

Hospital admissions 1:35 of daily cases reported by PHE, lagging by 8 days.
Long COVID 1:35 of daily cases reported by PHE.
Deaths 1:350 of daily cases reported by PHE, lagging by about 20 days.
UK Hospital bed occupancy - one quarter of daily cases, lagging by up to a month.

While a significant proportion of cases involve schoolchildren, most of whom should not fall seriously ill, these ratios were expected to over-estimate admissions and deaths.

However contrary to expectations daily deaths seem to have worsened to 1:250 of daily cases notified by PHE.

Three factors may be contributing to this:

the virus is weeding out the unvaccinated who are becoming increasingly complacent and no longer wearing masks and distancing;
a greater proportion of people are not bothering to record their positive Lateral Flow tests, so cases are under reported;
the protection offered by the vaccines is waning;

the latter being a good reason to get your booster jab now.

Friends report side effects ranging from a sore arm to feeling groggy for a day or two, so be prepared for this.

Advice for Seniors

COVID risk medium Recently there have been no more than 8 COVID related deaths per week in Worcestershire which has a population of 600,000 so we judge the risk of death for fully vaccinated Seniors to be fairly LOW while the risk of Long COVID might be MODERATE; see our annex and riskometer opposite.

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 if you are able get both doses of your vaccine and your booster and continue to take care of yourself and those you love. Also encourage others to be vaccinated.

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

Like Health Minister Sajid Javid and Sir Kier Starmer, it is quite possible, despite a second jab, for Seniors to become ill with COVID-19; some might have mild symptoms like a common cold or hay fever, while others could feel very poorly, but few except the frail, vulnerable, and unlucky will need to be admitted to hospital.

Until daily cases fall markedly the simple safeguards to remember are to:

get your booster vaccine six months after your second jab;
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 covering 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 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, ventilate by keeping doors and windows open as far as is practicable;
avoid crowded indoor settings and minimise TIME near strangers;
self-isolate and take a test if you feel unwell with cold or flu like symptoms; according to the Zoe COVID Study the top five symptoms amongst the fully vaccinated and children, in order of prevalence, are said to be headache (73%), runny nose (73%), sneezing (59%), sore throat (53%), and cough (49%), which are often hard to distinguish from a common cold;
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 use an alcohol based hand gel.

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

Annex to 14th November update

Commentary

Not much to report this week when the media was mainly reporting on the Climate Conference.

On Monday 8th November the USA opened to fully vaccinated travellers.

Gloucester and Cheltenham hospitals reported a surge in COVID cases.

On Tuesday it was announced NHS workers would have to be fully vaccinated against COVID by next Spring.

Also reports some individuals might have resistance to COVID from T Cells triggered by other viruses; possibly an area for future research.

On Friday the deadline was reached for Care Home workers to be either fully vaccinated or face dismissal.

COVID video updates

The usual charts showing vaccination take-up and COVID cases over time by age band can be found in the Zoe COVID Study weekly update. The Independent SAGE update looks at 'behaviour' this week, while Dr John Campbell looks at the worldwide picture.

Click to watch Tim Spector's Zoe COVID Study 12th November video update

The Independent SAGE weekly briefing is about how behaviour can influence the remainder of the epidemic followed by a short question/answer session. It's worth watching.

Click to watch Independent SAGE 12th November video briefing

Click for Independent SAGE paper - Using behavioural science to help minimise the spread of Covid-19

Dr John Campbell reviews the COVID figures worldwide

Click to watch Dr John Campbell's 13th November video

U3A

Malvern U3A groups have resumed. Some groups are continuing to meet using Zoom while others are meeting in person.

Members are being asked not to attend meetings if feeling unwell. Names will be taken at meetings and could be passed to NHS Test and Trace if a member subsequently tests COVID positive. Refreshments are being provided by some groups but not others.

Overseas travel

From 24th October travellers arriving from abroad need only take a Lateral Flow Test.

You can now travel to the USA.

List of vaccines (unchanged)

Here is the updated list of COVID-19 vaccines ordered by the UK. It looks as though the government has settled on Pfizer as first choice with Moderna second and Astrazeneca now held in reserve.

Valneva has been cancelled, and approval has not yet been sought for using Novavax in the EU and US although approval has been sought for use in third world countries.

For two doses plus boosters, only about 200M doses will be needed for the population of the UK, so it's possible the government will cancel orders for those vaccines marked in red which have been slow to come to market.

COVID-19 vaccine	Doses ordered (million)	Status
Pfizer BioNTech, two dose, -70 deg C	40+60+35	Approved, deliveries continuing, made in Belgium (EU). An additional 60M doses have been ordered for booster shots for the most vulnerable in the autumn. A further 35M doses were ordered in August 2021 for delivery in 2022.
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 order cancelled	A jab from French company Valneva will be made in Livingston, West Lothian, Scotland. Order cancelled September 2021. Delivery had been expected 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 being made in Stockton-on-Tees UK; phase III trials complete, but approval has not yet been sought in EU and US. Glaxo Smith Kline (GSK) contracted to fill and package vials.
GSK Sanofi	60 ?	Some delay due to adjusting the formula to give better protection to the elderly; possible approval 2022.
Curevac	50 ?	Contract placed with German company Feb 2021. Possible source of new variant vaccine, but disappointing trial results. Future uncertain.

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 fallen to 342 while in comparison the figure for Worcestershire is 362 and the Malvern Hills 351.

In Wales the case rate has fallen slightly to 479, whereas in Scotland the rate is 370.

England without restrictions is now doing slightly better than Wales and Scotland with restrictions.

As a yardstick we suggest a figure of below 10 can be considered LOW, so there is a long way to go.

The probability of fully vaccinated Seniors, without underlying conditions, catching and dying from COVID-19 is now possibly somewhere in the range 1 in 1,000 to 1 in 10,000 per year so we judge the risk fairly LOW compared to the risk of dying from other causes. Perhaps as many as 3% to 5% of people who catch COVID suffer from Long COVID so that risk might be assessed MODERATE.

The risk of death from Coronavirus for unvaccinated children and healthy teenagers is said to be small so for them the risk is LOW.

About the UK COVID-19 final death toll

The UK is probably going to have to live with COVID-19 and a background level of infection which may increase every winter as more time is spent indoors. Barring new variants, this could result in many thousands of COVID deaths per year, as with flu. So in that respect there can be no 'final' death toll.

The present 2020/2021 death toll will likely climb from 143,000 towards 150,000 by Christmas 2021 based on the PHE definition of deaths. If ONS figures are used the UK toll could be heading towards 205,000 or perhaps even a tad higher.

Worldwide, this pandemic is not played out and it could be a further 2 to 3 years before the 'dust' finally settles and third world countries are vaccinated. The PM has promised an independent inquiry in Spring 2022 to learn lessons for the future.

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 nearest the mark. A few might consider an outcome of about 145,000 deaths during 2020 and 2021 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 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.

A member of the marketing team at US company 'My Bio Source' sent us a link to a History of Pandemics. Let's hope our brilliant scientists can continue to protect us from future threats.