Web site logo c. 123-mcc.com

 Angus and Rosemary's Miscellany

  of Malvern - Other Resources

World logoBlogs >

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

21st November 2021


Skip preamble and go to summary

Skip to advice

Skip to links at end

Skip to menu of archived pages


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:


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:


Alternatively, when the time comes, 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.

Bio hazard signHow 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:


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 booked at Claremont Pharmacy in Barnards Green, Evans Pharmacy in Malvern Link, or taken 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 DeviceYou 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 now 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.


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 swab 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 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 by far 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:


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 Lateral Flow test kit

Nose swab home test kit obtained from Murrays

About the COVID Symptom Study app (Zoe)

COVID app logoYou 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 double 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.

Login from a desktop computer or laptop

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

21st November 2021


Cases remain very high but should dip a bit  around Christmas as boosters bolster resistance to the virus.

Some pundits had been hoping for cases to fall significantly by Christmas, while more recently others are suggesting a dip will come in the first quarter of next year, possibly followed by a rise in cases in the spring.

COVID has transitioned from the pandemic to endemic stage and we think it likely that levels of infection could remain fairly high for a further year or so, but not to worry as booster jabs, recurrent infections and annual vaccinations will protect most people from serious illness.

So far hospital admissions have not fallen much and COVID patients remain a significant burden on the overstretched NHS. Nevertheless the long term direction of travel should be downwards.

'Baked in' UK daily COVID deaths are continuing to flat-line at about 150.

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, double vaccinated 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.

Two weeks after the booster jab most people's resistance to COVID should be greatly increased so triple jabbed Seniors are likely to be as well protected this Christmas as ever they will be!

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 vaccinated; but the present vaccines are not a magic bullet so don't be too surprised if one or two of your friends become poorly. Unlucky 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.

Sadly a minority, particularly the elderly and frail with underlying conditions, may die of COVID despite vaccination.

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.

But for the vaccine-hesitant the 'emergency' will not be over as cases of COVID are likely to percolate for another year or so putting them at risk. If you are vaccine-hesitant and 50+ please do get your vaccine - you don't want this Christmas to be your last.

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


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 40+ will be able to get a booster jab without an appointment at the Three Counties Showground when their turn comes - that is 6 months after their second jab.

Those aged 16 - 17 years can now get a second jab 12 weeks after their first jab.

For details click this link:


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)

So that you can see the overall progress of the vaccination programme in the UK, the updated bar chart below shows the total number of first jabs (1) and second jabs (2), plus the combined number of booster and third jabs (3).

In comparison the population of the UK by age band is shown, extended to include 12 year olds (4).

COVID vaccination bar chart

Vaccinometer as of 21st November 2021

Apart from boosters, where good progress is being made, 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 regarding the vaccine-hesitant is about as good as it's going to get.

Total first jabs are reported 50,759,550 to the 21st November while second jabs are reported 46,152,913 and boosters/third jabs 15,064,693.

Boosters are now very important as they greatly increase the effectiveness of waning vaccinations given earlier in the year.

Regarding the unvaccinated group, probably the stage has been reached where as many are now achieving future 'resistance' through infection as vaccination - particularly the young.

The population of the UK aged 12+ is about 58M, so were everyone to be vaccinated the lower blue line showing first doses would reach 58M; currently it is about 7M short.

Most of those aged 12 to 15 years are currently only eligible for a single dose so the middle blue line would reach 55M at best; currently it is about 9M short.

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

England and NI are behind Wales and Scotland in the vaccination of children, particularly those aged 12 - 15 years; but bear in mind many more will have recently achieved resistance through infection.

Country 12-15 years 16-17 years
England 40% 64%
Wales 58% 79%
Scotland 57% 77%
NI 26% 57%

Percentage of children vaccinated as of 19th November

source: Independent SAGE

The ONS thinks about 90% of adults have antibodies either through infection or vaccination, but achieving herd immunity is unlikely 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 individuals 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 all 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

The Coronavirus dashboard reports as of 21st November 15,064,693 booster jabs and third doses have been given in the UK.

Now there are about 10M people aged 70+ to vaccinate, but half the jabs were initially given to others including NHS staff, so it could be towards Christmas before all those aged 70+ are boosted.

The booster rate is now about 2.5M per week.

Now that those aged 40+ years will in turn become eligible there are about 37M in total to boost. Assuming 2M jabs per week taking account of lower rates during the Christmas and New Year holiday we anticipate the youngest of those aged 50+ might have to wait until towards the end of January and those aged 40+ the middle of March for their booster.

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 a little behind many other countries. For example Portugal has fully vaccinated 88% of its population, Singapore 92% and Malaysia 76%, compared to 67% in the UK. Australia has overtaken the UK with 70% fully vaccinated and may soon open its borders to the fully jabbed.

Orange triangleNumber 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 slightly from 37,488 to 41,029 cases per day.

The ZOE COVID Study estimates there are more likely 71,000 cases per day compared to 65,000 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 21st November 2021

In recent weeks cases have bumped along at roughly 35,000 new cases per day.

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

Daily COVID cases to 2nd May 2021

UK daily new confirmed COVID cases 1st August to 21st November 2021

It looks as though the recent rise probably fuelled by schoolchildren returning after half term may be levelling off.

During the last week the cumulative total of confirmed UK COVID-19 cases reported by PHE rose by 284,393  to 9,845,492. That's a lot but it's a comfort rates aren't spiking.

In Worcestershire there have now been 79,016 confirmed cases of COVID-19 an increase of 2,944 on last week.

The next chart shows how daily cases in Worcestershire have risen in the last week.

COVID cases in Worcestershire

Daily cases in Worcestershire from 1st August to 21st November 2021

The rolling average of daily cases rose significantly from 304 to 421.

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 15,528 +531 98,529
Malvern Hills 7,391 +327 77,545
Redditch 13,537 +456 85,317
Worcester 13,640 +586 103,542
Wychavon 15,362 +637 126,240
Wyre Forest 13,558 +407 100,957
TOTAL 79,016 +2,944 592,130
County of Hereford 21,208 +905 195,000
Leicester (city of) 65,244 +1,322 400,000

Cumulative cases reported by PHE in Worcestershire to 21st November 2021

Daily cases rose significantly in Worcestershire, less so in Herefordshire, and remained level in the city of Leicester.

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.

Cases in Malvern Hills by age group

On the cases tab of the Coronavirus dashboard you can either select the county of Worcestershire or a local authority such as the Malvern Hills, and there you can find a heat map showing cases by age group over time and a chart comparing the number of cases under 60 years with those aged 60+.

The latest figures show the infection rate in those aged 60+ years is 5 times lower and going down, compared to those below the age of 60, whilst the heat map shows since the autumn the infection rate has been highest in those of school age.

Click for cases by specimen date age demographics in the Malvern Hills

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 much of England and Wales turned purple reflecting the bump up in cases.

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 16th November are: North Malvern 27; Malvern Link 13; Pickersleigh 16; Barnards Green 20; Malvern Wells and Priory 32; Callow End and Hanley 17; Upton and Welland 20.

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 1,029 in the last week to 143,927 while the daily average fell slightly from 156 to 147 deaths per day.

UK COVID death rate

COVID-19 death rate 1st July to 21st November 2021

Click to view the UK government Coronavirus Dashboard

Since England emerged from lockdown on 19th July about 15,000 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 account for about 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 5th November 2021 (week 44 of 2021) is shown below.

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

Districts of Worcs Deaths
Week 44 Population
Bromsgrove 164 120  3 98,529
Malvern Hills 61 90 77,545
Redditch 108 96 0 85,317
Worcester 87 126 0 103,542
Wychavon 157 141 4 126,240
Wyre Forest 171 123 2 100,957
TOTAL 748 696 10 592,130

Provisional cumulative COVID-19 deaths registered by ONS to 5th November 2021

In week 44 there was 1 death in a care home and 1 in hospital in Bromsgrove; 1 death in hospital in the Malvern Hills; 1 death in a hospice and 3 in hospital in Wychavon; and 1 death at home and 1 in hospital in the Wyre Forest.

In England and Wales 990 COVID-19 related deaths were reported in the week to 5th November, 132 more than the week before. Of these 79 were in a care home, 73 at home, 8 in a hospice, 825 in hospital and 5 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 19th November 2021.

Worcestershire Cumulative deaths Past week
Acute hospitals 878 3
Care hospitals 64 0
TOTAL 942 3

Click for NHS COVID-19 total announced deaths

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 8,079 -573
Patients on ventilation 923 -76
Patients admitted daily 881 -87

Headline summary of patients in hospital reported on 21st November 2021

Hospital admissions fell slightly for a second week. The number of hospital beds occupied by COVID patients is now about 20% of the peak last January.

Green triangleWorcestershire hospital beds

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 16th November there were 56 COVID-19 patients occupying Worcestershire Acute Hospital beds, of which 7 were ventilated beds; roughly 21% of the peak experienced last January.

33 patients have been admitted to hospital with coronavirus in the last 7 days, a 46% fall on the previous 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


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 28th November) the cumulative total of UK COVID-19 cases reported by PHE on the Coronavirus Dashboard could increase by 300,000 towards 10,145,000 with the 7 day rolling average of daily new cases hovering around 40,000.

In Worcestershire up to 3,000 new cases of COVID-19 can be expected, and 350 cases in the Malvern Hills district.

We estimate the number of UK COVID (28) deaths will increase by about 1,050 towards 145,000 during the 7 days ending 28th November 2021, with the average daily death rate hovering around 150 deaths per day possibly rising towards 160 deaths per day the week after that. 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 2,944 new cases this week may translate to 6 COVID deaths per week by the middle of December.

We expect the daily number of patients admitted to hospital to reach 950 next week tracking daily cases. Numbers may then fall a bit as the boosters increase the resistance to infection of fully vaccinated Seniors.


Longer term outlook

We must all be hoping to see a gradual downturn in daily hospital admissions and deaths during the next 3 months as those aged 40+ years receive booster jabs, and children are either vaccinated or gain immunity following infection by COVID-19.

The timing of this is uncertain and will greatly depend on the speed and extent of the 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 any marked improvement is seen in the figures. Any downturn is likely to coincide with the Christmas and New Year holiday when the reporting of figures is likely to be delayed.

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 or possibly even longer.

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 week and then decline slowly, reaching a minimum of about 25 per day in the New Year (later than originally predicted). We are sceptical the death rate will fall so far in the next quarter.

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

SPI-M models do not rule out a further minor 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' - based on autumn figures, 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.

During October when a significant proportion of cases involved schoolchildren, most of whom would not fall seriously ill, these ratios were expected to over-estimate admissions and deaths.

However contrary to expectations daily deaths seemed to worsen to 1:250 of daily cases notified by PHE.

 Three factors may have contributed 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 was waning.

Now boosters are being rolled out a significant improvement in these ratios should be observed in the next month or so.


Advice for Seniors

COVID risk mediumRecently there have been no more than 10 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.

Those that have been triple jabbed and are in generally good health may now feel no need for COVID precautions.

Until daily cases fall markedly, the simple safeguards for the remaining more vulnerable to remember are to:

  • get your booster vaccine six months after your second jab; don't worry if you have to wait a week or two to get an appointment; two weeks after the booster most people should be well protected.

  • 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, either ventilate by keeping windows open as far as is practicable or put a HEPA air purifier in the room;

  • 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 double 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 - you might alternatively suffer from fever with a temperature of up to 103 deg F, and a reduction in sense of taste.

  • respect others and give them space.


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 21st November update


How quickly might COVID cases fall in the UK

About 6 weeks ago a commentator on the radio suggested we had already moved from the pandemic to endemic stage and should expect of the order of 40,000 new cases per day in the UK for the foreseeable future. At the time we thought that a rather pessimistic outlook, but with cases hovering around 35,000 for the last 4 months is he right?

A disease become endemic when it cannot be eliminated and the level is one the public is prepared to tolerate. It seems the British public have got used to hearing about 35,000 new COVID cases, 800 or so hospital admissions, and 150 deaths per day.

So what will happen next? We assume the virus is currently weeding out pools of the unvaccinated, and infecting the frail and unlucky for whom the vaccines do not work well.

Currently about 66% of new cases are unvaccinated, so were that group eliminated we might still be left with 10,000 new cases and 50 deaths per day.

33% of the total UK population is unvaccinated, about 22M, of which say 8M are under 12 years, leaving up to 14M still unprotected, though some of course will have caught COVID. If the infection rate in that group is assumed 20,000 cases per day and cases fall exponentially then it could take roughly a year for cases to fall by half.

So a back of the envelope worst case scenario could be the present long term average of 35,000 new cases per day falls to about 20,000 cases per day (10,000 vaccinated+10,000 unvaccinated) in a years time, then to 15,000 a day (10,000 vaccinated + 5,000 unvaccinated) in two years time and towards 10,000 per day in three years time.

The booster programme, the summer when people spend more time outdoors, recurrent COVID infections, and annual COVID vaccinations will significantly modulate this curve, but if herd immunity is not achieved as many think, the vaccine-hesitant continue to refuse the vaccine, and children under 12 years are not immunised, then do not be too surprised if it takes a further year or so for COVID to drop to 25% of the present level.

Now in comparison, in Israel the surge in cases in the autumn fell to 25% over a period of just 4 weeks. That was achieved by a combination of booster jabs and restrictions on the lines of the UK government's PLAN B. Of course our PM has chosen not to implement PLAN B in the UK, and we are now heading for mid-winter when more time is spent indoors. Further, families will be criss-crossing the UK during the Christmas holiday. So the Effective R value in the UK will be suppressed less than in Israel, and consequently cases in the UK are certain to fall more slowly.

This week

On Monday the Prime Minister held a Number 10 Coronavirus Press Conference exhorting the public to get fully vaccinated.

Click for PM's press statement on 15th November

He announced, following JCVI advice, second jabs would be made available to all 16 and 17 year olds from 12 weeks after their first dose, and boosters would become available to all those aged 40 to 49 from six months after their second dose - and probably that will be in a month or two, so don't bother your GP surgery just yet.

Click to watch 15th November Press Conference on Youtube

Malvern Civic Society advised members who had attended the AGM last Friday to get tested as one of the attendees tested COVID positive.

The BBC reported a lockdown for the unvaccinated was to be introduced in Austria due to rising cases.

On Tuesday Radio 5 carried a report about ambulance delays in Wales which reminded us that you may have to wait several hours for an ambulance in Malvern if you have had a fall and can't get up.

Tighter COVID restrictions were imposed in the Republic of Ireland

On Wednesday another member of the family reported testing COVID positive despite being fully vaccinated. No classic symptoms apart from a temperature of 103 deg F, mild intermittent cough and slight loss of taste.

We had our Pfizer booster jabs at Prospect View; no side effects other than sore arm, tiredness and mild headache the next day. Friends have reported side effects ranging from a sore arm to feeling groggy for a day or two, so be prepared for this.

On Sunday the media reported unrest in Austria, Belgium and the Netherlands due to restrictions imposed to dampen escalating cases of COVID-19. The consensus seems to be Europe is lagging the UK so the rise across the channel is nothing for us to worry about.

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 and  Independent SAGE weekly updates. Dr John Campbell expresses disappointment that herd immunity is unlikely to be achieved  and in a second video mentions the need to wait 3 months after getting COVID before being vaccinated.

All in all there is not much new in this week's updates.

Click to watch Tim Spector's Zoe COVID Study 17th November video update

The Independent SAGE weekly briefing includes mention of climate change.

Click to watch Independent SAGE 19th November video briefing

Click to read more about Independent SAGE on Twitter

Dr John Campbell talks about the lack of herd immunity on 15th November,

Click to watch Dr John Campbell's 15th November video

In another video dated 18th November he talks about the situation in Europe and waiting 3 months after catching COVID before getting jabbed.

Click to watch Dr John Campbell's 18th November video



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.

Travel to other countries seems to be gradually opening up.


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
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 risen to 409 while in comparison the figure for Worcestershire is 447 and the Malvern Hills 391.

In Wales the case rate has risen to 536, whereas in Scotland the rate is 384.

 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 144,000 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 150,000 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.

Many 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.


Back to top



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


About joining the Zoe COVID Symptom Study:




UK government Coronavirus guidance

COVID-19 Response: Autumn and Winter Plan 2021 for England


COVID Alert states

Guidance on UK COVID-19 alert level methodology: an overview

COVID-19 Alert Level lowered to 3 on 10th May 2021



Guidance on tiers: what you need to know

Government postcode checker to find tier for other areas



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


HSA COVID-19 vaccine weekly surveillance reports


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

Click for chart showing % vaccinated



A forecast of the progression of the COVID-19 epidemic can be found on a University College London (UCL) website.

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

A projection of the future COVID-19 death toll and daily deaths can be found on The Institute for Health Metrics and Evaluation website. 

Click for IHME projection of COVID-19 deaths



ONS Coronavirus (COVID-19) Roundup


The bigger picture

Worldometer summary of coronavirus cases worldwide

European Centre for Disease Prevention and Control info


World Health Organisation info



Window on the USA

Centre for Disease Control (CDC)

American Association of Retired People (AARP)





Worcestershire County Council COVID-19 information:


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



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


The Malvern Hills logo

Back to top

The interpretations and opinions expressed are our own