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

12th December 2021

PM DECLARES OMICRON EMERGENCY

COVID Alert Level raised from 3 to 4

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

Summary

How to get vaccinated

More about vaccinations

Number of cases

Number of deaths

Healthcare numbers

Forecast for the week ahead

Longer term outlook

Advice for seniors

Annex/commentary

Further information:

How to request a COVID test

About the Zoe COVID symptom study

About the NHS contact tracing app

About the NHS COVID pass

Summary of links

Menu of archived pages

Summary

The situation is changing rapidly as the government realises that the exponential growth of the Omicron variant of COVID-19 will very likely lead to a tidal wave of infection in January, overwhelming the NHS. The COVID alert level has been raised from 3 to 4 and the Prime Minister has made a broadcast to the nation warning of what is to come and bringing forward the target date for offering all those aged 18+ years a booster jab to the end of December.

Daily cases have bumped along at a high level for several weeks in the UK, but now there are signs of an upturn. Daily hospital admissions and deaths continue to flat-line.

It seems the Omicron variant of COVID-19 arrived in the UK from South Africa before travel restrictions were imposed so the virus has been seeding undetected for some weeks.

The Reproduction Rate of the Omicron variant of COVID-19 is higher than that of Delta, so while current restrictions and vaccinations have been keeping the Effective Reproduction Rate (EFR) in check and close to 1, in the case of Omicron an EFR of 2 or higher is expected leading to exponential growth and the Omicron variant probably overtaking Delta by the end of December 2021.

Because Omicron is extremely infectious scientists expect a very sharp rise in daily cases and hospital admissions in January, leading to severe pressure on NHS hospital beds.

Many Seniors are likely to catch the Omicron variant of COVID-19 in January, but the hope is vaccines and booster jabs will protect most from severe illness and death.

The public can slightly dampen the peak by reducing contacts, for example by working from home and avoiding large gatherings, taking Lateral Flow tests, and wearing better masks.

However there are three areas where more needs to be done:

a plan is needed to protect children under 11 years who will otherwise bring the virus home from nurseries and schools;
guidance for family gatherings and travel at Christmas to contain spread;
clearer guidance from the government concerning the COVID pass for large indoor events and parties.

Sadly it is now too late for the vaccine-hesitant to be triple jabbed before the tidal-wave of Omicron arrives, but getting vaccinated with two jabs may protect some.

Lateral Flow Device kits which only require a nose swab can be used to test for COVID at home, for example before either going to an event or visiting relatives at Christmas and New Year.

Click to view our advice

Seniors should make sure to get their booster jab as soon as possible before the tidal wave of Omicron hits the county.

Don't forget your flu jab as it is expected there could be a greater chance of dying were an unfortunate individual to 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 for the latest UK Government Coronavirus advice

Omicron variant

UKHSA reports the Omicron variant of concern first found in South Africa is spreading exponentially in the UK, and Nadhim Zahawi reports that it now makes up a third of cases in London.

Based on what has happened in South Africa, the Omicron variant is expected to overtake Delta by the end of December. First indications are that the Omicron variant causes less severe illness than Delta, so the public should not be too concerned.

For example see Dr John Campbell's video of 11th December 2021

Scientists cannot know the infection/fatality ratio of the Omicron variant in the UK before New Year, but experts appear hopeful booster vaccinations will offer protection from serious illness and death in most cases.

The biggest concern is that because Omicron is so transmissible a tidal-wave of COVID hospital admissions could put great pressure on NHS beds during the first quarter of 2022.

The chart below illustrates how Omicron daily cases might rise in the UK if cases were to grow exponentially with a period of 3 days.

Projection of Omicron cases in UK

Illustration of rise in daily new cases of Omicron

Omicron is not expected to make a big difference to daily figures until after Christmas. Thereafter cases will probably rise steeply; possibly so steeply that the UKHSA capability to record the figures is overwhelmed.

We anticipate that those with 'less than severe illness' will have to self-medicate at home with only the very sickest patients being admitted to hospital.

Meanwhile, the government is accelerating the vaccination programme as its main line of defence, and no doubt the NHS is developing contingency plans to cancel elective operations and reallocate wards to COVID patients, should that prove necessary.

See the SAGE minutes of 7th December for situation update:

click for SAGE 98 minutes: Coronavirus (COVID-19) response, 7 December 2021 Published 8 December 2021

Eventually according to the SIR model the number of daily cases should reduce as the number of susceptible individuals (not yet infected) in the population shrinks, but we have not yet seen any estimate of the likely height of the peak and its duration. That will depend on both the effectiveness of the vaccines and the measures adopted by the public to protect against infection.

Ideally in our opinion the government should be offering guidance on protective measures rather than imposing restrictions and fines.

How to get vaccinated

The effectiveness of the vaccines falls slightly over time so the most important thing everyone can do now is get a booster jab.

All those aged 70+ years should have received either an email, letter or text message from their GP surgery, or a letter from the NHS inviting them to book an appointment for their booster.

Under the government's plan to deal with the Omicron Emergency, all those aged 18+ years are eligible to book a booster 3 months after their second dose, but when that appointment will be is another matter!

See the NHS website for walk-in opening times and vaccine availability:

www.nhs.uk/grab-a-jab

Alternatively click this link for more information and to book a vaccination on-line:

Book a Coronavirus vaccination - NHS (www.nhs.uk)

Note: the immuno-compromised may be offered a third jab as part of their primary course, followed by a booster 3 months later.

More about vaccinations

Plan

On the 19th November 2021 the JCVI issued new recommendations accepted in Parliament by Sajid Javid. The plan is to vaccinate fully as many people as possible before the Omicron variant becomes dominant in the UK.

adults aged 18+ years will now be eligible for a booster at least 3 months after their 2nd dose;
those aged 12 - 17 will be eligible for a 2nd dose at least 3 months after their 1st dose;
the immuno suppressed will be offered 3 doses and a booster at least 3 months after their 3rd dose;
the booster will normally be either Moderna (half dose) or Pfizer;
those that cannot tolerate mrna vaccines will be offered Astrazeneca;
the NHS will prioritise patients and call people forward in order of risk, that is the most elderly, and medically vulnerable aged 16+ first.

There appear no plans at present to vaccinate those aged 5 - 11 years.

The new arrangements are still being worked out, but once these have been set out, if you are worried and feel you have been missed out you should contact your GP.

On 12th December the PM announced a further target to offer all those aged 18+ years the chance to book an appointment by the end of December.

Vaccinometer

So that you can see the overall progress of the vaccination programme in the UK, our bar chart below shows the total number of:

first jabs;
second jabs;
booster and third jabs;
for comparison, the population of the UK broken down by age band.

COVID vaccination bar chart

Vaccinometer as of 12th December 2021

The population of the UK aged 12+ is about 58M, so were everyone in that age group to be vaccinated under the new plan the lower two blue lines showing 1st and 2nd doses should ideally reach 58M.

Currently there are about 7M in this age group who are unvaccinated, which is a lot, and 4M still to get their 2nd dose.

In comparison, if children aged 11 years and under are counted, the total population of the UK is roughly 66M.

Achieving herd immunity is now thought to be impossible as fully vaccinated individuals can still catch COVID-19 and pass it on to others; nevertheless vaccination is most important to protect as many individuals as possible of all ages 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.

Click for BBC report - Covid vaccine: How many people are vaccinated in the UK

Booster jabs

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

To date about 46M have had two doses, and 23M booster doses have been administered, suggesting up to 23M to boost in the UK.

The target set by the PM to 'boost' everyone eligible by the end of December is laudable but probably unattainable.

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 double vaccinated 88.8% of its population, Singapore 87.0% and Malaysia 77.6%, compared to 68.5% in the UK. Australia has overtaken the UK with 74.7% fully vaccinated and could soon open its borders to the fully jabbed.

Israel has already boosted its population. In Singapore all age groups are now eligible for a booster 5 months after their second dose. We imagine the UK is ahead of the EU booster programme.

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 46,006 to 51,497 cases per day.

Note: it seems too early for this increase to be due to Omicron.

The ZOE COVID Study estimates there are more likely 83,000 cases per day compared to 79,000 last week.

The chart below shows how the daily rate reported by PHE has varied since 1st September 2020. Cases of Delta appear to have ramped up by about 10,000 cases per day in the last quarter.

COVID daily new cases

UK daily confirmed COVID cases 1st September 2020 to 12th December 2021

Zooming in, the next chart shows in more detail how daily UK cases have risen during the last month.

Daily COVID cases to 2nd May 2021

UK daily confirmed COVID cases 1st September 2021 to 12th December 2021

During the last week the cumulative total of confirmed UK COVID-19 cases reported by PHE rose by 355,126 to 10,819,515.

In Worcestershire there have now been 88,152 confirmed cases of COVID-19 an increase of 3,239 on last week.

The next chart shows how daily cases in Worcestershire have remained fairly level during the last three weeks.

COVID cases in Worcestershire

Daily cases in Worcestershire from 1st September to 12th December 2021

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	17,034	+528	98,529
Malvern Hills	8,367	+296	77,545
Redditch	14,983	+574	85,317
Worcester	15,589	+698	103,542
Wychavon	17,311	+657	126,240
Wyre Forest	14,868	+486	100,957
TOTAL	88,152	+3,239	592,130
COMPARE WITH
County of Hereford	23,422	+790	195,000
Leicester (city of)	69,280	+1,386	400,000

Cumulative cases reported by PHE in Worcestershire to 12th December 2021

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 are mostly up a little on last week. Malvern Hills is down a tad.

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 fairly level and 6 times lower than in those aged under 60, while 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.

Cases across much of England and Wales remain high.

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 6th December are: North Malvern 33; Malvern Link 9; Pickersleigh 17; Barnards Green 24; Malvern Wells and Priory 23; Callow End and Hanley 30; Upton and Welland 27.

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 834 in the last week to 146,439 while the daily average flat-lined at about 120 deaths per day.

UK COVID death rate

COVID-19 death rate 1st September 2021 to 12th December

Click to view the UK government Coronavirus Dashboard

Since England emerged from lockdown on 19th July about 18,000 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 7%.

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 26th November 2021 (week 47 of 2021) is shown below.

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

Districts of Worcs	Deaths 2020	Deaths 2021	Week 47	Population
Bromsgrove	164	132	2	98,529
Malvern Hills	61	96	0	77,545
Redditch	108	99	2	85,317
Worcester	87	128	1	103,542
Wychavon	157	148	2	126,240
Wyre Forest	171	129	2	100,957
TOTAL	748	732	9	592,130

Provisional cumulative COVID-19 deaths registered by ONS to 26th November 2021

In week 47 there was 1 death in a care home, and 1 in hospital in Bromsgrove; 2 deaths in hospital in Redditch; 1 death in hospital in Worcester; 2 deaths in hospital in Wychavon; and 2 deaths at home in Wyre Forest.

In England and Wales 815 COVID-19 related deaths were reported in the week to 26th November, 134 less than the week before. Of these 65 were in a care home, 90 at home, 5 in a hospice, 649 in hospital and 6 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 10th December 2021.

Worcestershire	Cumulative deaths	Past week
Acute hospitals	897	6
Care hospitals	64	0
TOTAL	961	6

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 25th November 2021 when the daily death rate fell to 125.

Age band	Number of deaths	% of deaths
0 - 19	29	0.3
20 - 39	157	2
40 - 59	1,058	11
60 - 79	4,062	43
80+	4,134	44

Relative risk of COVID-19 death by age band

Those aged 60+ years account for 87% of deaths compared to 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

Some COVID deaths are 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 and NHS bed occupancy.

Hospital COVID cases (UK)	Number	Change since last week
Patients currently in hospital	7,413	+40
Patients on ventilation	900	+5
Patients admitted daily	839	+17

Headline summary of patients in hospital reported on 12th December

Hospital admissions have roughly flat-lined in recent weeks. The number of hospital beds occupied by COVID patients is about 18% of the peak last January.

Worcestershire 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 7th December there were 55 COVID-19 patients occupying Worcestershire Acute Hospital beds (down from 58), of which 4 were ventilated beds; roughly 20% of the peak experienced last January.

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 19th December) the cumulative total of UK COVID-19 cases reported by PHE on the Coronavirus Dashboard could increase by 385,000 towards 11,210,000 with the 7 day rolling average of daily new cases rising towards 55,000.

In Worcestershire up to 3,400 new cases of COVID-19 can be expected, and 300 in the Malvern Hills district.

We expect the number of UK COVID (28) deaths to increase by about 875 to 147,300 during the 7 days ending 19th December 2021, with the average daily death rate possibly rising towards 130 deaths per day. 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 3,239 new cases this week may translate to 6 COVID deaths per week by the end of December.

Daily hospital admissions are expected to rise slightly to somewhere in the range 850 - 950, tracking the rise in daily cases.

Longer term outlook

The outlook beyond Christmas is a little worrying following the emergence of the highly infectious Omicron variant which is expected to overtake Delta by New Years Day.

For the old scenario, based on the Delta variant remaining dominant and becoming endemic, we had been expecting to see a gradual downturn in daily hospital admissions and deaths during the next 3 months as those aged 40+ years received booster jabs, and children were either vaccinated or gained immunity following infection by COVID-19.

The timing of this was uncertain depending on the speed of the vaccine rollout and take-up; 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 we were looking towards the end of December to see a marked improvement in the figures.

The emergence of Omicron is a potential game changer. The only thing we currently know for sure is that cases are increasing exponentially in the UK, but little is known about how sick Omicron makes westerners in winter, how many might die, and to what extent Omicron escapes the Wuhan vaccines.

Scientists are hoping symptoms will be no worse than for Delta and booster jabs will reduce serious illness and death. Were that the case, the remaining problem is that Omicron is growing exponentially which could lead to one million cases per day by early January compared to fifty thousand for Delta.

By the New Year scientists should start to have a better idea about the reproduction rate of Omicron, the severity of illness in different age groups, and the level of protection offered by the current vaccines.

Recent modelling from University College London, based on the Delta variant, suggested the 7-day average of daily deaths of about 150 per day might fall slowly over the next weeks, reaching a minimum of about 25 per day in April 2022.

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

This and other models will need to be rerun in January once the outline parameters of the Omicron variant are known, and as they are refined, and taking account of the accelerated roll-out of boosters.

It's clear we are entering a period of great uncertainty just as the country closes down for Christmas festivities.

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

Hospital admissions 1:50 of daily cases reported by PHE, lagging by 8 days.
Deaths 1:300 of daily cases reported by PHE, lagging by about 20 days.
UK Hospital bed occupancy - one fifth of daily cases, lagging by up to a month.

The situation could change, for better or worse, as the Omicron variant overtakes Delta.

Advice for Seniors

COVID risk medium Recently 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.

7M people remain unvaccinated in the UK. 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.

In these increasingly uncertain times the simple safeguards to remember are to:

book your booster dose as soon as you are contacted by either your GP or the NHS; between five days and two weeks after the booster most people should be well protected from severe illness caused by the Delta variant and most probably Omicron.
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 either a FACE covering, FFP2, or N95 face mask when unavoidably near other people for example when in shops, health-care settings, and when 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 current top five symptoms amongst the double vaccinated and children, in order of prevalence, are said to be runny nose (74%), headache (72%), sneezing (60%), sore throat (48%), and persistent cough (48%), 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.

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.

3) The COVID Symptom Study people suggest that if you have symptoms of a common cold there is currently a 1 in 3 chance you might have COVID.

4) If you are attending a festive event consider taking a Lateral Flow test before you go to check you are not taking COVID to the party.

5) If you are organising an event, ask those attending to take a Lateral Flow test.

6) Depending on your circumstances, think about attending a carol service or pantomime with lots of children present who could be spreading the virus.

Annex

Commentary

Events are now fast moving as the Omicron variant of COVID-19 rears its head in the UK. The government is to make a statement on Tuesday 14th December when we should hear whether any further restrictions are in the pipeline.

This week

On Tuesday the Scientific Pandemic Influenza Group on Modelling, Operational sub-group (SPI-M-O) issued a gloomy statement on the possible spread of the Omicron variant highlighting there were many unknowns.

SPI-M-O: Consensus Statement on COVID-19, 7 December 2021 Published 8 December 2021

On Saturday the BBC reported modelling at the London School of Hygiene and Tropical Medicine (LSHTM) outlining some alarming scenarios for the spread of the Omicron variant of COVID-19.

Click for BBC report - Covid: Omicron study suggests major wave in January

On Sunday the COVID Alert Level was raised from 3 to 4 and the PM announced an Omicron Emergency on TV.

Click for text of Prime Minister's address to the nation on booster jabs: 12 December 2021

Click to watch Prime Minister's address to the nation on booster jabs: 12 December 2021

What might happen next

In the worst case, assuming there are now 2,000 confirmed cases of the Omicron variant in the UK, transmission is not slowed much by the vaccines, and the virus grows exponentially doubling every 3 days or so, daily cases could be largely masked by the Delta variant during the next week.

Expect cases of Omicron to surge after Christmas Day competing with and then overtaking the Delta variant by the New Year.

All we can do for now is stick with present plans, keep an eye on the figures as Christmas Day approaches, and be prepared to modify our behaviour should that become necessary.

COVID video updates

The usual charts can be found in the Zoe COVID Study and Independent SAGE weekly updates. The chief topic this week is the Omicron variant. If you are interested and have the time all these videos are worth watching.

Click to watch Tim Spector's Zoe COVID Study 9th December update

The Independent SAGE weekly briefing briefly starts with this week's data and goes on to discuss the arrival of the Omicron variant.

Click to watch Independent SAGE 10th December video briefing

Dr John Campbell talks about the rapid spread of Omicron in South Africa, where it has taken only 4 weeks to become dominant.

Click to watch Dr John Campbell's 8th December video about Omicron

Dr John Campbell also speaks about a large outbreak of COVID at a Norwegian party and more about the rise of Omicron world-wide.

Click to watch Dr John Campbell's talk on 9th December about Omicron in Norway

Dr John Campbell talks more about the spread of Omicron on 10th December

U3A

U3A groups are packing up for Christmas. The Social History group has decided to cancel its party.

Overseas travel

Refer to current government advice, and prepare contingency plans in case circumstances change..

From 10th January 2022, travellers to the EU may have to show evidence of a booster vaccination if 9 months have elapsed since their last jab.

Click for Guardian report

List of vaccines

Here is the updated list of COVID-19 vaccines ordered by the UK. It looks as though for now the government has settled on Pfizer as first choice with Moderna second and Astrazeneca 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 in 2021 and Jan/Feb 2022 for the population of the UK. The government has now signed deals to buy 114 million additional doses of the Pfizer (54M) and Moderna (60M) vaccines to use in 2022 and 2023.

Click for press announcement - Government agrees new deals to future proof vaccine rollout in light of new variant

The press announcement goes on to say that 60M doses of Novavax vaccine are expected to be delivered in 2022 and 7.5M doses of GSK/Sanofi, so there seems no intention to cancel these late arrivals.

Click for Guardian report - Novavax expected to be become fourth Covid vaccine available in UK

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. Delivery expected in 2022.
GSK Sanofi	60	Some delay due to adjusting the formula to give better protection to the elderly; expected approval and delivery of 7.5M doses in 2022.
Curevac	50 ?	Contract placed with German company Feb 2021. Possible source of new variant vaccine; disappointing trial results have resulted in the company working on a second generation vaccine. 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 is shown in the following table.

Region	Case rate
England	507
Wales	508
Scotland	373
Northern Ireland	663
Worcestershire	509
Malvern Hills	364

Seven day Case Rate per 100,000

The case rate is up a little on last week.

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

Based on back of the envelope sums in earlier blogs, 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.

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

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 check you are 'virus free' at home - either before visiting an elderly person, going to work, or attending a crowded event. It also provides a means to check whether or not you have Coronavirus if you are 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 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.

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 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 within 24 hours at:

www.gov.uk/report-covid19-result

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)

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.

About the 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 may be advised to self-isolate

The rules for contacts self isolating keep changing. The latest is that if you are unvaccinated you must isolate for 10 days.

If you are fully vaccinated you can alternatively take Lateral Flow tests for 7 days. Should you test positive you should isolate and then take a PCR test to confirm.

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

About the NHS app and Covid Pass

An NHS COVID Pass shows your coronavirus (COVID-19) vaccination details and/or test results. This is your COVID-19 status. You may be asked to show your pass to travel abroad, or at events and venues in England asking for proof of your COVID-19 status.

For large UK events you may get in either by the fact: