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

2nd January 2022

CASES STILL RISING

Hospitals coming under pressure

No new restrictions

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

Cases of Omicron are spreading rapidly across the UK, but not as quickly as some had feared. Hospital admissions are rising but some of this is said to be patients going into hospital for other reasons, and testing positive after admission; not because of difficulty breathing.

Sickness from Omicron has been spreading mainly in younger age groups and few patients are being taken into Critical Care; so far Omicron has not yet spread in any degree to the elderly so it may be a week or two before reasonably accurate estimates can be made of hospitalisations and deaths.

If illness from Omicron is milder, as South African sources suggest, a fall should be seen in the ratio of UK daily hospital admissions and deaths to daily new cases during January.

The primary impact from Omicron mentioned initially in the media was sick absence amongst airline pilots, train drivers and NHS staff; now there is also said to be increasing pressure on NHS beds, particularly in London.

Children returning to school may cause an uptick in cases in January, but the short sharp rise in Omicron cases could be all but over in a few weeks.

Click to view our advice

Seniors should make sure to get their booster jab. Don't forget your flu vaccination 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.

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 friends.

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

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.

Under the government's plan to deal with the Omicron Emergency, all those aged 18+ years are now eligible to book a booster 3 months after their second dose.

For information about walk-in centres in Worcestershire go to the website:

www.swhealthcare.org.uk

and click the Vaccine Rollout tab at the top of the page.

Click for information about vaccination at the Three Counties Showground

Otherwise either see the NHS website for walk-in opening times and vaccine availability:

www.nhs.uk/grab-a-jab

Or 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 recommendations accepted in Parliament by Sajid Javid. The plan was to vaccinate fully as many people as possible before the Omicron variant became 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;

MHRA has approved vaccination of those aged 5 - 11 years. The next hurdle is getting the JCVI to confirm there is sufficient benefit

The Omicron variant is now dominant and spreading rapidly, so there is still good reason to get a booster jab in January if you have not already done so.

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 31st December 2021

Data on the Coronavirus Dashboard is incomplete due to the Christmas and New Year holidays, but any changes to this chart will be tiny.

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 6M 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.

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

A summary can also be found on the Coronavirus Dashboard.

The government says everyone aged 18+ years has been offered a booster jab. To date about 47M have had two doses, and 33M booster doses have been administered, suggesting up to 14M still to boost in the UK, so there is still considerable work to be done.

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 some other countries. For example Portugal has double vaccinated 89.3% of its population, Singapore 87.0% and Malaysia 78.0%, compared to 69.3% in the UK. Australia has overtaken the UK with 76.4% fully vaccinated and could soon open its borders to the fully vaccinated.

Israel has already boosted its population and is now trialing a second booster for those boosted more than 4 months ago.

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 107,432 to about 156,000 cases per day reflecting the continuing surge of the Omicron virus. Data from Scotland and NI is delayed and could add 10%.

The ZOE COVID Study estimates there are more likely 205,000 cases per day compared to 177,000 last week.

The chart below shows how the daily rate reported by PHE has varied since 1st September 2020. Cases of Omicron are rising at an unprecedented rate.

COVID daily new cases

UK daily confirmed COVID cases 1st September 2020 to 2nd January 2022

Zooming in, the next chart shows in more detail how daily UK cases have varied over the last 3 weeks as the Omicron variant has gradually replaced Delta.

Daily COVID cases to 2nd May 2021

UK daily confirmed COVID cases 12th December 2021 to 2nd January 2022

During the last week the cumulative total of confirmed UK COVID-19 cases reported by PHE rose by 1.1M to 13.2M.

In Worcestershire there have now been 105,289 confirmed cases of COVID-19 an increase of 8,418 on last week.

The next chart shows how daily cases in Worcestershire have tripled as the Omicron variant has replaced Delta.

COVID cases in Worcestershire

Daily cases in Worcestershire from 1st September to 2nd January 2022

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	20,557	+1,677	98,529
Malvern Hills	10,010	+766	77,545
Redditch	17,784	+1,551	85,317
Worcester	18,751	+1,453	103,542
Wychavon	20,679	+1,621	126,240
Wyre Forest	17,508	+1,350	100,957
TOTAL	105,289	+8,418	592,130
COMPARE WITH
County of Hereford	27,661	+2,347	195,000
Leicester (city of)	80,558	+5,558	400,000

Cumulative cases reported by PHE in Worcestershire to 2nd January 2022

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.

Broadly speaking cases are at least 50% up on last week.

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 both age groups rising with cases in the younger age group 4 times that of the older.

The rolling number of cases per 100,000 per week is 240 in the over 60s and 970 in those aged 0 - 59 years (up about 16% on the week before).

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 of Omicron are extremely high in London where the vaccination rate is below average, and cases are rising throughout the UK, especially in a band reaching from the SE to the NW of England. This band broadly matches areas of poorest vaccination on the Zoe Covid Study map.

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 27th December are: North Malvern 57; Malvern Link 47; Pickersleigh 34; Barnards Green 41; Malvern Wells and Priory 32; Callow End and Hanley 39; Upton and Welland 37.

Roughly the same as last week.

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 991 in the last week to 148,851 while the daily average rose from about 100 deaths per day to 142.

Most of these deaths will have been due to the Delta variant, with Omicron possibly causing 20 deaths per day towards year end.

Note that late reporting of Christmas deaths may have skewed the most recent 7 day average and that New Year data for Scotland and NI is still to add.

UK COVID death rate

COVID-19 death rate 1st September 2021 to 2nd January 2022

Click to view the UK government Coronavirus Dashboard

The discontinuity in the red chart in recent days is caused by delayed reporting of data over Christmas and the New Year and the figures cannot be relied on.

Since England emerged from lockdown on 19th July about 20,000 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 6%.

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 17th December 2021 (week 50 of 2021) is shown below.

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

Districts of Worcs	Deaths 2020	Deaths 2021	Week 50	Population
Bromsgrove	164	138	1	98,529
Malvern Hills	61	98	1	77,545
Redditch	108	104	2	85,317
Worcester	87	131	0	103,542
Wychavon	157	152	0	126,240
Wyre Forest	171	130	0	100,957
TOTAL	748	753	4	592,130

Provisional cumulative COVID-19 deaths registered by ONS to 17th December 2021

All Worcestershire deaths this week were in hospital.

In England and Wales 753 COVID-19 related deaths were reported in the week to 17th December, 9 less than the week before. Of these 42 were in a care home, 71 at home, 6 in a hospice, 633 in hospital and 1 elsewhere.

The death rate has been slowly falling in recent weeks, probably due to the vaccination programme. Most of these deaths will have been due to the Delta variant. The Omicron Daily Overview of 19th December reported 12 deaths up to 17th December, less than 2% of the total.

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 31st December 2021.

Worcestershire	Cumulative deaths	Past week
Acute hospitals	912	4
Care hospitals	64	0
TOTAL	976	4

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 (Delta)

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 for Delta variant

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.

This table can be updated towards the end of January once the majority of deaths are due to Omicron.

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	11,918	+3,678
Patients on ventilation	842	+26
Patients admitted daily	1,915	+744

Headline summary of patients in hospital reported on 29th December 2021

Hospitals are beginning to come under pressure from increasing COVID cases combined with unusually high staff absence, especially in London. The number of hospital beds occupied by COVID patients is now about 30% of the peak last January.

Bed number by region in England

Tabulated figures for COVID bed occupancy in England can be found on the NHS England website:

Click for NHS England COVID-19 Hospital bed Activity statistics

Note: see the latest Daily Admissions and Beds spreadsheets

For example compare figures for 21st December with 31st December for All beds COVID in London and the Midlands.

Region	21st December 2021	31st December 2021	15th January 2021
London	1,904	3,636	7,811
Midlands	1,247	2,122	5,890

Comparison of All beds COVID data

In the last 10 days COVID beds have risen by 90% in London due to the surge in Omicron cases, compared to 70% in the Midlands.

For comparison the number of beds occupied during the peak of the epidemic last January is shown in red in the right hand column.

It is said many COVID beds are now occupied by asymptomatic patients who came into hospital for other reasons. These patients are not ill with COVID but have to be allocated a COVID bed after testing positive.

Worcestershire hospital beds

Tabulated figures for bed occupancy in Worcestershire Acute and Care hospitals can also be found on the NHS England website.

A summary can be found on the UK government Coronavirus Dashboard which reports on 28th December there were 53 COVID-19 patients occupying Worcestershire Acute Hospital beds, of which 3 are 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 9th January) the cumulative total of UK COVID-19 cases reported by PHE on the Coronavirus Dashboard could increase by about 1.2M towards 14.4M with the 7 day rolling average of daily new cases possibly starting to level off at about 160,000 cases per day.

In Worcestershire about 8,000 new cases of the Omicron COVID-19 variant can be expected, and up to 800 cases in the Malvern Hills district.

The number of UK COVID (28) deaths will likely increase by about 900 towards 149,750 during the 7 days ending 9th January 2022, with the average daily death rate lying somewhere in the range 75 to 175 deaths per day.

In the county of Worcestershire, assuming a 0.2% death rate, the 8,418 new cases this week could translate to 16 COVID deaths per week in the second half of January.

Daily hospital admissions are becoming difficult to predict, but a rise of about 50% cannot be ruled out.

Longer term outlook

Professor John Edmunds with others at the London School of Hygiene and Tropical Medicine have made estimates of the likely spread of the Omicron variant for different scenarios; see paper below.

Modelling the potential consequences of the Omicron SARS-CoV-2 variant in England

Daily cases in January/February might peak roughly in the range 600,000 to 800,000; daily hospital admissions 3,000 to 7,000; and deaths 500 to 1,200.

These are 'best guess' projections as data about the virus is still limited.

Daily cases

A fortnight ago we made a simple back of the envelope calculation assuming cases follow a simple S-shaped Logistic Curve matched to the rise in cases of Omicron in order to provide an order of magnitude estimate of what might happen during January.

Note: this illustration was to provide an indication of the likely direction of travel and it was thought the absolute figures could be out by a factor of 4.

We assumed the whole population has been booster vaccinated and that 75% are protected from symptomatic illness.

This curve has been further adjusted to take account of recent numbers and a possible levelling off of daily cases

The next chart illustrates how daily cases might peak around 5th January 2022 and then begin to fall - but there is no guarantee this will happen.

Projection of Omicron cases in the UK

Illustration of possible peak in UK Omicron daily cases

The curve suggests this wave of Omicron could be largely over by the end of January. However the return to school of children in January might cause the peak either to rise higher or broaden slightly.

Daily hospital admissions

The next chart is a projection of daily hospital admissions, assuming the same ratio of cases as Delta, delayed by 10 days, showing admissions peaking about 15th January.

Forecast Omicron hospital admissions UK

Illustration of possible Omicron daily demand for hospital admission

Assuming Omicron hospital stays are shorter than for Delta the NHS may be able to sustain such case levels for a week or two but just in case NHS England is setting up Nightingale surge hubs.

Click for BBC report - Nightingale surge hubs to be set up in eight hospitals, NHS England says

Overload of the NHS in London looks possible as vaccination rates there are lower than in the rest of the UK.

The ambulance service is already hard pressed, due to staff absences aggravated by queuing to offload patients at hospitals, so could be hard pressed by Omicron related 999 calls without military assistance, unless of course severe illness turns out to be much lower than that for Delta.

During January, sickness and quarantining is likely to lead to a shortage of all those providing essential services including shop staff, refuse collectors, firemen, police, paramedics, teachers, power industry workers, telecom engineers and delivery drivers. The government has asked public bodies to prepare contingency plans for scenarios of 10%, 20% and 25% absence.

London hospital beds could be the first to come under pressure if the admission rate becomes too high, so worth keeping an eye on. It is rumoured the government has set a threshold of 4,000 London COVID hospital beds, which if exceeded might lead to further restrictions.

Deaths

Deaths have been occurring on average three weeks or so after testing COVID positive.

This illustration assumes the ratio of deaths to daily cases is half that for Delta.

Omicron death rate forecast UK

Illustration of possible Omicron daily deaths in UK

So far, Omicron deaths have been largely hidden by the tail end of Delta deaths averaging about 100 deaths per day.

Our chart suggests deaths could rise to a peak of about 250 deaths per day towards the end of January.

There are two notes of caution. Firstly, the UKHSA Omicron Daily overview report says there have already been 75 Omicron deaths to 30th December which seems rather high if Omicron causes less severe disease. Secondly so far Omicron has been circulating mostly in those aged under 35 years, and we have yet to see how Omicron affects the elderly.

Ratios

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 for Delta 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 10 days.
Deaths 1:300 of daily cases reported by PHE, lagging by about 20 days.
UK Hospital bed occupancy - 8 times daily hospital admissions, lagging by up to a month.

These ratios may 'improve' now that Omicron has replaced Delta but we may have to wait until the second half of January to find out.

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.

6M people remain unvaccinated in the UK and you tell us of obstinate people in Malvern who refuse to get vaccinated. 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 well fitting 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 (see note 3);
take a Lateral Flow test before visiting others (see notes 4 and 5);
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 plan to attend either a meeting or event take a Lateral Flow test before you go to check you are not taking Omicron with you.

5) If you are organising a meeting, ask those attending to take a Lateral Flow test immediately beforehand.

6) Think twice about attending an indoor event with lots of children present who could be spreading the virus.

Annex

Commentary

This week

On Monday we updated our blog a day late as the UK Coronavirus Dashboard was not updated on 25th and 26th December.

On Tuesday we caught up with the latest talks by Dr John Campbell on YouTube.

Click to watch 'Omicron in London and NY' on 26th December 2021

In summary, the gap between first symptoms and possible complications is only 9 to 10 days with Omicron, the number of people being hospitalised is between 50 and 75% less than Delta, and symptoms are milder. Most people affected so far are in younger age groups.

Cases are rising steeply in Australia, Canada, United States, Ireland, UK, Denmark, amongst others.

Click to watch 'Omicron so far' on 28th December 2021

As cases and infections surge, so far, hospital admissions do not appear to be going up much and deaths are going down a little.

South Africa had proposed to drop contact tracing as it has become impossible to stop the spread of Omicron but there seems to have been some wobble over this policy - click for Africa News report.

On Wednesday on Radio 5 Live Breakfast, Chris Hopson Chief Executive of NHS Providers said COVID beds in England had risen to 9,500 this week up 38% while COVID beds in London had risen to 3,000 up 59%. Omicron had spread beyond London eg to NW England. However fewer patients were in Critical Care compared to previous waves.

Chris Hopson flagged the fact that the Dashboard statistics hide the fact that many patients now in hospital with COVID went into hospital for other reasons showing no symptoms of COVID - so the situation is less bad than the figures suggest.

The main pressure on hospitals is coming from non COVID patients and staff sickness. In a normal winter sickness is about 6% compared to 13% currently (including the ambulance service).

A high demand for Lateral Flow tests was mentioned on the news with some Pharmacies running out.

Prof Paul Hunter, professor in medicine at the University of East Anglia, told BBC Breakfast TV that in time people with Covid should be allowed to "go about their normal lives" as they would with a common cold.

Click for BBC report - Covid: Evidence does not support more England curbs

That view is being actively considered in South Africa, right now.

Commentator Dr John Campbell said in one of his YouTube talks that most Omicron hospitalisations were incidental and that around 80% of English hospital admissions with Coronavirus were for other reasons, agreeing with the comments made by Chris Hopson.

Click to watch talk - Most omicron hospitalisations incidental

On Thursday there was a lot of chatter in the media about a shortage of PCR and Lateral Flow tests. Stock in Malvern pharmacies was low but there were a few kits at Evans in Malvern Link - no doubt new supplies are on there way.

Professor Stephen Bustin of Anglia Ruskin University was a guest on BBC Radio 5 Live Breakfast and spoke about PCR and Lateral Flow tests and how things might be improved.

In the evening we watched the last episode of the Royal Institution Christmas Lectures presented by Jonathan Van Tam. Professor Jonathan Van Tam dives into the microworld of viruses, revealing how these invisible invaders can infect our bodies and how a revolution in testing may transform medicine forever.

Click for episode 1 - The Invisible Enemy

On Friday the BBC reported that up to 40% of people are not showing up for their vaccination appointments. Professor Anthony Harnden a member of JCVI said on Radio 5 Live Breakfast that children aged 5 - 11 years who either have an underlying health issue or lived with an immuno suppressed adult would be probably be offered vaccination in January.

The UKHSA published a comparison of vaccine effectiveness for Omicron and Delta.

UKHSA publishes updated Omicron hospitalisation and vaccine efficacy analysis

On Saturday Chris Hopson, chief executive of NHS Providers, which represents health trusts, said hospital admissions are rising across the country but what could happen next is unclear.

Click for BBC report - The next few days are crucial in understanding the impact of Omicron on the NHS

What might happen next

See longer term forecast for general direction of travel.

COVID video updates

The usual charts can normally be found in the Zoe COVID Study and Independent SAGE weekly updates.

Dr Claire Steves presented a short 30th December 2021 COVID Symptom Study update in place of Tim Spector

There was no Independent SAGE update on 31st December 2021.

Omicron update

During December UKHSA had been publishing a daily update on the Omicron numbers and a chart, providing a pointer to trends.

Now that Omicron has risen to become the dominant strain in all regions of the UK a separate report on Omicron will no longer be published with effect from 1st January 2022. Daily COVID-19 statistics continue to be available via the Coronavirus Dashboard.

Click for UKHSA COVID-19: Omicron daily overview

The daily Omicron reports need to be treated with some caution:-

The cumulative Omicron figures are the total number of cases over time BUT the data is a subset (about 35%) of all tests. Hence the data cannot be directly compared with the Coronavirus Dashboard numbers.

The Epidemiology curve of confirmed Omicron cases by region seems to show a levelling off of daily cases but unfortunately not. Infectious disease surveillance systems are subject to reporting lags that introduce daily fluctuations in numbers. This variation particularly affects more recent data; generally speaking, data from the last 3-4 days is not considered to be a reliable indicator of trend (especially over Christmas).

U3A

Nothing to report

Overseas travel

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

From 18th December 2021 UK tourist were banned from entering France. Perhaps that will be reviewed now that cases in France are as high as in the UK?

Click for BBC report - France travel ban: UK tourists need essential reason for entry

From 20th December it sounds as though UK tourists may be banned from entering Germany and Austria due to fears about Omicron.

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 (previous week)	Case rate (this week)
England	1,145	1,385
Wales	909	1,720
Scotland	714	1,387
Northern Ireland	1,015	1,851
London (region)	2,016	1,720
Worcestershire	774	1,149
Malvern Hills	623	750

Seven day Case Rate per 100,000 reported 2nd January 2022

The case rate in the Malvern Hills has gone up a bit but in London where cases have been at their highest the good news is the rate has dropped slightly.

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 the Delta variant of COVID-19 was possibly somewhere in the range 1 in 1,000 to 1 in 10,000 per year so we judged 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.

It is rumoured Omicron will cause less serious illness than Delta, but we have seen no accurate statistics.

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.

However, it's tedious to enter your Lateral Flow Test result on the government website and we imagine many people now don't bother.

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: