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

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4th September 2022

FALL IN THE PREVALENCE OF COVID-19 BEGINNING TO SLOW?

Preamble

For more than two years we have been keeping an eye on the published government figures and monitoring the media to asses the likely level of risk for Seniors in the Malvern Hills district and providing links to where further information could be found.

During the epidemic Public Health England was split into the UK Health Security Agency and Office for Health Improvements and Disparities. However for simplicity, in this blog, we have continued to refer to this as PHE data.

Testing has been run down and the public can no longer record the result of Lateral Flow tests so the daily cases reported on the Coronavirus Dashboard greatly underestimate the actual situation, and we have deleted our section on testing; this can however be found on archived pages.

The only remaining sources of data indicating direction of travel are:

• The ONS infection survey

• Registered deaths (ONS, NHS)

• NHS hospital bed occupancy, and

• The Zoe Health Study

Now the epidemic seems largely over in the UK the numbers are of less importance, but we'll carry on with our blog for a little while longer.

As sections become no longer relevant we are deleting them, but you can always refer back to archived pages.

This page will continue to be updated each weekend using Friday's data, nominally with Sunday's date.

Contents

Summary

Booster shots

How to get vaccinated

Number of cases

Number of deaths

Healthcare numbers

Forecast for the week ahead

Longer term outlook

Advice for seniors

Annex/commentary

Summary of links

Menu of archived pages

Summary

For most people COVID no longer represents a critical threat to health in Worcestershire - at present relatively few people are being admitted to hospital and only a handful a week are dying in a population of approximately 600,000.

The COVID Omicron BA.5 death rate peaked at the end of July 2022 and has been gradually falling; there is however a little concern about excess deaths (10% or so above the five year average) which needs to be explained; it may perhaps be because patients could not see their doctor or treatment was delayed during the pandemic.

While the prevalence of COVID has continued to fall, the Zoe Health Study reports a slight upturn in new infections in the last few days.

There may be a further rise as children go back to school and winter sets in, but the effects of that may not be felt for several weeks.

Any upturn could be either reduced or negated by the NHS Autumn booster campaign; this will depend on how many step forward to be jabbed (see next section).

Because the Wuhan vaccines rarely stop people catching the Omicron variant and prevalence is still quite high, do not be surprised if you catch COVID despite being fully vaccinated.

Some may either show no symptoms or have a mild fever, sore throat, general aches and pains, and quickly get over it; while others could feel quite poorly and spend between two and five days in bed, with it taking five to ten days or so to recover.

Many of those who have caught COVID report either getting easily tired or suffering from shortness of breath for some weeks afterwards; if so patients are advised take it easy until fully recovered.

Any precautions to take are now a personal decision.

Click to view our advice

This bookmark will take you  to the Worcestershire County Council webpage links at the end - there is little new to see.

Click for Worcestershire Dashboard and associated links

Booster shots

To reduce the likelyhood of hospitalisation amongst the most vulnerable, a second COVID-19 booster jab has been available to Seniors aged 75+ years known as the Spring Booster.

Click for information about the Spring Booster

A further Autumn booster dose will now be offered to those aged 50+ starting with the oldest towards mid September.

Millions of invitations will be landing on doormats from 7th September 2022 inviting people to book their appointment without delay as the NHS sets out to protect the nation from COVID-19 ahead of the winter. The NHS should contact you when it is your turn to book - you do not need to contact the NHS.

For more information click this link:-

NHS invites more than four million people for Autumn booster as care homes set to get first jabs

The first of those eligible should be able to book a vaccine through the National Booking Service next week, with the first appointments available from the following week.

Those with transport in Malvern and surrounds should be able to get a jab at the Three Counties Showground vaccination centre (use brown gate).

Click for information about Walk-In Clinics

You will be able to book if it is at least 3 months since your last jab, but we are wondering whether to wait 6 months which would suggest around November 2022 for us.

Depending on availability you could be offered either of the original Pfizer and Moderna vaccines, or the new Pfizer and Moderna bivalent vaccines which protect against both the original Wuhan strain and Omicron BA.1.

How to get vaccinated for COVID-19

For older information about how to get vaccinated select an archived report eg

Go to 'How to Get Vaccinated' section of the 7th August 2022 blog

More about vaccinations

For historic information about the vaccination programme select an archived report eg

Go to 'Vaccination' section of the 7th August 2022 blog

Number of cases

There are now three sources reporting the prevalence of COVID-19 in the UK.

• The ONS which conducts a weekly random survey by collecting nose and throat swabs from the public for PCR tests, and analysis for variants.

• The ZOE Health Study, whereby participating members of the public log their symptoms, tests and vaccines.

• PHE data gathered from PCR testing, mostly now in hospitals. Hospitals are stopping surveillance and will now only be testing patients showing symptoms. Will not now therefore report either COVID in the general population or asymptomatic cases in hospital.

ONS infection survey

ONS estimate that 893,300 people in England had COVID-19 in the week ending 23rd August; a fall of about 25% since the previous report.

Note: the methodoloy for ONS testing has changed and it is rumoured the sample size has been reduced.

Click for latest Coronavirus (COVID-19) Infection Survey, UK

Prevalence of COVID-19 in England estimated by ONS

Zoe Health Study

The ZOE Health Study estimates are shown in the following table.

Prevalence of COVID-19 in UK estimated by the Zoe Health Study

According to the more up-to-date Zoe figures prevalence in the UK has fallen by only 6% in the last week, while daily cases have risen by 4%.

The Zoe figures suggest the current wave of COVID may be reaching a plateau.

Numbers testing COVID positive in Worcestershire (PHE)

Note: this section has been deleted due to COVID testing being run down in the UK; figures can still be found on the Worcestershire Coronavirus dashboard, but these greatly underestimate the true number of infections. The direction of travel in Malvern is down.

Click for Worcestershire Coronavirus Dashboard

Number of deaths

Statistics on COVID deaths are published by Public Health England, The Office of National Statistics, and NHS England. These can't be directly compared as  they cover different periods, but together the figures paint a picture of the direction of travel - which is that COVID weekly deaths have been falling.

PHE figures

The Dashboard chart of COVID (28) deaths, following a positive test, by date of death shows that the 7 day average peaked in England at 183 per day about 18th July, then steadily falling to 66 by 22nd August.

Note that some of the deaths reported by PHE will be people who die with COVID but not from it.

Click to view the UK government Coronavirus Dashboard

ONS figures

The Office of National Statistics (ONS) reports registered deaths in England and Wales where COVID-19 is mentioned somewhere on the death certificate. The ONS figures lag the PHE figures by 10 - 14 days and do not include Northern Ireland and Scotland.

Note: the figures include cases where COVID may have been a secondary cause of death.

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 19th August (week 33 of 2022) is shown below.

Note: the numbers are from summation of rows 9 to 339 of the ONS Death Registrations-Pivot table, which gives the provisional total of deaths reported in any week, which can be distorted by delayed reporting over public holidays.

Deaths by 'date of death' is a more accurate metric but takes longer to be confirmed.

Provisional cumulative COVID-19 deaths in Worcestershire registered by ONS to 19th August 2022.

There were 2 deaths in hospital and 1 elsewhere in the Malvern Hills; 2 deaths in hospital in Redditch; 1 death at home in the city of Worcester; and 2 deaths in care homes and 1 at home in Wychavon.

Two weeks ago 721 deaths were reported in England and Wales  in the week to 5th August. Then 591 deaths were reported of which 7 were in Worcestershire in week ending 12th August.

In England and Wales 549 COVID-19 related deaths were reported in the latest week to 19th August, 42 less than the week before and a fall of just 7%. Of these 87 were in a care home, 50 at home, 7 in a hospice, 403 in hospital and 2 elsewhere.

Deaths in Wales represent about 5% of the total.

So far this year in England and Wales 25,026 people have died with COVID mentioned on their death certificate.

ONS provisional deaths 'by week reported' in England and Wales 2022

Note: the steps in the chart above in weeks 18 and 22 were probably due to delayed reporting over the Easter, Mayday and Jubilee holidays.

The figures on the Coronavirus Dashboard of ONS deaths by date on the death certificate show ONS England deaths peaked at 120 deaths per day on 18th July; since gradually falling to 71 deaths per day by 5th August.

Note: reference to June in the last blog should have read July.

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

Click for ONS Coronavirus (COVID-19) latest insights: Deaths

NHS England figures for Worcestershire

The table below shows the latest COVID deaths in Worcestershire hospitals reported by NHS England on 31st August 2022.

Excludes deaths in care homes, deaths at home and deaths in hospices.

In fact no deaths were reported last week and 5 this week; too small a number to establish a trend.

Click for NHS COVID-19 total announced deaths

Look for COVID Total announced deaths file, then select tab Deaths by Trust.

Note: NHS say all deaths are recorded against the date of death rather than the date the deaths were announced. As from 1st July 2022 reporting has moved to publication once per week on a Thursday, rather than every weekday.

Trend in Worcestershire COVID deaths this year

Since 1st January 2022 there has been a baseline level of up to 1 COVID death per day in NHS Worcester acute hospitals.

A peak of typically up to 3 deaths per day occurred either side of 1st April, with a more recent upturn of up to 2 deaths per day during July 2022. On some days no deaths were reported.

With a Worcestershire population of roughly 600,000 and assuming one COVID death per day that equates to 0.06% COVID deaths per year. Taking into account that most deaths are of the elderly the risk of Seniors dying of COVID this year will probably be less than 0.5%.

Worcestershire represents about 1% of the population of England, so all other factors being equal, one might expect the Worcestershire death rate to be one hundredth of the figure for England.

England peaked at about 800 (ONS) deaths per week at the end of July, so for Worcestershire assume a pro rata average of 8 deaths per week or 1 per day.

To get things in perspective, at the present time, Seniors are 20 times more likely to die of something else, for example cancer, heart attack, stroke, and old age.

For that reason most people now seem to be taking the view that COVID is no longer a critical threat to their health.

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 snapshot of 2,898 recent deaths for the period 6th May 2022 to 6th July 2022 when most of these deaths will have been from the Omicron variants.

Relative risk of COVID-19 death by age band May - July 2022

The main point to note is those aged 60+ still account for 93% of deaths despite young people being more likely to catch COVID-19.

The risk profile for Omicron appears to be the same as for Delta. Age is the greatest risk factor; perhaps reflecting that older people have more health problems.

Healthcare numbers

The UK government Coronavirus Dashboard includes information about healthcare statistics and NHS bed occupancy.

Headline summary of patients in hospital reported on 31st August 2022

Note: 'Patients admitted daily' is the weekly total divided by 7. This number includes both patients admitted to hospital with COVID-19 from the community, and those diagnosed with COVID-19 in hospital.

The daily number of COVID patients admitted to hospital continues to fall. See charts on the Coronavirus Dashboard and below.

COVID daily NHS hospital admissions in England

The next chart shows how COVID daily hospital admissions have varied since 1st April 2022.

Note: shows the number of patients admitted in previous 24 hours where patient known to have COVID-19 plus patients diagnosed in hospital with COVID-19 in previous 24 hours.

NHS England - COVID daily admissions to 29th August

Due to scatter on the chart it's not clear what direction hospital admissions will take next week.

Bed numbers by region in England

Tabulated figures for COVID bed occupancy in England can be found on the NHS England website and are another indicator of the prevalence of COVID.

Click for NHS England COVID-19 Hospital bed Activity statistics

Note: see the latest Daily Admissions and Beds spreadsheets, then look for all COVID beds.

Comparison of All beds COVID data for England, London and Midlands

In the last week the number of COVID-19 General and Acute beds fell by between 10 and 15% in England, London and the Midlands.

For comparison, the number of beds occupied during the peak of the epidemic in January 2021 is shown in red in the right hand column of the table.

The chart below shows how COVID bed occupancy peaked in England about 18th July. The peak in beds is about one week delayed on the peak in daily admissions.

In the last few days there have been signs COVID bed occupancy may be reaching a plateau of about 5,500 beds in England. We'll have to wait a week or two to see if this is real or a statistical blip.

COVID bed occupancy in England from 1st April to 31st August 2022

Deaths can be expected to follow a similar shaped curve to bed occupancy delayed by one week or so.

Worcestershire hospital beds

Between 22 August 2022 and 28 August 2022, 30 patients went into hospital with coronavirus. This shows a decrease of 34% compared to the previous 7 days. There were 53 patients in hospital with coronavirus on 30 August 2022; one on a ventilator.

Click for Summary of Malvern numbers on the Coronavirus dashboard

This link also reports deaths.

Deaths in Malvern Hills

Between 20 August 2022 and 26 August 2022, there were no deaths within 28 days of a positive coronavirus test.

Forecast for the week ahead

We expect about 500 COVID related weekly deaths in England and Wales (as registered by ONS) in week 34 ending 26th August, to be reported on 6th September.

In the county of Worcestershire, based on 30 new hospital cases last week and assuming the ratio of all deaths (including those in care homes and at home) to be 1:11 of admissions, then there should be no more than 3 COVID deaths per week in the second half of September.

NHS COVID bed occupancy could continue to fall but might flat-line in England next week.

Longer term outlook

Theoretically we were supposed to have entered the endemic stage of the disease with a high background level of infection, falling in the summer as more time is spent outdoors, and then rising  in  the winter, but that is not what happened.

Factors have been the new Omicron variants against which the vaccines offered little protection from infection; vaccinations waning in effectiveness; booster shots; overseas travel during school holidays; and super-spreader events such as summer music festivals and sports events

Consequently it has become difficult for computer models to predict what happens next.

Currently there are no signs of a new variant of concern so infections could fall during September, except for the fact children go back to school and students to university, which could increase infections; including amongst their parents.

Based on current rates of fall in COVID beds we hazard a guess the ONS death rate could fall to between 360 and 400 deaths per week or about 54 deaths per day in England and Wales by the end of September.

New infections may then rise in October/November due to educational mixing and more time being spent indoors with the windows shut.

To counter this the NHS is offering Autumn booster shots to those aged 50+ years to protect the most vulnerable from serious illness; however we wonder to what extent there will be vaccine fatigue - that is people who for one reason or another do not get their booster shot.

A new factor is the dramatic surge in inflation and the cost of energy. The Clear and Present Danger is - if the poor cannot afford adequately to eat and heat their homes those that fall sick with COVID will more likely be hospitalised putting a greater strain on the NHS.

UCL modelling charts suggesting the COVID death rate may fall to a minimum of 35 deaths per day, that is 245 certified deaths per week by the end of September, which is credible; but concerningly the charts hint at a possible rise towards 1,400 deaths per week during the winter months.

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

What happens will greatly depend on the uptake and effectiveness of the Autumn booster shots, human behaviour, such as mask wearing, and the effect of inflation and energy pricing on the public's health.

We can be fairly sure that the COVID death rate will rise in the winter; but we'll have to wait and see by how much.

In our opinion, providing the death rate remains below 700 deaths per week it is unlikely either the public or the government will be concerned.

Advice for Seniors

We currently judge the risk of exposure to COVID-19 as MODERATE in the UK.

See our riskometer opposite.

Many people are taking the view that COVID is no longer a critical threat to their health.

For the more cautious the simple safeguards to remember are to:

• make sure your COVID vaccinations are fully up to date

• 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);

• if infection rates become high, ideally wear either a well fitting FACE covering,  or better an FFP2 face mask when in crowded settings for example when in shops, theatres, 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 consider putting a HEPA air purifier in the room;

• avoid crowded indoor settings;

• avoid friends and colleagues with cold and flu like symptoms;

• ideally self-isolate for 5 to 10 days to protect others if you feel unwell with cold or flu like symptoms; according to the Zoe COVID Study the current top five COVID symptoms are sore throat, headache, cough, blocked nose, and runny nose, which may be difficult to distinguish from a common cold; other symptoms may include sneezing, tiredness and muscle aches and pains.

• respect others and give them space;

• looking further ahead, don't forget to get your annual Flu jab when it next becomes available; that is usually sometime in September/October.

 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, wash hands with an alcohol based hand gel.

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

3) If you are 'clinically vulnerable' consult your GP or specialist; you may need to take a test and consider anti viral drugs if testing positive.

4) However careful you are, don't be too surprised if you catch COVID as the Omicron variants are highly infectious and the Wuhan vaccines give little protection against transmission and infection (although they do reduce the severity of symptoms).

5) You may still have to take a test and wear a facemask when travelling to some overseas countries.

Annex

Commentary

This week

It seems like COVID has gone away, but most of a family group gathered at a seaside resort in Malaysia caught it. All were vaccinated and not severely affected.

Mask wearing in Singapore has been relaxed and is now only necessary on public transport and in healthcare settings.

There are signs the fall in the prevalence of COVID in the UK is slowing so infections may possibly go up as children return to school

Testing by hospitals of patients and staff showing no symptoms of COVID-19 has been discontinued.

JCVI has published new advice for pregnant women and those breast feeding but Dr John Campbell in one of his Youtube videos highlights the government is sending mixed messages (see link below).

Autumn booster jabs should start to be rolled out in a week or two:-

Click for explainer - NHS invites more than four million people for Autumn booster as care homes set to get first jabs

The MHRA has approved the new Pfizer bivalent vaccine for Autumn Boosters:-

Click for government press release - Pfizer/BioNTech bivalent COVID-19 booster approved by UK medicines regulator 3rd September 2022

JCVI approval has yet to be obtained; no statement yet on number of doses and delivery schedule.

COVID video updates

Links to updates by Professor Tim Spector of the Zoe Health Study, Independent SAGE  and pundit Dr John Campbell can be found here:-

Click to watch Zoe Health Study fortnightly update on 25th August 2022 presented by Tim Spector.

Tim discusses the polio detection in London sewers; the ZOE Blood Pressure Study and initial results; the latest COVID data on rates which have levelled off, as well as which symptoms have reduced the most over the last month now that the Omicron BA.5 variant is dominant.

Tim also discusses the Astrazeneca COVID drug Evusheld and the UK government's decision to retract its use - an issue of interest to the immuno compromised.

The last Independent SAGE briefing was on 12th August.

Click to watch Independent SAGE weekly update on 12th August  2022

Dr John Campbell talks about vaccine guidelines in his 2nd September video:

Click for Dr John Campbell's talk on vaccine guidelines for pregnant women

Dr Campbell talks in another video about the probability of natural immunity from a previous infection protecting from from catching the BA.5 variant.

Dr John Campbell talks about natural immunity in Portugal

This seems to range from 50% to 75%.

List of vaccines

Autumn bivalent boosters

A second bivalent vaccine has been approved 3rd September 2022 as a booster by the Medicines and Healthcare products Regulatory Agency (MHRA) after it was found to meet the UK regulator’s standards of safety, quality and effectiveness. The updated booster vaccine made by Pfizer/BioNTech, targeting two coronavirus variants, has been approved for use in individuals aged 12 years and above.

An updated version of the COVID-19 vaccine made by Moderna that targets two coronavirus variants (known as a bivalent vaccine) has been approved for adult booster doses by the Medicines and Healthcare products Regulatory Agency (MHRA) after it was found to meet the UK regulator’s standards of safety, quality and effectiveness.

Click for government press release - First bivalent COVID-19 booster vaccine approved by UK medicines regulator

The earlier vaccine story

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

Moderna has been offered for Spring Boosters at the Three Counties Showground.

The order for Valneva has been cancelled, but nevertheless it has now been approved for use by MHRA.

Click for BBC report - Valneva Covid vaccine approved for use in UK

 Nuvaxoid (Novavax) was approved in February.

 The government has 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

Table of vaccines ordered by the UK government

Summary of Links

Some of this information is now out of date but provides a historical context to the epidemic.

Information about Coronavirus can be found on the NHS website:

https://www.nhs.uk/coronavirus

Symptoms

About COVID symptoms

Note: the list of symptoms was updated on 1st April 2022

Article about the effects of Wuhan Coronavirus on the human body

Reporting and how to obtain a test

How to get a test

https://www.nhs.uk/coronavirus

About joining the Zoe COVID Symptom Study:

 https://covid19.joinzoe.com

Guidance

UK government Coronavirus guidance

See also - government sets out next steps for living with COVID

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

UK Health and Security Agency (UKHSA) website

COVID Alert states

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

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

Tiers

Guidance on tiers: what you need to know

Government postcode checker to find tier for other areas

Statistics

UK government COVID-19: Omicron daily overview

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

Reports on COVID intensive care beds - see intensive care national audit and research centre (ICNARC) website

Worcestershire Coronavirus Dashboard

Worcestershire COVID-19 Vaccinations Dashboard

HSA COVID-19 vaccine weekly surveillance reports

Information about NHS hospital bed numbers: past, present, future

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

Click for chart showing % vaccinated

Modelling

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

Reports

Coronavirus (COVID-19) latest insights by ONS

A live roundup of the latest data and trends about the coronavirus (COVID-19) pandemic from the ONS and other sources.

https://www.medrxiv.org/

MedRxiv is a US preprint server for Health Sciences. A depository for reports which have still to be peer reviewed.

COVID-19 rapid guideline: managing the long-term effects of COVID-19

NICE guidance on managing Long COVID

The bigger picture

Worldometer summary of coronavirus cases worldwide

European Centre for Disease Prevention and Control info

https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases

World Health Organisation info

https://covid19.who.int/

Window on the USA

Centre for Disease Control (CDC)

CDC COVID Data Tracker

Find maps and charts tracking cases, deaths, and trends of COVID-19 in the United States.

American Association of Retired People (AARP)

Worcestershire

A local summary of COVID data can be found on the Worcestershire Coronavirus Dashboard.

Note 1: use the arrow <> buttons at the bottom of the Dashboard screen to move between pages.

Note 2: the figures for COVID cases are becoming meaningless as testing is run down.

Note 3:  deaths are on page 7, and hospital beds on page 9.

Click for Worcestershire County Council COVID-19 news

There is a colourful webpage offering advice on learning to live with COVID for those aged under 30 years. 'Rona' is slang for Coronavirus.

Click for The Worcestershire 'Rona' Hub

COVID Outbreak Control Plan

Click for Simple Summary of Malvern numbers on the Coronavirus dashboard

Miscellaneous

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

Views of Prof Christina Pagel, a member of Independent SAGE

Follow Christina Pagel 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

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The interpretations and opinions expressed are our own