Blogs > Coronavirus (COVID-19) epidemic weekly update for Malvern SeniorsClick to read our observations on politics and world events 23rd October 2022 COVID BED OCCUPANCY LEVELLING OFF - BUT INCIDENCE STILL HIGH Those aged 50+ years can book Autumn booster vaccinations PreambleFor 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:
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. ContentsSummaryThe incidence of COVID remains high which is a good reason to take care; test if you still have Lateral Flow Tests; and take any necessary precautions to limit the spread. For example, do not attend meetings in person if you are feeling poorly. It still seems, for most people, COVID no longer represents a critical threat to health in Worcestershire - at present relatively few people are being admitted to hospital with severe illness and typically only a handful of patients a week are dying in a population of approximately 600,000. Death rateAfter dipping to somewhere between 230 and 300 deaths per week the COVID death rate in England and Wales has risen to 400 and could possibly rise towards 800 deaths per week this winter. That's a lot but nothing for most people to be concerned about. Winter wave of COVID-19There are signs that the peak of the Winter Wave has already been reached so a fair chance that COVID will not affect celebrations this Christmas. Autumn booster jabsAutumn booster vaccinations are now on offer to all those aged 50+ years and the vulnerable. Seniors are advised to get both the COVID booster and flu jab to reduce the likelyhood of severe illness and hospitalisation. Independent SAGE say of those aged 65+ years in England 63% have had Autumn Boosters, Scotland 64%, Wales 46% and Northern Ireland 42%. This week, ONS reports infections running especially high in those aged 50 - 69 years so a good reason to get an Autumn booster. See Booster shots section below. What happens if you get sickBecause the vaccines rarely stop people catching COVID and prevalence is rising do not be surprised if you catch COVID despite being fully vaccinated. Infection 12 months ago rarely stops people getting sick for a second time. 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 to take it easy until fully recovered. PrecautionsAny precautions to take are now a personal decision. The bookmark below 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 shotsAn Autumn booster jab is being offered to all those aged 50+ years and vulnerable groups. Note: you should not book if it is less than 3 months since your last vaccination or you have had COVID within the last 2 weeks. Either the NHS or your GP Surgery (or both) should contact you when it is your turn to book; either by email, text message or letter. You should not need to contact them. The arrangements for getting vaccinated have changed slightly with the rollout of Autumn boosters. According to SW Healthcare, representing GP Surgeries, the centre at the Three Counties Showground has closed and vaccinations will either be at GP Surgeries, or at walk-in 'Pop-Up' Clinics, else roving 'Vaccine Vans' which are otherwise known as 'Jab-Vans'. That is not the complete picture as some pharmacies such as Claremont House in Barnards Green and Evans in Malvern Link will also be offering walk-in and timed appointments. To book an Autumn Booster on-line:- Click for NHS National Booking Service Note: you may sometimes have to travel out of town to get an Autumn booster appointment, depending on vaccine availability. Alternatively you can wait to be contacted by your GP Surgery and in due course get your Flu vaccine at the same time. Don't forget to check the mobile phone you have registered with your GP surgery for text messages. If you think you have been forgotten or don't have a mobile phone, phone your GP surgery to book an appointment. Our email from the NHS included a link for finding walk-in centres: Click this NHS link to find a walk-in coronavirus (COVID-19) vaccination site 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. The SW Healthcare website explains the Worcestershire arrangements that are gradually being put in place by GPs in conjunction with NHS Herefordshire and Worcestershire. Click for SW Healthcare information about where to get your vaccination in Worcestershire Hint: click Vaccine Rollout on the navigation bar at the top of the page and then Vaccine Van for pop-ups. When we last looked pop-up venues for Malvern had been deleted from the calendar. In summary, if you want to get your Autumn booster you can either book an on-line appointment, possibly having to travel out of town, look for a local walk-in centre such as Claremont House and Evans Pharmacies, look for a pop-up, or perhaps easiest contact your GP Surgery and book your flu jab at the same time. Vaccination SitesThe NHS England website has a spreadsheet updated 5th October 2022 listing vaccination centres under the categories:
Note: this does not mention plans for pop-ups or vaccination-vans. Click for NHS England Vaccination Sites Two pharmacies in Malvern are listed Evans in Malvern Link, and Claremont House in Barnards Green. Prospect View is the only GP Health centre listed in Malvern. (No information listed for Whiteacres Medical Centre, Malvern Link; do tell us if you know) Upton Surgery is used by some residents of Malvern and surrounds. The Malvern Showground remains listed as a Vaccination Centre despite SW Healthcare saying it has closed. If you know the situation there do please let us know. No hospital hubs are listed for Worcestershire. Note: for historical information about how to get vaccinated, which may be out of date, select an archived report eg Go to 'How to Get Vaccinated' section of the 7th August 2022 blog Number of casesThere are now three sources reporting the prevalence of COVID-19 in the UK.
ONS infection surveyONS estimates that 1,706,200 people in England had COVID-19 in the week ending 10th October 2022; an increase of 12% since the previous report. Note: this information is almost two weeks out of date. Click for latest Coronavirus (COVID-19) Infection Survey, UK
Prevalence of COVID-19 in England estimated by ONS Compare with estimated prevalence in Scotland (1:35), Wales (1:25), and Northern Ireland (1:40). Zoe Health StudyThe 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 later Zoe figures estimated prevalence rose by just 2% in the UK last week while daily cases fell by 14% leading to hope the Winter Wave may have peaked. Hospital bed occupancy has levelled off and may be about to fall. 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 deathsStatistics 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 are rising tracking the recent increase in prevalence due to the Winter Wave. PHE figuresThe 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 43 per day by 13th September before rising to 112 deaths per day on 10th October. Note: roughly half the deaths reported by PHE may be people who die with COVID but not from it. Click to view the UK government Coronavirus Dashboard ONS figuresThe 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 7th October (week 40 of 2022) is shown below. Note: the numbers are now derived from Table 1 of the ONS Death Registrations spreadsheet using the in-built filters. This gives the provisional total of deaths registered in any week, which can be distorted by delayed reporting, for example, due to public holidays. Deaths by Welsh Health Boards are excluded to avoid duplication as these are totals of Local authorities. Death occurrences 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 7th October 2022. There were just 2 deaths in hospital in Wychavon, and 1 death in hospital in Wyre Forest. In England and Wales 400 COVID-19 related deaths were reported in the week to 7th October, 113 more than last week and a rise of 39%. Of these 50 were in care homes, 26 at home, 8 in a hospice, 315 in hospital and 1 elsewhere. So far this year in England and Wales 27,375 people have died with COVID mentioned on their death certificate.
ONS provisional deaths 'by week reported' in England and Wales 2022 Note: steps in the chart above can be caused by delayed reporting. Following the recent upturn in hospital admissions it's possible the death rate will rise a little for a week or two but, as can be seen from the chart, the long term trend over the past nine months has been downwards. 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; gradually falling to a 7 day average of 30 deaths per day by 9th September, since risen slightly to 37 on 23rd September. This is the most reliable measure of deaths. 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 WorcestershireThe table below shows the latest COVID deaths in Worcestershire hospitals reported by NHS England on 20th October 2022.
Excludes deaths in care homes, deaths at home and deaths in hospices. An upturn, mirroring the recent rise in hospital bed occupancy, was expected, but deaths this week are a tad higher than expected. 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 (overview)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 but now no more than 400, so for Worcestershire assume a pro rata average of fewer than 4 deaths per week. To get things in perspective, at the present time, Seniors are 30 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 bandNHS 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 still the greatest risk factor; perhaps reflecting that older people have more health problems. According to the Coronavirus Dashboard sex is an additional risk factor - males are roughly 50% more likely to die than women. Healthcare numbersThe UK government Coronavirus Dashboard includes information about healthcare statistics and NHS bed occupancy.
Headline summary of patients in hospital reported on 20th October 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. See charts on the Coronavirus Dashboard and below. The number of COVID patients admitted daily has levelled off but it is too early to be sure the peak of the Winter Wave has been reached. Bed numbers by region in EnglandTabulated 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 2% in England, 1% in London and 3% in the Midlands. Note: Independent SAGE think the number of beds occupied by those with community acquired infection has remained level, while the number of beds occupied by those who caught COVID in hospital has dropped slightly. The very small drop in COVID beds could therefore be due to improved infection control in hospitals rather a reduction of COVID in the community. 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 levelled off in England during the seven days ending 19th October. The peak in beds is usually one week delayed on the peak in daily admissions, and deaths lag beds by a further week.
COVID bed occupancy in England from 1st July to 19th October 2022 Worcestershire hospital bedsBetween 11th October 2022 and 17th October 2022, 71 patients went into hospital with coronavirus. This shows a decrease of 10% compared to the previous 7 days. There were 92 patients in hospital with coronavirus on 19th October 2022, six less than the week before; 3 on a ventilator Click for Summary of Malvern numbers on the Coronavirus dashboard This link also reports deaths. Deaths in Malvern HillsBetween 9 October 2022 and 15 October 2022, there was 1 death within 28 days of a positive coronavirus test. Forecast for the week aheadAs a condequence of the Winter Wave we expect roughly 550 COVID related deaths to be registered in England and Wales (as registered by the ONS) in week 41 ending 14th October, to be reported on 25th October. In the county of Worcestershire, based on 71 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 7 COVID deaths per week in early November. NHS COVID bed occupancy in England could fall 10% or so next week. Longer term outlook (up to Christmas)According to Independent SAGE there are many new Omicron variants such as BQ.1.1, BQ.1 and BF.7 circulating which now make up about 18% of cases but so far none are seen as a variant of concern. Factors favouring a possible increase in infections are:
These factors are being countered by the Autumn Booster programme, and natural immunity developed after being infected by the Autumn/Winter wave. Hospital admissions, COVID bed occupancy and the Zoe Health Study are suggesting the Winter Wave may have peaked early, but even were this true there is no way of knowing how future cases will evolve. We speculate cases could fall slowly for the next 2 to 3 weeks and later rise due to friends and families mingling over Christmas and the New Year. The remaining profile of the Winter Wave could turn out somewhat like the northern ridge of the Malvern Hills.
The northern ridge of the Malvern Hills Assuming that COVID hospital bed occupancy fell to 4,000 beds in England, and has peaked at 10,608 it's possible the death rate will rise from say 230 to 300 deaths per week and peak at somewhere between 600 and 800 deaths per week in England and Wales during the next fortnight or so. UCL modelling charts have for some time 'hinted' the COVID Winter Wave could head towards 170 deaths per day or 1,190 deaths per week in the UK during November 2022. Click for UCL Long-term forecasting of the COVID-19 epidemic Even allowing for deaths in Scotland and Northern Ireland we don't think the death rate is going to exceed UCL's projection and more likely weekly deaths before Christmas could be half. Exactly what happens will depend on the uptake and effectiveness of the Autumn Booster shots, human behaviour such as mask wearing, improvements to ventilation, winter temperatures and the effect of inflation and energy pricing on the public's health. Additional deaths due to the Winter WaveThings don't look too bad. The UK COVID-19 death rate is rising a bit, but assuming that hospital admissions are already levelling off we are fairly sure any further rise should be nothing for most Seniors to worry about. It has been our opinion that as long as the COVID death rate remained below 700 deaths per week neither the public nor the government would be concerned. This threshold could be reached by early November - but if exceeded it probably won't be by much. We doubt many will be concerned by a 'blip' - possibly of the order of 10,000 additional UK COVID deaths amongst OAPs this winter. Flu could yet turn out a greater threat To put things in perspective, Worcestershire's share might only be of the order of 100 COVID related deaths. In a population of 600,000 few will be concerned about that as, barring new variants of concern, the vast majority (we estimate 99.98%) can be expected to survive any winter bout of COVID-19. Advice for SeniorsWe judge the risk of exposure to COVID-19 has returned to HIGH in England. See our riskometer opposite. Despite this many, perhaps most, healthy people will be 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:
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). No information yet on the efficacy of the new bivalent vaccines. 5) You may still have to take a test and wear a facemask when travelling to some overseas countries. AnnexCommentaryThis weekAfter a dip there are once again people catching COVID-19 in the Malvern Hills area, so it makes sense to take a little more care. Seasonal colds are also circulating. Those aged 50+ years can now take advantage of the Autumn Booster. COVID video updatesLinks to updates by Professor Tim Spector of the Zoe Health Study, Independent SAGE and sometimes pundit Dr John Campbell can be found here:- Click to watch Zoe Health Study fortnightly update on 21st October 2022 presented by Tim Spector Tim thinks daily cases are beginning to fall. Click to watch Independent SAGE weekly update on 21st October 2022 Join Independent SAGE for a discussion on women's health with regard to Covid, with guests Dr Viki Male, Dr Teresa Kelly, Dr Nighat Arif and Dr Louise Newson, hosted by Dr Zubaida Haque & Dr Binita Kane, chaired by Prof Anthony Costello and Prof Christina Pagel on numbers at the start. List of vaccinesAutumn bivalent boostersA 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 the Wuhan virus and Omicron BA.1 variant, 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. The earlier vaccine storyHere 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. 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 LinksSome 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
SymptomsNote: 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 testHow to get a test https://www.nhs.uk/coronavirus About joining the Zoe COVID Symptom Study:
GuidanceUK 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 statesGuidance on UK COVID-19 alert level methodology: an overview COVID-19 Alert Level lowered to 3 on 10th May 2021
TiersGuidance on tiers: what you need to know Government postcode checker to find tier for other areas
StatisticsUK 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 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
ModellingA 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
ReportsCoronavirus (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. 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 pictureWorldometer 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
Window on the USACentre for Disease Control (CDC) Find maps and charts tracking cases, deaths, and trends of COVID-19 in the United States. American Association of Retired People (AARP)
WorcestershireA 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 Click for Simple Summary of Malvern numbers on the Coronavirus dashboard
MiscellaneousSpanish 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
BibliographyWoolhouse, Professor Mark, The Year the World went Mad, published 2022 by Sandstone Press Ltd, ISBN: 978-1-913207-94-3
The interpretations and opinions expressed are our own |
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Last updated 23rd October 2022 |