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

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25th December 2022

The next update will likely be on 8th January 2023

COVID JUST ANOTHER VIRUS BUT TRY NOT TO GIFT IT TO THE ELDERLY

Cases are rising and NHS hospital bed occupancy is ramping up

Preamble

For nearly three 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 was run down many months ago and the public can no longer record the result of Lateral Flow tests so those daily cases reported on the Coronavirus Dashboard greatly underestimate the actual situation.

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

• The ONS infection survey (all nations of UK);

• The Zoe Health Study;

• Registered deaths in England and Wales reported by ONS;

• Hospital deaths reported by NHS England, and;

• Hospital admissions and bed occupancy reported by NHS England.

We'll carry on with our blog for a little while longer as the epidemic passes and life returns to normal.

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

This page will continue to be updated weekly nominally with Sunday's date.

Contents

Summary

What happens if you get sick

Booster shots

Vaccination Sites

Number of cases

Number of deaths

Healthcare numbers

Forecast for the week ahead

Longer term outlook

Advice for seniors

Annex/commentary

Summary of links

Bibliography

Menu of archived pages

Summary

We are taking a break for Christmas, so this is a brief update.

The daily number of cases of COVID-19 is now ramping up quite sharply so, in order to to minimise the burden on the NHS, please take reasonable steps not to gift it to others, particularly the elderly.

It is recommended that you get your Autumn Booster as soon as possible if you have not already had it.

Crisis in the NHS

The rise in cases, while being of little interest to most people, will be of greater concern to hospital managers and the NHS; and for that reason we should take reasonable steps to slow the spread of COVID-19 during the festive season.

We think it very likely the Winter Wave of COVID-19 could push NHS England COVID Bed Occupancy up to somewhere between 12,000 and 16,000 beds in January, which together with rising hospitalizations due to Influenza, an estimated 13,000 patients awaiting discharge but unable to be sent home, and strikes by nurses, may put enormous pressure on the NHS during the next quarter.

These factors will likely result in some patients failing to get timely treatment and Excess Deaths, several times those currently due to COVID, could be reported by the ONS in future months.

Jump to forecast

What happens if you get sick with COVID

If you are feeling poorly there is now a fair chance it won't be COVID but some other winter respiratory illness; according to the Zoe Health Study only 30% or so of respiratory infections are currently COVID related.

If you have a stash of Lateral Flow Tests you can test yourself at home. However be aware that a negative test does not guarantee you don't have COVID. Whatever the virus best stay away from other people until you feel better.

Do not be surprised if you catch COVID because prevalence is still high and vaccination, while protecting from severe illness, has rarely in the past prevented infection.

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.

Some 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.

A small number of patients report debilitating symptoms for months after so-called recovery. For example see Dez Medinger and Danny Altmann's book The Long COVID Handbook in bibliography.

Precautions

Nowadays few people seem to be taking precautions - for many months that has been a personal decision.

Click to view our advice

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 shots

An Autumn booster jab is being offered to all those aged 50+ years and patients designated Clinically Extremely Vulnerable, such as with a severely weakened immune system.

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.

Seniors are advised to get both the COVID booster and flu jabs in order to reduce the likelyhood of severe illness and hospitalization. The NHS advises it is safe to have both jabs at the same time, but to minimise side effects you might want to consider having them a week apart.

 About two weeks ago Independent SAGE said Autumn Booster take-up in England was >90% in  those aged 75+ years, 83% in those aged 65 - 74, but only 56% in those aged 50 - 64 years.

Lately there seems to have been no government push to get more of the over 50s boosted and vaccination has come to a standstill.

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 may 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.

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 Sites

The NHS England website has a spreadsheet updated 5th October 2022 listing vaccination centres under the categories:

• Pharmacies

• GP led vaccination services

• Vaccination centres

• Hospital Hubs

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 cases

There are now two 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, is mostly now in hospitals. Hospitals have stopped surveillance and are only testing patients showing symptoms.

Now the government has declared the pandemic over, PHE no longer offers nationwide testing.

ONS infection survey

ONS estimates that 1,197,200  people in England tested positive for COVID-19 in the week ending 9th December 2022; a rise of 9% in 4 days.

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

Prevalence of COVID-19 in England estimated by ONS

Prevalence is estimated 1:55 in Wales; 1:40 in Scotland; and 1:50 in Northern Ireland.

One must remember these estimates are about two weeks behind real time, and prevalence may have risen further; also note prevalence varies between regions and age groups.

Prevalence is rising in the West Midlands, but not all areas, and is up in those aged 12 - 24 and 35 - 69 years.

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 recent Zoe figures, estimated prevalence has risen by 22% and daily cases by 20% during the last week; the direction of travel is confirmed by figures for Hospital bed occupancy rising.

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 the death rate has reached a plateau after which the weekly death rate can be expected to increase slowly due to the rising Winter Wave.

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 about 148 on 19th October, then gradually falling, and levelling off at about 60 deaths per day during 10 days proceeding 5th December. Since risen to 76 deaths per day as of 12th December.

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 real time by 10 - 14 days due to the administrative delay in submitting and processing reports, 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 ONS data on deaths (Excel spreadsheet)

The ONS figures are broken down by Local Authority providing a glimpse of where deaths are occurring. The provisional cumulative total of COVID related deaths in Worcestershire reported by the ONS up to 9th December (week 49 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 the most accurate metric but takes longer to be confirmed.

Provisional cumulative COVID-19 deaths in Worcestershire registered by ONS to 9th December 2022.

Figures during the next fortnight may be skewed by the Christmas and New Year holiday.

In England and Wales 326 COVID-19 related deaths were reported in the week to 9th December, 10 more than the week before and a rise of 3%. Of these 47 were in care homes, 15 at home, 5 in a hospice, 252 in hospital and 6 elsewhere.

So far this year in England and Wales 31,853 people have died with COVID mentioned on their death certificate.

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

You will see from the chart (which only goes up to week 48) that this year deaths have presented as a series of waves each lower than the one before. Please do let us know if you can explain this periodicity.

If the amplitude of the Winter Wave is less than the one before,we should see no more than 700 deaths per week; and if the periodicity is maintained the peak of the Winter Wave will come in early to mid February 2023.

The figures on the Coronavirus Dashboard of ONS deaths by date on the death certificate show ONS England deaths rose to 95 on 14th October, but since fallen and levelled off at about 46 deaths per day between 11th and  18th November 2022.

In comparison averaged over recent years roughly 1,700 people die daily from all causes in the UK, so current COVID deaths represent 3%.

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

NHS England figures

Daily COVID hospital deaths in England  have hovered around 40 during the last week.

NHS England figures for Worcestershire

The table below shows the latest COVID deaths in Worcestershire hospitals reported by NHS England on 22nd December 2022.

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

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

Numbers have been less than a handful per week recently, but trend is upwards.

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 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 numbers

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

Headline summary of patients in hospital reported on 15th December 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.

Bed occupancy has risen by about 28% and daily admissions by 36% during the last week.

See charts on the Coronavirus Dashboard and below.

Bed numbers by region in England

Tabulated figures for COVID bed occupancy in England can be found on the NHS England website providing 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 rose by 28% in England, 20% in London and 28% in 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 due to the Autumn Wave peaked in England about 16th October 2022 and had been falling until three weeks ago since when there has been an accelerating upturn due to the Winter Wave.

Note: the peak in beds is usually one week delayed on the peak in daily admissions, and deaths roughly lag beds by a further week.

COVID bed occupancy in England from 1st October to 21st December 2022

Worcestershire hospital beds

Between 13 December 2022 and 19 December 2022, 72 patients went into hospital with coronavirus. This shows an increase of 28% compared to the previous 7 days. There were 86 patients in hospital with coronavirus on 21 December 2022. That is 25 more than the week before; one on a ventilator.

Click for Summary of Malvern numbers on the Coronavirus dashboard

This link also reports deaths.

Deaths in Malvern Hills

Between 11 December 2022 and 17 December 2022, there have been 2 deaths within 28 days of a positive coronavirus test.

Forecast for the week ahead

We expect COVID related deaths registered in England and Wales to start rising from roughly 320 per week towards 500 over the Christmas and New Year holiday; that is during weeks 50 and 51 of 2022 as reported by the ONS.

ONS is next expected to report on 8th January 2023, when the figures could be skewed by delayed reporting over the holiday period. Possibly we will have to wait until 15th January to get reliable figures.

In the county of Worcestershire, based on 72 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 the first half of January 2023.

NHS COVID bed occupancy in England could rise by 20% next week.

Longer term outlook (up to the end of January 2023)

Hospital bed occupancy is ramping up due to both flu and the Winter Wave of COVID-19.

We expect COVID cases to continue rising as a result of the Football World Cup and due to increased travel and mingling of friends, families, office colleagues, and shoppers during December, and New Year.

It's possible this Winter Wave may turn out little larger than the Autumn wave, but we'll have to wait and see.

Given that COVID hospital bed occupancy peaked at 10,608 beds in England, had fallen to 4,600 and is now 8,643 it's likely that the ONS death rate will plateau at about 320 and then head towards 570 deaths per week in England and Wales during the next fortnight or so; thereafter the death rate is expected to climb slowly until the end of January

If it is assumed hospital bed occupancy rises linearly for 3 weeks at the present 1,200 beds per week, bed occupancy could approach 12,000 by the middle of January and if the death rate rises proportionally, the death rate could rise towards 790 deaths per week in England and Wales by the end of January.

Though significant, that's not a level for the majority to be concerned about.

UCL modelling

The latest UCL projection is that the 7-day average of daily (certified) deaths per day may rise slowly, peaking in late January at around 150 per day or 1,050 deaths per week, which roughly equates to our 'back of the envelope' calculation.

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

The UCL projection of the death rate is 50% higher than last week and were it to occur, we estimate COVID beds might rise towards 16,000 which would be very bad news for the NHS.

NHS COVID Beds

If our projection is near the mark, the number of NHS hospital beds occupied by COVID patients in England could start rising from 8,643 towards 12,000 beds this winter adding to the pressure on the NHS. If the UCL projection is right COVID bed occupancy might head towards 16,000.

Taken with other pressures such as flu and strikes doctors, nurses and ambulance controllers are increasingly going to have to decide who to treat and who to leave to take their chance, during the next 8 weeks.

Additional deaths due to the Winter Wave

Things don't look too bad. We think Worcestershire's additional deaths might only be of the order of 50 COVID related deaths. In a population of 600,000 few are likely to be concerned about that as, barring new variants of concern, the vast majority (we estimate 99.99%) can be expected to survive any winter bout of COVID-19.

Advice for Seniors

We judge the risk of exposure to COVID-19 is once again HIGH in England, but remember there are other respiratory viruses circulating that could make you feel just as sick.

See our riskometer opposite.

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

For the more cautious the simple safeguards are to:

• make sure your COVID and FLU 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);

• 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 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, runny nose, blocked nose, headache and cough, 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;

 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.

Annex

Commentary

No commentary this week.

COVID video updates

Links 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 15th December 2022

Tim discusses the increase in COVID along with high rates of cold-like illness, and brings you some fascinating insights from the Intermittent Fasting Study on how snacking has changed for people during their fasting days.

Click to watch Independent SAGE weekly update on 16th December 2022

Join Independent SAGE on the last Q and A for the year, plus End of Year Statement to be presented by Prof Stephen Reicher, Prof Anthony Costello chairing, and Prof Christina Pagel on numbers.

Lateral Flow test work better if swab taken from both nose and throat. Possibly take a swab from the inside of the lips if throat hard to reach (see video for advice).

It was suggested about 6% of symptomatic patients suffer from Long COVID and roughly 1M people have had Long COVID for more than a year.

Christmas message:

Be kind

Considerate

Be careful

Five point plan for Christmas:

1. Get vaccinated

2. When ill, stay at home

3. Take a test (especially if visiting elderly or vulnerable people

4. Ventilate rooms

5. Wear a mask in stuffy crowded situations (eg public transport)

The next update from Independent SAGE is planned for 13th January 2023

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 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.

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

A video with Dr John Campbell and mathematician Professor Fenton explaining the various ways in which RISK can be specified.

Risks and benefits with Professor Fenton

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

Bibliography

Woolhouse, Professor Mark, The Year the World went Mad, published 2022 by Sandstone Press Ltd, ISBN: 978-1-913207-94-3

Medinger Dez, Altmann Danny, The Long Covid Handbook, Penguin Books, 2022. Kindle version available.

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The interpretations and opinions expressed are our own