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Occasional Coronavirus (COVID-19) update for Malvern Seniors

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24th September 2023

COVID CASES RISING

Cases of COVID fell rapidly during the spring and early summer but are now rising once again so we will keep an 'occasional' eye on the figures.

COVID related deaths fell to just 65 per week in England and Wales towards the end of July but have risen to about 215 per week, while the Coronavirus dashboard suggests weekly hospital admissions in England have risen from 757 in July to 2,767 though now possibly levelling off.

The rollout of COVID Autumn boosters has begun and shots can be booked on-line at Claremont Pharmacy in Barnards Green and Evans in Malvern Link.

Those aged 65 years and over, and at risk groups are eligible.

You may be offered annual Flu and COVID booster jabs at the same time at your GP surgery. Our surgery is currently making appointments for Flu jabs only, as delivery dates for the COVID booster are not yet known.

We are hearing of cases amongst our friends in Malvern and while for most this may be no more than a cold, the unfortunate few can be very seriously affected, so it would be a good idea to get your booster and think about precautions.

There is a new source of data for COVID and Flu metrics which is a development of the Coronavirus dashboard:

The UKHSA data dashboard

Here you should find the principal figures at the touch of a button.

Preamble

Those wishing to monitor the figures will still find a summary of some data on the Coronavirus Dashboard which continues to be updated weekly at 4 pm on Thursdays.

Following a summer break, fortnightly Independent SAGE briefings resumed on 8th September 2023.

If you are familiar with Excel spreadsheets, NHS England hospital admissions and beds; and deaths reported by ONS continue to be a measure of COVID-19 in the UK.

You will see this is a cut down version of our weekly reports during the height of the epidemic.

Contents

Summary

What happens if you get sick

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

The incidence of COVID-19 which fell to a minimum in July 2023 has been rising. This may be due to waning immunity and mutating variants, but the symptoms are said to be no worse than from the earlier Omicron strain.

Autumn Boosters for those aged 65+ wishing to top up their immunity should remain available until 23rd December 2023 but as time goes on you may have to travel further to find a clinic.

If you catch COVID for a second or perhaps even a third time it is likely to be a mild illness, though you might feel quite poorly and be left feeling very tired.

However the unlucky few might suffer breathing difficulties and become severely ill.

(Definitions: mild = treatable at home; severe = treated in hospital).

What happens if you get sick with COVID

If you are feeling poorly it might not be COVID-19 but some other respiratory illness.

Whatever the virus best stay at home until you feel better, and wear a face mask to protect others if you do have to go out.

Nowadays, you probably won't know it's COVID and brush it off as just another cold.

You now have to buy test kits. Pharmacies do not always have these and the results can be uncertain.

Despite vaccination, 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 as there seems to be no 'one size fits all' treatment.

A small number of patients (less than 10%) report debilitating symptoms for months after so-called recovery especially middle aged women. See Dez Medinger and Danny Altmann's book The Long COVID Handbook in bibliography.

Precautions

Click to view earlier advice

Vaccination Sites

Autumn boosters should be offered to those aged 65+ at GP surgeries between September and December 2023.

Your GP surgery (or the NHS) should contact you possibly as part of the annual Flu campaign once vaccines become available.

Malvern Health Centre was giving COVID boosters yesterday while New Court Surgery was giving flu shots. New Court Surgery anticipates COVID vaccine will arrive mid October.

Alternatively you may be able to book an earlier appointment on-line for example at either Claremont Pharmacy in Barnards Green, Evans Pharmacy in Malvern Link or Upton Surgery at Tunnel Hill, Upton-upon-Severn.

Click to book, cancel or change a COVID-19 vaccination appointment

You are unlikely to find a walk in clinic in Malvern (but note jabs have in the past been offered at Claremont Pharmacy).

Number of cases

There seems to be little testing going on these days, so the main indicators of COVID are hospital admissions, hospital beds and deaths.

The Zoe Health Study continues to publish estimates of cases based on reports from the public; though with dwindling reports this source of data could possibly soon dry up.

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 using data to 11th September 2023.

Hospital admissions suggest daily cases may have levelled off in the last week.

The numbers suggest that roughly 1 in 50 people are currently suffering from COVID; we are aware of cases amongst our acquaintances.

Number of deaths

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)

ONS figures for Worcestershire by date reported

The ONS figures can be filtered 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 on 19th September (week 36 of 2023) is shown in the table below.

Note: these numbers are 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.

Provisional cumulative COVID-19 deaths in Worcestershire registered by ONS reported on 19th September 2023.

ONS figures for England and Wales by date reported

In England and Wales 215 COVID-19 related deaths were reported in week 36.

ONS provisional deaths 'by week reported' in England and Wales since the start of 2022 (so week 53 is week 1 of 2023)

Averaged over recent years roughly 11,900 people die weekly from all causes in the UK so currently COVID deaths are about 2% of all deaths.

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 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+ 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; possibly because women have a stronger immune system.

Healthcare numbers

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 bed numbers in England have roughly flat-lined.

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.

Also see charts on the Coronavirus Dashboard

Worcestershire hospital beds

Click for Summary of Malvern numbers on the Coronavirus dashboard

The Worcestershire Coronavirus dashboard appears to have been retired.

Forecast for the week ahead

Because daily cases may be levelling off no great change is expected during the next week or so.

Longer term outlook

New daily cases of COVID-19 could yet rise further with hospital bed occupancy possibly falling in the range 3,000 to 5,000 in England by Christmas.

What happens with regard to deaths will largely depend on the take-up of Autumn boosters by the elderly. In the worst case COVID deaths in England could possibly rise towards 400 per week between now and Christmas, but that would be only 3% of all deaths and few are likely to worry about that.

Advice for Seniors

Apart from the Autumn booster programme, the government seems to have largely washed its hands of COVID considering to be just one of many viruses in circulation.

We have little feel for the benefits of booster vaccinations and the health risks posed by the latest variants in circulation so can only offer observations.

The risk of exposure to COVID-19 is likely quite high in Malvern at present, but there is no evidence that COVID is currently causing alarming numbers of people in Worcestershire to fall severely ill; so for most, the risk might perhaps be considered LOW.

Consequently our riskometer currently remains at LOW (see opposite).

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

For the more cautious the simple safeguards to protect against all respiratory infections have been to:

• make sure vaccinations are up to date, noting Flu and COVID booster jabs for those aged 65+ years are expected to be available between September and December 2023.

• wash 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 still an FFP2 (N95) face mask when in crowded settings for example when in shops, theatres, health-care settings, when using public transport, and travelling by air;

• SPACE at least 2 metres from people you don't feel safe with (see note 2); remember when people are at their most infectious they do not show symptoms.

• 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, people shouting and singing, and friends and colleagues with cold and flu like symptoms;

• stay at home to protect others if you yourself feel unwell with cold or flu like symptoms;

• 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, for example filling the car up with fuel, either wash hands with an alcohol based hand gel after touching suspect surfaces or wear gloves.

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.

Annex

Commentary

After rising a little COVID cases could be levelling off this week, but don't be fooled, the incidence of COVID is still high and that healthy looking person you are talking to could give it to you.

We don't know how effective the booster vaccines are but it might be a good idea to get your Autumn booster especially if you missed the Spring booster.

If you reacted badly to getting the Flu and COVID boosters at the same time last year you might want to consider getting them a couple of weeks apart.

Independent SAGE

The next Independent SAGE fortnightly update is expected on 6th October 2023.

You can watch the last briefing by clicking the link below.

Click to watch Independent SAGE update on 22nd September 2023

This was a discussion on the resilience of healthcare systems, with guests Prof John Drury, Prof Steve Thomas and Dr Anna Sagan. Hosted by Prof Anthony Costello and Dr Steve Griffin; Dr Kit Yates on data trends and situation update.

Independent SAGE wonder if the monitoring of daily cases by the Zoe app is petering out. Remaining metrics are hospital admissions and deaths.

It is rumoured  an updated XBB1.5 vaccine may soon be offered in Scotland. However, Independent SAGE recommends getting your COVID booster as soon as it becomes available taking whatever vaccine is offered.

List of vaccines

Section deleted. Refer to archived pages for historical information about vaccines.

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

The UKHSA data dashboard (new source of data on COVID and Flu)

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