Angus and Rosemary's Miscellany

COVID related deaths fell to 65 per week in England and Wales towards the end of July 2023 but are now about 270 per week and could rise towards 400 per week during January as a result of rising infections over the Christmas period.

Based on relative population that equates to about one COVID death per week in the Malvern Hills District, so nothing for most to be concerned about.

Though the Autumn booster campaign ended on 15th December 2023, expect a further opportunity for COVID vaccination later in 2024.

If you catch COVID it is likely to be a mild illness, though you might feel very poorly for two weeks and be left feeling very tired after. 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

If you are feeling poorly it might not be COVID-19 but quite likely 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.

You can still test for COVID at home using Lateral Flow Self-Testing Kits. These are no longer free but additional kits can often be purchased from pharmacies.

If concerned, you can purchase an Oximeter to measure your Oxygen levels at home, but note these can give erratic readings if your pulse is weak and hands are cold, so don't panic and take a number of readings if you are worried.

Patients are advised to take it easy until fully recovered; some suggest overdoing it might even damage your health.

A small percentage of patients suffer from Long COVID to a greater or lesser extent and an unfortunate few can be disabled for a long time.

Precautions

Many of those catching COVID often have little idea of where or who they caught COVID from, although groups of people catching COVID at the same time following an event, such as a conference or wedding, have a very good idea!

It appears few people are taking precautions; most people no doubt hoping that vaccination will protect against serious illness. UKHSA is no longer publishing data on the benefits of vaccination versus side-effects; one can only trust the vaccines offered by the NHS provide some protection from the latest variants.

Click to view earlier advice

Vaccination Sites

Vaccination ceased to be offered by the NHS on 15th December 2023.

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

(You cannot currently book with this link, but opportunities may arise later in 2024)

Number of cases

Widespread monitoring of daily COVID cases has ceased in the UK.

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 4th January (week 51 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.

Districts of Worcs	Deaths 2020	Deaths 2021	Deaths 2022	Deaths 2023	Week 43	Population
Bromsgrove	164	142	59	32	0	98,529
Malvern Hills	61	98	74	53	0	77,545
Redditch	108	109	47	13	0	85,317
Worcester	87	134	51	30	0	103,542
Wychavon	157	154	85	58	0	126,240
Wyre Forest	171	132	62	35	1	100,957
TOTAL	748	769	378	221	1	592,130

Provisional cumulative COVID-19 deaths in Worcestershire registered by ONS reported on 4th January 2024.

There was one COVID related death in a care home in Wyre Forest.

Note: the ONS report was rerun to correct deaths in earlier weeks.

ONS figures for England and Wales by date reported

In England and Wales 269 COVID-19 related deaths were reported in week 51.

Chart of ONS deaths

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

During January 2024, it is expected COVID related weekly deaths will increase from 269 towards 400 as a result of rising hospital admissions over the Christmas period. These deaths are already 'baked in' and it is likely few will be concerned.

Averaged over recent years roughly 11,900 people die weekly from all causes in the UK so currently COVID related deaths are less than 3% of all deaths.

Risk of COVID-19 death by age band

NOT UPDATED

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.

Age band	Number of COVID deaths	% of deaths
0 - 19	8	0.3
20 - 39	25	0.9
40 - 59	165	5.7
60 - 79	1,010	34.9
80+	1,692	58.4

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.

Region	5th November 2023	31st December 2023	15th January 2021
England	3,176	4,114	33,362
London	482	800	7,811
Midlands	651	776	5,890

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

COVID beds in England peaked at 4,500 around 10th October, dipped to 2,275 towards the end of November but have since gradually risen to 4,114.

In recent days the rise in COVID bed occupancy has slowed so perhaps this wave of COVID is near its peak and cases will drop as the weather improves.

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.

Charts can be found on The UKHSA data dashboard

Forecast for the week ahead

The numbers are changing slowly so expect little change during the next week or so.

Longer term outlook

While there is quite a lot of COVID about and it can make people feel very poorly, relatively few people are being admitted to hospital.

It is expected the frequency of COVID will decline in the summer, returning next winter, like the flu.

Advice for Seniors

Apart from the Autumn booster programme, the government seems to have largely washed its hands of COVID considering it to be just one of many viruses in circulation. Little or no recent statistical information about the benefits of booster vaccinations and the health risks posed by the latest variants in circulation has been published.

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

Consequently our riskometer remains at LOW (see opposite).

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 to protect against all respiratory infections are to:

make sure vaccinations are up to date - (when offered)
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 many 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

Little to report other than the UK COVID-19 Inquiry is underway.

The module on Decision-making and Political Governance (Module 2) was aired on TV just before Christmas with senior MPs and officials being questioned by Barristers such as Hugo Keith KC who took the lead. Other barristers represented family support groups, such as the Bereaved Families Support Group.

Dominic Cummings came across as somewhat arrogant and foul mouthed.

While entertaining in parts we learned little that had not been already reported by the media during the pandemic; so this module seemed largely an exercise whereby Barristers made a lot of money at the tax-payers' expense with little learnt.

Independent SAGE updates have ceased.

List of vaccines

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

Summary of Links

A lot of this information is now out of date, some links are now broken, but working links may provide 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

Statistics

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

UK government COVID-19: Omicron daily overview

UK government Coronavirus Dashboard (retired)

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 (retired)

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.

The Malvern Hills logo

The interpretations and opinions expressed are our own