Covid Situation Report: Jun 20, 2024
Update on Covid providing information on prevalence and hospital admissions for England and its regions. This post is best viewed using the browser or Substack app.
Introduction.
This report is part of a weekly series that summarises the Covid situation in England and its regions.
A reminder that not all of the data previously included in the situation update is now available on a weekly basis. Where relevant, changes to the content and data sources have been noted.
This week’s report has more data available with the return of the UKHSA surveillance report, which is now only published every two weeks. In addition, the report covers some recent data released by the ONS on the impact of Long Covid. Finally, an update on the Spring 2024 booster campaign is provided.
Summary.
The data this week shows that Covid levels are rising with both positivity rates and hospital admissions increasing.
In the past week, the positivity rates for Covid increased from 8.4% to 10.0% and are at their highest since the end of Dec 2023.
Weekly hospital admissions also increased to levels last seen at the start of May.
Recent data from the Office for National Statistics confirmed that in March 2024, 1.1 million individuals in England and Scotland reported experiencing Long Covid symptoms for more than 12 weeks, with the highest rates occurring among those aged 45 to 64.
The Spring 2024 booster campaign in England closes at the end of June. As of now, slightly more than 4 million doses have been administered, but there has been a decline in the number of doses distributed this week. It is unlikely that vaccination coverage for all eligible groups will reach the levels of the 2023 booster campaigns.
As always, it’s important to remember that the risk of hospitalisation from Covid infection increases significantly with age and for those immunocompromised. Also Long Covid remains a risk for all as shown by the recent ONS report. Therefore, it is prudent to take appropriate measures such as self-isolating when experiencing Covid symptoms and enhancing ventilation or wearing masks whenever possible.
For those who are interested, I recently published an article covering the ONS data on Long Covid in more detail which can be found here. Also a comprehensive review of the evidence in support of wearing masks is available here.
Status of main respiratory diseases in England.
This section presents the latest available data on positivity rates for primary respiratory infections in England. It is important to understand that positivity differs from prevalence, which refers to the overall percentage of COVID-19 in the general population. Appendix 1 provides a more detailed explanation of the difference and why positivity rates are a useful indicator of trends in Covid infection levels
The chart below displays the test positivity rates for the main respiratory illnesses in England, including Flu, Covid, RSV, and Rhinovirus.
The Covid positivity rate increased to 10.0% for the week ending Jun 16 indicating a resurgence of Covid levels in the general population. Meanwhile, the flu positivity rate has continued to fall and remains significantly lower than that of Covid. Additionally, RSV rates have dropped to very low levels, accompanied by a minor decrease in Rhinovirus rates.
The final chart in this section shows weekly hospital admissions per 100,000 people in England for the main respiratory diseases.
For the week ending Jun 16, weekly hospital admission rates for Covid increased by 20% over the prior week to 3.3 admissions per 100,000 people confirming that Covid levels are once again increasing. Note that hospital admission data for Flu and RSV is no longer published.
While the age data for hospital admissions is no longer published, history indicates that this increase in hospitalisations will predominantly affect the over 75 year old age group. This age group is the most recently vaccinated and should be well protected against hospitalisation, suggesting that prevalence levels might be higher among the general population.
It's important to note that while testing policies have been updated from April 1, 2024, the guidelines for testing patients showing Covid symptoms or when a positive result would change the patient's treatment remained unchanged. Consequently, the number of Covid hospital admissions should be a dependable indicator of the virus's prevalence in the community for the period shown in these charts.
Covid hospital admissions and bed occupancy.
This section gives a more detailed examination of the most recent daily Covid data for hospitals in England.
NHS England stopped the weekly publication of data used to create these dashboards from April 4, 2024 and have moved to a monthly publication schedule. The next update will be on July 11, 2024 covering June Covid hospital admissions and bed occupancy.
Impact of Long Covid
In April, the Office for National Statistics (ONS) released a report on Long Covid in the UK, drawing on data from the 2023/2024 Winter Infection Survey. The main findings of the report are detailed in my recent Substack article, available here.
The ONS report found that an estimated 2.0 million individuals (3.3% of the population) in England and Scotland reported experiencing Long Covid of any duration from February 6 to March 7, 2024. However, according to the World Health Organisation (WHO), Long Covid is defined by symptoms that persist for more than 12 weeks. Recently the ONS have released supplementary information that provides data based on the WHO definition of Long Covid.
Based on the WHO definition, there are an estimated 1.1 million people (1.9% of the population) suffering from Long Covid in England and Scotland. The following chart shows the percent of the population in each age group who report suffering from Long Covid for over 12 weeks.
The chart shows the rates of self-reported Long Covid of any duration was greatest in people aged 45 to 64 years, with an estimated 480,000 individuals. Conversely, the youngest and oldest age groups reported the lowest rates.
The next chart shows the number of people who report their activity levels being impacted ‘not at all’, ‘a little’, and ‘a lot’ by Long Covid symptoms lasting longer than 12 weeks by age. Hovering over each bar reveals the number of affected people in thousands.
The chart show that whilst most peoples activity levels are impacted a little or not at all, a substantial number report a significant impact. Among the working-age population (aged 18 to 64 years), this accounts for just over 200,000 individuals.
The following chart shows the percent of those suffering from Long Covid who report that physical and mental activity worsens their symptoms across the age groups.
The chart indicates that across all age groups, the majority of individuals with Long Covid reported a worsening of symptoms following physical and mental activity. Younger adults were especially affected by this trend.
The final chart in this section shows the number of people economically inactive due to long term sickness in the UK for those aged 16 to 64 years old.
The chart shows a significant rise in economic inactivity due to long-term sickness following Covid, with the figure now exceeding a record 2.8 million people. Various reasons have been proposed for this increase, with Long Covid cited as a contributing factor. The high number of Long Covid cases reported by working aged individuals suggests that it may be a significant factor in this increased economic inactivity within the workforce.
Spring 2024 booster campaign
The Spring 2024 booster campaign started on April 15 and will close at the end of June. Considering the decline in vaccine efficacy after 15 weeks, a successful Spring 2024 booster campaign is important to protect the most vulnerable populations.
The following chart displays the weekly number of doses administered during the booster campaigns for England to date. The Spring campaigns are represented in green, the Autumn campaigns in brown, and doses administered outside of these campaigns are depicted in grey.
The Spring booster campaigns are exclusively for individuals aged 75 and above, residents of care homes, and those with compromised immune systems. According to NHS England, approximately 7.3 million people qualify for the Spring campaign in England.
The Spring 2024 booster campaign in England is progressing at a similar pace as the Spring 2023 campaign, with just over 4 million doses administered to date. However, progress is slowing, with just 135,535 doses administered last week.
Finally, the following table indicates that disparities among the eligible groups remains an issue. It compares the latest available coverage of the Spring 2024 booster campaign by eligible group to the final coverage of the 2023 booster campaigns for England, Scotland and Wales. Unfortunately, care home coverage is not available for the 2023 booster campaigns for England and for the immunosuppressed in Wales.
The data shows that across all home nations and eligible groups, the present vaccine booster coverage is trailing the levels reached at the end of the Spring and Autumn 2023 booster campaigns, with only a few weeks left until this campaign ends. Notably, individuals with compromised immune systems continue to have lower vaccine coverage.
Just a reminder that the Spring 2023 booster campaign closes at the end of June.
From now until the 30 June, there are thousands of appointments available every day across the country, including at pharmacies and GP practices. Some areas also offer convenient walk-in options, with a full list of walk-in sites available online.
You can check to see if you are eligible and book a booster at the following link.
In conclusion
Despite the reduced level of data now published, the available information indicates that Covid levels are once again rising.
Long Covid remains an issue with over 1.1 million people in England and Scotland reporting symptoms lasting longer than 12 weeks.
The Spring 2024 booster is progressing reasonably well, with just over 4 million doses administered so far. However, the immunosuppressed remain under vaccinated.
As always, if you have any comments on this Covid Situation Report or suggestions for topics to cover, please post a message below.
Appendix 1. Test positivity rates and prevalence
Positivity rates are derived from the results of hospital laboratory tests conducted on patients exhibiting symptoms of respiratory diseases. Test positivity is the percentage of patients who test positive for Covid of the total number of patients tested. Since the individuals tested for this measure are not a representative sample of the general population it differs from prevalence, which is derived from a representative sample of the population.
Test positivity rates, while not directly estimating the number of Covid infections in the general population, can be a valuable indicator of the infection trend. The panel chart below compares the weekly test positivity rate among hospital patients with respiratory symptoms to the prevalence of Covid in the general population, as reported in the Winter Infection Survey.
The chart shows that the weekly test positivity rates for patients with symptoms of respiratory infections follows the same pattern as the prevalence for Covid reported by the Winter Infection Survey. Since the Winter Infection Survey is based on a representative sample of the general population this supports using test positivity as a useful proxy for infection trends.
Many thanks. I do hope that the statistics regarding Long Covid, suffered now by an increasing number of individuals, and the life changing effect upon them, their family, friends and colleagues, catalyses some recognition by and remedial action from, our government.
There are at least two competing variants in the UK now, if not three. The KP2 FLiRT variant seems to induce more severe mild cases. That is to say, the infectious period is longer, the duration of symptoms longer and the symptoms experienced are worse than recent past mild cases. The word mild encompasses a sniffle all the way through to bed bound for weeks, and is a misnomer.
From what I have seen in my GP surgery and the volume of calls for respiratory complications I expect this summer to see a significant covid wave, maybe even two to three times as many cases per week than this report has noted. My real concern for most is longcovid and post-covid complications. This has been largely forgotten by the public and the media, one following the other. I am becoming concerned at the volume of children and otherwise healthy adults presenting with long term shortness of breath and difficulty exercise. The statistics presented do not capture these people and the NHS mandates reporting that treats symptoms as not covid related. We are making a mistake and walking blindly into longcovid disrupting lives and the economy due to ignorance.