Covid Situation Report: Dec 14, 2023

Update on Covid providing information on prevalence and hospital admissions for England and its regions. Plus the latest status on vaccinations across the home nations.

Introduction

This is the fifth of the weekly Covid Situation Reports I plan to publish over the Winter 2023 / Spring 2024 season.  Each report provides an overview of the present Covid status in England and its regions using a standard set of interactive charts.   For those who want a bit more detail I will do a deeper dive on topics of interest each week.  This week I look at hospital admissions by age, an update on the JN.1 variant (sometimes referred to as the 'Pirola' variant), and vaccination coverage across the regions.

Summary

This past week saw week on week increases in all key Covid metrics for hospitals in England albeit from relatively low levels.  This continues the trend from last week and is almost certainly the start of the anticipate ‘winter wave’ of Covid infections. The good news is that all metrics are presently much lower than this time last year.

Hospital admissions are highest and rising fastest in the oldest age groups. However, the unvaccinated youngest age group are also seeing increases in admissions although from low levels.

The JN.1 variant (Pirola) is now the dominant variant in England and is contributing to the recent growth in Covid infections.

London has the lowest vaccination coverage of all the regions.

Covid status for England and it’s regions

Covid positivity is starting to rise but remains just below the level of Rhinovirus and RSV which have similar symptoms to Covid.  Chances are that if you have cold like symptoms it’s more likely to be Rhinovirus or RSV than Covid, but best to test to make sure.

Unfortunately, positivity levels for Flu rose significantly last week indicating the start of the winter flu season. On the plus side, the positivity level for RSV, which mainly effects children, continues to fall and looks to have peaked.

The following chart shows hospital admissions per 100,000 people in England for the main respiratory diseases. Both Covid and Flu had appreciable week on week increases in hospital admission rates, but there are early signs of a fall in RSV admissions. Again these are consistent with the positivity data shown in the chart above.

The dashboard of key Covid metrics for hospitals in England are also increasing.  Hospital admissions, beds occupied, and mechanically ventilated beds occupied all saw week on week increases, although they are still at relatively low levels.

The regional picture also shows that most regions had significant week on week increases for hospital admissions.  The following interactive dashboard gives the Covid hospital admissions per 100,000 by region.

The highest admission rate is in the London and South East regions with the South West having the largest weekly increase. The East of England, which had the largest increase last week, was the only region to have a very small decrease this week.

The following chart shows the number of beds occupied by Covid patients per 100,000 by region split by those being treated for Covid (red bar) and patients with Covid (green bar) but are being treated for other conditions.

As well as having the highest admission rates, London and the South East regions also have the highest number of beds occupied by Covid patients per 100,000 of population. In London, however, most Covid patients are not being treated for Covid. The South West has the highest rate for patients being treated for Covid. This is most likely because the South West is the region with the highest proportion of older people who are more vulnerable to Covid.

Hospital admissions by age

This section looks at hospital admissions per 100,000 by age group. The following chart shows the admission rates for the oldest age groups compared to those under 65 years old.

The chart shows that the admission rate for those 85 years and older is consistently higher than any other age group and there has been a significant increase in their admission rate in the past week. The 65 to 84 year year olds also have higher admission rates than the under 65 year olds but are not increasing as quickly.

The next chart shows admissions rates for the under 65 year olds in more detail.

In the under 65 year olds, the under 6 year olds have the highest hospital admission rates and are showing the fastest increase of the under 65 year old age groups. This group is unvaccinated and will have little protection against infection from Covid.

Covid Variants

Last week UKHSA reported that JN.1, also known as the ‘Pirola’ variant, had the highest growth advantage (84%) of the variants presently in circulation.

The following chart shows that the BA.2.86 family, which includes JN.1, is outcompeting all other variants and is now the dominant variant in England.

At the moment, the number of cases is low so the number of sequenced cases is very low making it difficult to draw firm conclusions. However, it seems most likely that the Pirola variant is the cause of the recent increase in Covid infections.

Vaccination Update

The total number of vaccinations continues to reduce with only 218,889 doses given in the week ending Dec 10, the second lowest since the start of the Autumn 2023 booster campaign.

The following table shows the latest Covid Winter vaccination coverage for the 65 year and older age group for England, Scotland and Wales.  Northern Ireland (NI) does not publish comparable data so I have shown the coverage for the over 60 year olds based on all vaccinations given after the Spring 2023 booster campaign.

Scotland and Wales made some progress last week increasing their coverage by 2% and 3% respectively. However, England and Northern Ireland’s progress has slowed considerably.

Amongst the regions, London has the lowest coverage for over 65 year olds (50%) by some margin. This has been the case for all the vaccination campaigns and London has the lowest vaccination rates across all ages. This may account for the higher number of hospital admissions we are presently seeing in London.

In conclusion

As we have seen, Covid and Flu hospital admissions are increasing in England and across most regions particularly in the older age groups. The JN.1 (Pirola) variant is now the dominant variant in England and is adding variant pressure to the rising winter COVID-19 wave.

Finally, the Autumn 2023 booster campaign is slowing in England and Northern Ireland with more to do. So if you are eligible for a Covid booster or the Flu vaccine and haven’t yet been vaccinated then now is the time to get protected.

As always, if you have any comments on this Covid Situation Report or have suggestions for topics to cover then please post a message below.