Covid Situation Report: May 30, 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 that was 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.

Unfortunately, the UKHSA report, which was previously released weekly, will now be published every two weeks further limiting the data available for this week's article.

Summary.

Last week UKHSA announced that they are changing the reporting frequency and content of the National influenza and COVID-19 surveillance report.

Please note that after the week 21 report (covering data up to week 20), this surveillance report will be moving to a condensed summer report and released every two weeks.

Consequently, there is no updated information on Covid test positivity or weekly hospital admissions available to report. The next update will be published on Thursday, June 6 but it is unclear what information will be published.

A reminder that last week there were signs that the recent increases in Covid levels had reversed as the Covid positivity rate had peaked and weekly hospital admissions had plateaued across most regions and age groups.

Although the Covid-19 surveillance report did not provide data, daily Covid case rates were still published on a weekly basis. The case rates have been falling in England and most regions up to May 24 indicating that the recent small wave is over.

Considering the recent increased Covid levels, the notable decline in vaccine efficacy after 15 weeks and the emergence of a new variant, a successful Spring 2024 booster campaign is important to protect the most vulnerable populations.

The Spring 2024 booster campaign in England, which began on April 15, has had a good start, with over 3.6 million doses administered in the first six weeks. However, the number of doses administered fell this week and vaccination coverage for the immunosuppressed remains low.

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.

Further analysis of the ONS data on Long Covid was covered in a recent article I posted which can be found here. Also a comprehensive review of the evidence in support of wearing masks can be found here.

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Status of main respiratory diseases in England.

The data used for this section is no longer published weekly but, hopefully, will be available next week. In the meantime, I have republished the previous weeks national level charts as a reminder of the status.

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 up to week ending May 19.

The Covid positivity rate fell to 6.4% for week ending May 19 indicating that the recent Covid wave is likely to be over. Meanwhile, the flu positivity rate has declined further and remains significantly lower than that of Covid. Additionally, RSV rates have continued to drop to very low levels, accompanied by a minor decrease in Rhinovirus rates.

The following chart shows weekly hospital admissions per 100,000 people in England for the main respiratory diseases up to May 19.

In the week ending May 19, weekly hospital admission rates for Covid started to fall slightly whilst admissions for Flu stabilised and were at low levels.

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.

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Covid case rates

Although data on case positivity and hospital admissions were not published this week, information on case rates can be found on the UKHSA Covid dashboard. Since most testing is now conducted on patients in hospitals or under a doctor's care, these rates closely correspond to case positivity.

The first chart in this section compares the case rate per 100,000 individuals, shown in red, with prevalence reported from the Winter Infection Survey, depicted in blue. As prevalence is considered the ‘gold-standard’ measure of Covid levels in the general population this provides a good indication of how well case rates measure Covid levels.

The chart indicates that case rates mirror the overall trend of prevalence, offering confidence that the decline in recent Covid rates is a reliable sign of falling Covid levels in the general population.

The next panel chart in this section shows Covid rates for England and it’s regions. Hover your cursor over one of the chart lines to display the admission rates for all regions.

The panel charts show that case rates are falling in most regions and are at historically low levels.

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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. As a result, the next update of the daily Covid data for hospitals in England will be on June 13, 2024.

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Spring 2024 booster campaign

The Spring 2024 booster campaign started on April 15. Considering some recent signs of increasing Covid levels and 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 chart shows the difference between the Spring and Autumn campaigns, each with its unique eligibility requirements. The Spring booster campaign is 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 advancing successfully, with over 3.6 million doses administered within the first six weeks, matching the pace of the Spring 2023 campaign.

However, progress is slowing, with 277,778 doses administered last week compared to 477,761 the week before. The chart below illustrates the weekly progress in coverage for the three eligible cohorts in England.

The chart shows that progress in vaccine coverage is slowing across all eligible cohorts and that disparities between the groups remain.

The following table compares the latest coverage of the Spring 2024 booster campaign by eligible group to the final coverage of the 2023 booster campaigns where data is available. The Spring 2024 coverage for England is based on the eligible populations from the Autumn 2023 booster campaign. In addition, the eligible population for the immunosuppressed in Wales covers all age groups whereas for England it only includes those under 75 years old. Consequently, these coverages are not comparable.

The table clearly shows that although good progress is being made for those in care homes and 75 years and older, vulnerable individuals with compromised immune systems are still falling behind on vaccine coverage.

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 the recent rise in Covid levels has peaked.

A new variant, KP.2, is widely circulating although, at present, it does not appear to have a significant relative growth advantage over other variants in circulation.

The Spring 2024 booster is progressing well, with over 3.6 million doses administered in the first six weeks. 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.

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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.