Covid Situation Report: Jun 13, 2024
Update on Covid providing information on positivity and hospital admissions for England and its regions. This post is best viewed using the browser or Substack app.
Introduction
This weekly Covid Situation report was originally posted on my substack ‘Seeing the Forest for the Trees’ where I publish articles on Covid and other topics. You can access my substack at the following link.
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.
The UKHSA report which provides data on weekly positivity and hospital admissions was not published this week, limiting the information available for this article.
Summary.
This week, the data indicates that Covid levels in England have stabilised, following the recent decline from the small increase seen in mid-May.
Even though the UKHSA Covid-19 surveillance report was not released this week, the daily Covid case rates were still updated on the UK Covid dashboard. These rates have levelled out in most regions, suggesting that the recent minor surge has ended.
The daily hospital admissions and the number of beds occupied by Covid patients also fell in May, reaching levels significantly lower than those recorded on the same days in 2023.
Considering the recent increased Covid levels, the notable decline in vaccine efficacy after 15 weeks and the increased risk of hospitalisation and death in the elderly (see Appendix 1 for details) 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, continues and 3.9 million doses have been administered to date. 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.
Status of main respiratory diseases in England
The UKHSA National influenza and COVID-19 surveillance report has moved to a condensed summer report and is now 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 20.
Covid case rates
Although data on case positivity and hospital admissions were not published this week, information on case rates was published 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 test 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 historically low and stable level of recent Covid rates is a reliable sign of low Covid levels in the general population.
The next panel chart in this section shows Covid rates for the regions of England. Hover your cursor over one of the chart lines to display the admission rates for all regions.
The panel charts indicate that case rates remain largely stable and are at historically low levels throughout the regions. However, there have been small rises in the past week in both the South West and East Midlands regions.
Covid hospital admissions and bed occupancy
Starting April 2024, NHS England moved from a weekly to a monthly publication schedule for daily Covid data in hospitals. This section provides an overview of the most recent data, released on June 13, which covered the month of May. As a result, it does not include the most recent weeks data used in the prior section.
The following chart illustrates the daily number of Covid hospital admissions, including patients diagnosed with Covid after admission, for the year 2024 up to the end of May, in comparison with the complete data for 2023.
The charts show that there was a small peak of Covid hospital admissions in May 2024 which is now over. Moreover, at no point in 2024 have the admissions exceeded the numbers recorded on the corresponding days in 2023.
The next chart shows a comparison of the daily number of beds occupied by Covid patients in 2024 compared with 2023. The number of beds occupied by Covid patients includes both those being treated primarily for Covid and those ‘with’ Covid as a secondary infection. As a guide, about 25% of patients occupying these beds were being treated primarily for Covid in March 2024.
Reassuringly, the data on hospital bed occupancy by Covid patients mirrors the pattern of Covid hospital admissions. This confirms that the slight increase in Covid levels observed in mid-May 2024 has concluded, and that the levels are significantly lower than those in 2023.
In summary, the daily Covid hospital admissions and occupied bed data confirms the falls seen seen last week in the UKHSA weekly admissions data.
Spring 2024 Booster Campaign
The Spring 2024 booster campaign started on April 15. 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 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.
Just over 3.9 million doses have been administered within the first eight weeks of the Spring 2024 booster campaign in England. Although this matches the pace of the Spring 2023 campaign it is well short of the anticipated 7.3 million people eligible.
Unfortunately, progress is slowing, with 135,872 doses administered last week compared to 148,096 the week before. The chart below illustrates the weekly progress in coverage for the three eligible cohorts in England.
The chart 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.
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 have fallen from the small rise in May and have stabilised.
The Spring 2024 booster is progressing well, with over 3.9 million doses administered in the first eight 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.
Appendix 1. Covid infection hospitalisation and fatality risk
On May 30, UKHSA published a report estimating the hospitalisation and fatality risk from a Covid infection. The analysis was based on data from the ONS Winter Infection Study so covers the period 14 Nov 2023 to 3 Mar 2024.
The Infection Hospitalisation Risk (IHR) measures the risk of hospital admission given that an individual has been infected with the Covid. It is important to note that the IHR represents an average risk for the average person in a subgroup at a population level, individual risk will vary due to co-morbidities and other factors.
The following chart shows the Infection Hospitalisation Risk by age for England based on linking data from the Winter Infection Survey and NHS England records of hospital admissions.
It is very clear that the risk of hospitalisation for infected individuals increases significantly with age. Individuals aged 75 and older face a 1 in 30 probability of hospital admission upon infection, while those between 6 to 17 years old have only a 1 in 3,930 chance.
Before looking at the Infection Fatality Risk it is important to understand how UKHSA defined a Covid death. The study defined a Covid death as those individuals who had Covid listed as a cause of death on their death certificate or individuals that died within 43 days of a positive test. The threshold of 43 days was based of the time delay from a positive test to the date of death for those individuals with Covid on their death certificate.
The following chart shows the Infection Fatality Risk (IFR) by age for England based on linking data from the Winter Infection Survey and deaths.
The gradient of infection risk for fatalities is significantly steeper than for hospitalisations, highlighting the increased risk of death for the elderly from a Covid infection. Indeed, the Infection Fatality Rates for individuals under 45 years old are so low that they do not show up on the chart. However, those 75 years and older have an estimated 1 in 138 (IFR = 0.725%) chance of dying if they are infected with Covid.
The significantly higher hospitalisation and fatality rates for those aged over 75 years old following a Covid infection emphasises the importance of the Spring 2024 booster campaign.
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