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Update on COVID-19 and vaccinations

Published 02/11/2022   |   Reading Time minutes

As we head for our third winter with COVID-19, we’re past the pandemic stage and total cases remain low compared to the previous peaks.. But concerns remain about pressures on health and social care services, and long COVID...

This article looks at the current position; the numbers of cases, the trends in those numbers, the vaccination uptake and some of the key emerging policy issues.

COVID-19 infections

Data published by Welsh Government from the Office for National Statistics (ONS) indicates that the overall trend in people testing positive for COVID-19 in Wales has decreased since the beginning of the year. There was some increase during September, but the percentage of people testing positive in Wales has decreased in the most recent weeks.

Modelled daily rates of the percentage of the population testing positive for COVID-19, Wales

The graph shows a steady increase from 1.4% on 6 September 2022 to 3.5% on 7 October 2022. This was followed by a decrease to 2.4% on 17 October 2022 – the latest data available. The width of the 95% credible interval is about one percentage point.

 

Source: COVID-19 Infection survey, ONS. The green line and shading represent the modelled trend and 95% credible intervals based on the latest data.

The Welsh Government note that the estimates are based on a relatively low number of positive tests, so we should be cautious about over-interpreting any small movements in the latest trend. We also don’t have the same level of totality around figures as when there was mass testing.

Modelled daily rates of the percentage of the population testing positive for COVID-19 by UK country

Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.Graph showing overall increases from 6 September for all UK nations. Trends for the most recent week are described below.

 

Source: COVID-19 Infection survey, ONS. The lines represent the modelled trends based on the latest statistics.

In the week ending 17 October 2022 the percentage of people testing positive decreased in Wales but increased in Northern Ireland and Scotland. In England, the percentage testing positive increased over the two weeks up to 17 October, but the trend was uncertain in the most recent week.

The most recent estimated figures indicate:

  • Wales: 86,100 – around 2.83% or 1 in 35 of the population;
  • England: 1,748,400 - around 3.21% or 1 in 30 of the population;
  • Northern Ireland: 53,700 - around 2.92% or 1 in 35 of the population; and
  • Scotland: 159,200 - around 3.02% or 1 in 35 of the population.

This overall downward trend in UK infections since early 2022 mirrors the pattern globally as reported by the World Health Organisation.

COVID-19 deaths

ONS data shows the COVID-19 age-standardised mortality rate for Wales was 19.9 deaths per 100,000 people in September 2022, compared to 72.2 deaths per 100,000 people in January. The rate in England was 16.7 deaths per 100,000 in September 2022 compared to 81.0 per 100,000 in January.

In the leading causes shown below, COVID-19 was the 6th leading cause of death in Wales from January to September 2022.

Number of deaths registered in Wales for selected leading causes, January to September 2022

Ischaemic heart diseases 2895, Dementia and Alzheimer's disease 2749, Chronic lower respiratory diseases 1458, Malignant neoplasm of trachea bronchus and lung 1375, Cerebrovascular diseases 1244, COVID-19 1064, Influenza and pneumonia 932, Malignant neoplasm of colon sigmoid rectum and anus 762, Symptoms signs and ill-defined conditions 668, Cirrhosis and other diseases of liver 529.

 

Source: Office for National Statistics

ONS registered deaths include people who died in the community and in hospital. The data shows how many more people have died from all causes than we would usually expect by comparing to a 5-year average. 'Excess deaths' are increases above the 5-year average.

Weekly registered deaths and excess deaths

Both excess deaths and COVID-19 deaths show two peaks of approximately 400 to 500 deaths per week centred on April 2020 and January 2021. Weekly deaths have fluctuated since autumn 2021 with COVID-19 deaths largely remaining below 100 per week and excess deaths below 200 per week.

 

Source: Office for National Statistics

The 2015 to 2019 five-year average was used to compare against deaths registered in 2020 and 2021. Deaths registered in 2022 are compared with the 2016, 2017, 2018, 2019 and 2021 five-year average.

COVID-19 variants

Since the end of June, the majority of UK COVID-19 infections have been Omicron variants BA.4 or BA.5. According to the Technical Advisory Cell, who provide scientific advice to Welsh Government, BA.5 comprised 88% of all sequenced COVID-19 infections in Wales as at 5 October and over 75% of all sequenced infections across the UK as of 24 October. PHW publish weekly data on variants of concern and variants under investigation for Wales.

Long COVID

Long COVID is when symptoms continue, or new symptoms develop, more than 12 weeks after infection with COVID-19.

The ONS estimates that as of 3 September, 2.3 million people in UK private households (3.5% of the population) were experiencing self-reported long COVID (symptoms continuing for more than four weeks after the first confirmed or suspected COVID-19 infection that were not explained by something else). The most recent estimate for Wales was 90,000 in July, slightly down from May and June.

Impact on health and social care services

An average of 15 people a day were admitted to hospital in Wales with confirmed or suspected COVID-19 as at 25 October compared to 22 on 30 September. This is a significant reduction from admissions at the peaks of the pandemic, as shown in the chart below.

Patients admitted to hospital as suspected or confirmed with COVID-19, from 1 April 2020

Hospital admissions were around 150 per day in early April 202. Following a decrease to below 50 per day in summer 2020, admissions peaked again in January 2021 to around 125 per day before dropping to about 10 per day in July 2021. Since then, admissions have fluctuated, typically staying below 50 per day.

 

Source: Welsh Government

Hospitalisation rates are lower than those in early 2022, with 826 hospitalised with COVID-19 (confirmed, suspected or recovering) as of 25 October. However, this represents an increase of 165 from 661 on 30 September. Pressure on services is evident, with general and acute medical bed occupancy in acute hospitals at 95.2% as at 25 October.

Number of people in hospital with COVID-19 (includes suspected, confirmed and recovering cases)

The number in hospital peaked over 1,000 in April 2020 and nearly 3,000 in January 2021. The number reached a minimum in July 2021 and has since fluctuated, typically staying between 500 and 1,500.

 

Source: Welsh Government

COVID- 19 vaccination programme

Following on from it’s Winter respiratory vaccination strategy: autumn and winter 2022 to 2023 (July2022), on 25 October the Welsh Government published a National Immunisation Framework for Wales. The Framework sets out a series of actions “which will make it easier for people to know what vaccinations they are eligible for and how to receive them”. The Minister for Health and Social Services, in announcing the launch said the Framework:

…sets out a series of actions which will make it easier for people to know what vaccinations they are eligible for and how to receive them. This includes digital vaccination records, simplified booking systems and vaccines being given at the same appointment, so people can get their flu and COVID-19 jabs at the same time, for example. This will be more convenient for people and help to increase take-up of these two seasonal vaccines in the future.

The process to transform vaccination services is underway as the autumn COVID-19 booster and winter NHS flu jab programmes are integrated this year. The framework also outlines the move towards the national procurement of the flu vaccine over the next two years, although GPs and pharmacies will continue to administer the vaccine to patients.

The vaccine remains a critical tool in tackling COVID-19 and the World Health Organisation estimates that vaccination prevents up to three million deaths worldwide each year. The roll-out of the COVID-19 autumn booster started on 31 August. This includes residents and staff working in care homes, frontline health and social care workers, those aged 50 and over, and those aged 5 to 49 years in clinical risk groups. The charts below show the level of uptake of the earlier vaccine programmes, as well as the autumn booster.

Number of people who have received a vaccination by dose

After initial rapid uptakes that lasted about four months, the curves for first, second and 2021/22 booster doses flattened and have since remained close to current numbers. The autumn 2022/23 booster dose is still in a phase of rapid uptake. As of 23 October 2022, the uptake is: First dose 2,579,553. Second dose 2,463,339. 2021/22 booster 2,021,566. Autumn 2022/23 booster 637,732.

 

Source: Public Health Wales

Uptake of Autumn 2022/23 booster by priority group

Residents in a care home for older adults 74.5%. All adults aged 65 years and older 53.5%. Severely immunosuppressed 50.8%. Health care staff 40%. Staff working in care homes for older adults 29.5%. All adults aged 50 to 64 years 20.4%. Aged 5 to 49 years in a clinical risk group 7.2%. Social care staff 16,167 immunised, group size not available.

 

Source: Public Health Wales

Note: Public Health Wales (PHW) publish a range of data relating to COVID-19, including information on vaccinations, mortality, variants, hospitalisation, hospital-acquired infections, and testing.


Article by Paul Worthington, Joe Wilkes, Božo Lugonja and Helen Jones, Senedd Research, Welsh Parliament