Latest PHE flu & COVID surveillance report, up to 15th Nov.
- ⬆️Case rates in over 70yrs.
- ⬆️hospitalisations, ICU admissions & deaths.
- Big variation by region, ethnicity, age, and deprivation.
- (+ some good news on flu & flu jabs)
Confirmed cases of COVID plateaued this week, and positivity rates dropping.
Still probably a little early to see results of 6th Nov restrictions, but local restrictions likely important. And new use of lateral flow tests (pillar 2) may be contributing to lower positivity rates.
And case rates falling across most aged but crucially NOT among age 70yrs+
The North + Midlands vs South divide still v marked, but (generally) things improving in the N/Mids, and getting worse in the S.
Inequalities by ethnicity and deprivation are as stark as ever.
Also note differences by ethnicity b/w first wave and second. Other ethnic groups v over-represented in both, but people of Black ethnic groups far more likely to get infected in the first wave cf the second, and vice versa for ppl of some Asian ethnic groups.
Number of COVID outbreaks in primary and secondard schools has pretty much doubled this week (two wks after half term). Although ONS data suggest community case rates in school age children still flat or falling.
Tomorrow's ONS survey data by age will be interesting.
Also alongside the increase in cases over 70yrs, more outbreaks in care homes being reported.
After a slight pause last week, hospitalisations continue to climb across most of the country.
Although note NW where 4 weeks(ish) of falling case numbers seems to have slowed hospitalisations
And ICU admissions also still climbing, but more regional variation (look at East Mids).
Sadly deaths and excess mortality also following suit
But to finish on a more positive note. No flu-related hospital admissions this week, and just one case picked up through routine surveillance.
And flu vax uptake is the HIGHEST EVER at this stage for age 65+ & age 2-3years.
This is brilliant news and shows just how hard GPs & the teams involved have worked on this.
If you're eligible, please get vaccinated. You (and the NHS) really don't want flu right now.
In summary, whilst overall case numbers might be stabilising, they're still rising in over 70yrs+, the health system remains under huge pressure, and it's still likely to get worse before it gets better.
Please stay at home where you can.
12% increase in people getting tested which is good (now 1.74m in a week(!)), but note from 6th Nov, pillar 2 now includes people having the rapid lateral flow tests (e.g. Liverpool pilot) and this will only increase in numbers.
The knock-on impact is lower P2 positivity rates.
The implications of this is that it makes it far harder to interpret positivity rates, esp if you don't separate out test device, or asymptomatic vs symptomatic testing.
Irrespective of the fact that 50,000 of 5,000,000 is 1% rather than 0.1%, here's a v short selection of data that might help to clarify some of the differences between flu and COVID-19.
Lots happened during this week
- schools back after half term
- Liverpool's mass testing started on 6th Nov
- national restrictions (second lockdown-ish) started 5th Nov
Number of cases continued to rise, but overall positivity dipped for the first time suggesting more testing now being done.
As mass testing starts, gets increasingly important to separate asymptomatic from symptomatic testing.
One thing missing is positive predictive and negative predictive values (PPV and NPV) that crucially depend on what proportion of people being tested have disease - the prevalence.
Take recent ONS survey - 1.1% of pop infected: PPV is 73%, meaning around 1 in 4 positive tests are false positives
(NPV is 99.7% - if you test -ve, you are)
Test 1000 people: there will be 8 true positives, 3 false positives, 3 false negatives, and 986 true negatives.
If in NW where prevalence is 2.2%, PPV rises to 84% (about 1 in 6 positive tests are false)
BUT in SE, prevalence is 0.5% meaning PPV is 55%, i.e. every other positive result is a false positive.