Adroddiad sefyllfaol COVID-19: 15 Gorffennaf 2021

Y pwyntiau allweddol i’w nodi

Mae trosglwyddiadau cyffredinol COVID-19 yn cynyddu yn gyflym ym mhob ardal ar draws Cymru. Mae amcangyfrif consensws SAGE ar gyfer y rhif atgynhyrchu yng Nghymru rhwng 1.2 a 1.5, tra bod amcangyfrif Iechyd Cyhoeddus Cymru (PHW) rhwng 1.25 ac 1.3. Ffynhonnell: SAGE / PHW (14/7/21). Sylwer bod fel arfer oedi o 2 i 3 wythnos yn amcangyfrif SAGE a bod oedi yn achos amcangyfrif PHW, sy’n defnyddio methodoleg wahanol, o tua 1 wythnos. Mae’r digwyddedd achosion a chanran y bobl sy’n profi’n bositif am COVID-19 hefyd wedi cynyddu. Sleid 3, Ffynhonnell: PHW

Er bod y defnydd o welyau lle darperir cymorth anadlu mewnwthiol yn parhau’n sefydlog, mae nifer y gwelyau mewn ysbytai a ddefnyddir gan gleifion COVID-19 yn dechrau codi. Sleid 4, Ffynhonnell: Data Gweithredol GIG Cymru

Ar 13 Gorffennaf 2021, mae’r achosion a gadarnhawyd o’r amrywiolyn Delta, sy’n fwy trosglwyddadwy, yn 5,601 yng Nghymru (cynnydd o 1,935 o achosion ers yr wythnos flaenorol), sy’n golygu mai Delta yw’r amrywiolyn COVID-19 amlycaf yng Nghymru. O’r 5,601 o achosion a ganfuwyd hyd yma, roedd 45.4% o’r achosion mewn unigolion nad ydynt wedi’u brechu, roedd 34.0% wedi derbyn 1 dos ac roedd 20.6% wedi derbyn 2 ddos. Sylwer efallai fod y data hyn yn cynnwys brechiadau nad oes 14 i 21 o ddiwrnodau, fel sy’n angenrheidiol i ddarparu’r amddiffyniad gorau posibl rhag COVID-19, wedi pasio ers iddynt gael eu derbyn. O’r 5,601 o achosion, cafodd 64, neu 1.1% y cant, eu derbyn i’r ysbyty. Ffynhonnell: PHW

O ran brechu, ar 13 Gorffennaf 2021, mae cyfanswm o 4.14 (+0.11) miliwn o ddosau o frechlyn COVID-19 wedi cael eu rhoi yng Nghymru. O’r rhain, dosau cyntaf oedd 2.28 (+0.01) miliwn ac ail ddosau oedd 1.86 miliwn (+0.10). Yn seiliedig ar amcangyfrifon SAGE, ei bod yn ofynnol i 80% o’r boblogaeth fod wedi’i brechu er mwyn ymateb i’r amrywiolyn Delta, os na cheir unrhyw ymddygiadau diogelu eraill, ni fydd y niferoedd presennol sydd wedi’u brechu yn amddiffyn ar lefel y boblogaeth gyfan. Ffynhonnell: PHW, SPI-M-O.

1. Mae data diweddaraf yr Arolwg Heintiadau COVID-19 ar gyfer y cyfnod o 4 Gorffennaf 2021 i 10 Gorffennaf 2021.
2. Y cyfartaledd treigl saith diwrnod hyd at y dyddiad presennol o gleifion y cadarnhawyd bod ganddynt COVID-19 – nid yw’n cynnwys cleifion yr amheuwyd bod ganddynt COVID-19 neu sy’n gwella.
3. Mae data marwolaethau diweddaraf ONS hyd at 2 Gorffennaf 2021 (yn hytrach na 10 Gorffennaf 2021) ar gyfer y gwerth cyfredol. Defnyddir data hyd at 25 Mehefin 2021 ar gyfer y newid ers yr wythnos flaenorol. 

At a Wales level, on 2 July, the 7-day rolling incidence of COVID-19 cases and the percentage of people testing positive for COVID-19 have increased since last week (slide 2). 

The SAGE/ SPI-M consensus estimate of Reproduction number (Rt) remains between 1.2 and  1.5 (as at 14 July 2021). When we look at reproduction numbers using PHW positive test data only (see second table below) - a more timely estimate but limited by variation in testing - we see a reproduction number estimate of between 1.25 and 1.3 for Wales. PHW estimate a national doubling time of 12 days. The Rt number is highest for the Powys health board. Central estimates of doubling times at local authority level range from 5 to 18 days. Source: PHW. 

7-day cumulative case incidence in Wales has increased by a third in the last week. Case incidence has risen to 145.3 per 100,000 population in Wales compared with 110.0 per 100,000 population last week. 

Case incidence is increasing in almost all local authorities. All 22 local authorities have a case incidence above the 50 per 100,000 population threshold. Local authorities with the highest case incidences are in North Wales. Case incidence is highest for Wrexham and Denbighshire at 318.5 and 227.8 per 100,000 population, respectively. 

Over the past week, case incidence is highest in those aged 10-19 and 20-29. Case incidence continued to increase throughout the week in these age groups, but their growth slowed at the end of the week.  Case incidence is highest for the Betsi Cadwaladr health board.  

The second table below provides estimates of doubling and halving times based on PHW COVID-19 positive test data. In this table, doubling times are positive, whilst halving times are negative. The 95% confidence intervals are showing in brackets after the central estimate. An asterisk (*) means that there are small numbers and estimates should be treated with caution. Local health board level estimates of Rt and halving times will be unstable when incidence is low. 

Cases per 100k (PHW Data) (7 day rolling sum)

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Cases per 100k by age (PHW Data) (7 day rolling sum)

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Data as at 12:00PM 14 July 2021 unless otherwise specified.

COVID-19 pressure on the NHS has remained relatively stable. The number of new daily admissions with suspected or confirmed COVID-19 remains close to the lowest levels since reporting began, however there has been a steady increase in the number of beds occupied with COVID-19 related patients over recent weeks. 

As at 14 July 2021, there were 150 COVID-19 related patients (Suspected, Confirmed and Recovering) occupying a hospital bed. This compares to 124 (26 more occupied beds) on 7 July 2021. Confirmed patients accounted for 79 of the total occupied beds, and are at similar levels to mid-April 2021.  

There are 9 patients with Suspected or Confirmed COVID-19 in critical care beds in Wales. This is 155 lower than the maximum COVID-19 position of approximately 164. The total number of patients in critical care for both COVID-19 and non-COVID-19 stands at 156, 4 more than the historic maximum critical care capacity of approximately 152.

In the 7 days up to 30 June 2021, 20 (1.9%) adult care homes in Wales notified CIW of one or more confirmed cases of COVID-19, in staff or residents. This is 5 more notifications compared to the last 7 days up to 23 June 2021 and compares to 4 notifications on 2 June 2021, which was the lowest number of notifications since reporting began on 16 December 2020. 

Confirmed hospital occupancy (7 day rolling average)

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Overall invasive ventilated bed occupancy (7 day rolling average)

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Hospital bed occupancy for suspected and confirmed COVID-19 positive patients (7 day rolling average)

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Invasive ventilated bed occupancy for suspected and confirmed COVID-19 positive patients (7 day rolling average)

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Number of adult care homes reported an ongoing outbreak/incident (last 7 days)

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Childcare settings

The latest National Situation Background Assessment Recommendation (SBAR) report covering the week of 5 July to 12 July reported that the incidence of clusters in child care settings remains low. 

3 new clusters were reported last week compared to 1 new cluster reported the previous week. 

Schools

There were 59 new clusters and 108 ongoing clusters associated with schools reported by IMTs last week. 37* are attributed to school settings and 75* to household, social or extra-curricular activities. Source: National SBAR *Figures do not include Gwynedd data

Weekly COVID-19 per 100,000 population for school age children and young adults incidence in Wales (data as at 1pm 14 July 2021)

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Schools with more than one COVID-19 case identified within the last 21 days, excluding 306 schools with 1 COVID-19 case

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Epidemiological curve of cases in all staff and pupils linked to a school between 22 February 2021 and 12 July 2021 for all Wales maintained schools 

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School Attendance

An average of 81% of all pupils were present in school over the week of 5 July to 9 July Source: Stats Wales

Absence due to COVID

Absence due to a COVID-19 related reason was similar between primary and secondary age pupils up until mid-June where absences in secondary schools started to increase at a faster rate. The latest data shows that in early July the percentage of pupils absent in secondary schools is two to three times that in primary schools. Source: Stats Wales

Pupils present by day in Wales, from 7 September 2020

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Further Education (FE)

The latest National SBAR reported no new clusters associated with FE settings last week. Source: National SBAR.

Higher Education Institutions (HEIs)

HEIs report cases notified to them by students and staff. Over the past week, the 7-day rolling average has been less than 3 positive COVID-19 cases for all HEI's. Source: Stats Wales.

In addition, according to the National SBAR, local IMTs reported there were 3 new clusters associated with HE settings last week. Source National SBAR

7 day rolling average of positive cases in Welsh universities 27 September to 11 July 2021

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Please note: Due to accuracy & timeliness limitations with the capability of our surveillance systems, distinguishing exact case associations between children over 19, school staff and/or family members is currently not possible. We are looking to develop this with local health protection officers.

There is an increase since last week in overall arrivals (approximately 15%). Red list positive cases are 0.22% whilst amber and green remain low at 0.15% and 0.14%, respectively.

Due to increasing traveller volumes, increasing community cases and limited staff capacity, the Arriving Travel Team (ATT) in Wales are prioritising travellers from highest risk countries who have been contacted by phone. 

• 4,895 total for this week (4,258 last week)
  • Amber: 3,890 (3,772 last week)
  • Red: 211 (159 last week)
  • Green: 758 (296 for last week)
• There were 11 positive arrivals (0.2%)
• In the same period 465 (524 last week) of 4,895 travellers marked themselves as exempt (9.5%)

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Source: Home Office, as at 8 July 2021

Please note that the data provided by the Home Office is derived from Passenger Locator Forms (PLF) which are self-completed by travellers. As such, data may contain inaccuracies. Due to the limitations associated with data capture and legislation, some minor discrepancies may be present in the data.

The latest mobility data shows a similar pattern to the previous week. In some cases mobility remains above the baseline - but mobility has decreased overall from half term week (end of May/early June). The baseline for much of the data is during Jan-Feb 2020 and changes are relative to that period. It is not possible to determine if mobility is higher/lower than would have been expected prior to the pandemic as data for 2019 or earlier years is not published.

Mobility data by location of trip

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Adherence

The most recent IPSOS MORI data for the period 2 – 5 July for Wales shows that those who reported making essential trips only was the lowest since the survey began in March 2020. Other measures are similar to the last survey wave. It should be noted that this is self-reported adherence and will be affected by individuals’ understanding of the rules and circumstances that apply to them. 

The latest results from the Public Engagement Survey on Health and Wellbeing during Coronavirus Measures is the same as last week, showing that 85% of people said they understand current restrictions in Wales ‘very well’ or ‘fairly well’ and that 90% of people said they were following coronavirus restrictions ‘completely’ or with 'majority compliance'. 

Results from the Coronavirus (COVID-19) Infection Survey, 4 July to 10 July 

The percentage of people testing positive has continued to increase in England, Scotland and Ireland. The trend is uncertain in Wales. The positivity rate is highest for Scotland and lowest for Wales.

It is estimated that an average of 8,400 people in Wales had COVID-19 (95% credible interval: 5,000 to 12,900), equating to around 1 in 360 people or 0.28% of the community population. This compares to around 1 in 95 people in England, around 1 in 90 people in Scotland, and around 1 in 290 people in Northern Ireland.

Source: Office for National Statistics COVID-19 Infection Survey

Positivity rates (%) across UK countries up to 10 July 2021

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Vaccination and antibody status of individuals aged 16 and over in Wales

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Immunity estimates and antibody status of individuals aged 16 and over in Wales

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The COVID-19 vaccination rollout continues to progress well in Wales. As at 10 July 2021, 87% of people aged 16 and over had received at least one COVID-19 vaccine dose in Wales. 17% of people aged 16 and over had exactly one vaccine dose and 70% were fully vaccinated. Uptake of first doses has slowed since the final priority group was reached.

Between 14 and 20 June 2021, the ONS COVID-19 Infection Survey estimated that 91.8% of the community population aged 16 and over in Wales tested positive for COVID-19 antibodies.

As at 10 July 2021, it was estimated that 79% of people aged 16 and over in Wales had some immunity against COVID-19 infection. The lower and higher estimates of immunity are 63% and 83% of people aged 16 and over in Wales. If no vaccines had been administered, it is estimated that 30% of people aged 16 and over would be immune. These estimates assume 84% of natural infections lead to immunity, but do not account for waning immunity (SIREN study paper).

It is currently estimated that over 80% (may be closer to 90%) of the population, spread evenly across Wales, must be immune to COVID-19 before population immunity effects would be observed (TAG advice on the Delta variant, published 18 June 2021). Note that the immunity estimate of 79% is for individuals aged 16 and over, not the total Wales population, and varies across age groups. 

Differences between antibody presence and immunity estimates include:

• ONS antibody estimates are based on study participants who have volunteered for the study and estimates are extrapolated.
• ONS estimates are based on the 16+ community population, which excludes people in care homes or hospitals. Immunity estimates are based on the whole 16+ Wales population.
• While antibody protection doesn’t equal immunity from infection, it does give a useful indication of the level of protection from infection in the Welsh population.
• Antibody estimates use 2019 mid-year population estimates while we use 2020 estimates.

Source: ONS COVID-19 Infection Survey, PHW, SPI-M, Swansea University modelling

Based on the current rates observed with current restrictions:

Cases 

The probability of incidence greater than 200 per 100,000 between 25 July and 31 July is above 80% for 5 local authorities. The figure illustrates the probability (between 0 – 100%) of incidence being greater than 200 per 100,000. Source: Imperial College London

Probability of greater than 100 per 100,000 cases by local authority

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18 to 24 July and 25 to 31 July

Deaths per day

SPI-M's consensus view is that the number of deaths in Wales will remain low over the next four weeks. Source: Modelled medium term projections, SAGE/SPI-M, 13 July.

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Hospitalisations per day

Projected to increase to around 30 per day over the next four weeks before levelling off. Source: Modelled medium term projections, SAGE/SPI-M, 13 July.

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These projections are based on current trends and will not fully reflect the impact of policy or behavioural changes over the past two to three weeks. The projections include the impact of vaccines, but cannot capture any future increases in transmission resulting from new variants. They are not forecasts or predictions. 

Key risks

Transmissions, incidence and prevalence

Overall transmission, percentage of people testing positive is rapidly increasing since last week. 

Trends vary across health boards and local authorities.

NHS Capacity

Invasive ventilated bed occupancy remains low and stable. However there has been a steady increase in hospital bed occupancy for COVID-19 related patients in recent weeks. 

Mortality

Low numbers of deaths in the most recent week.

Variants

Wales has 5,601 confirmed cases of the more transmissible Delta variant (an increase of 1,935 from the previous week) making Delta the dominant variant of COVID-19 in Wales.

Immunity and vaccines

4.14 million (+0.11 million) doses of COVID-19 vaccine have been given in Wales, of which 2.28 (+0.01) million were first doses and 1.86 million (+0.10) were second doses. Around 79% of people aged 16 and over have some immunity in Wales.

International

There is an increase in travellers numbers this week, however positive rates continue to remain low.

Key sources for this update

Technical Advisory Cell brief

COVID infection survey results

Public Health Wales

Hospital occupancy

Higher Education

School attendance

Public Health England VoC Technical Briefing