York Health and Wellbeing Board

 

 

 

 

 

Health and Wellbeing Board

16 November 2022

 

Report of the Director of Public Health.

 

COVID-19 Update

Summary

1.        This report provides the Health and Wellbeing Board members with an update on COVID data for York.

2.        The report asks members of the Board to support the continued promotion of safer behaviour messages and vaccinations in line with evidenced based actions to manage other respiratory illness such as colds and influenza.

3.        Responding to the COVID virus will be through a ‘business as usual’ response with an emphasis on managing outbreaks in high risk settings.

4.        Living with COVID means that there are no formal restrictions in place but instead there is an emphasis on personal behaviours to reduce the risk of infection and transmission although if there is a significant change in the COVID virus this may change the national approach.

5.        On the 31st August 2022, based on advice from the UK Health Security Agency (UKHSA), the national COVID-19 alert level was lowered from level 3 to level 2.

6.        York Hospital and the wider health and care system continues to be extremely busy overall. Severe COVID cases, direct COVID healthcare pressures and direct COVID deaths are decreasing following a recent increase in activity and ONS community positivity estimates appear to be stabilising.

7.        Further COVID surges are likely as we head into winter and so getting a vaccination when it is offered continues to be very important.

 

Background

8.        The COVID-19 pandemic in the UK has now moved into the recovery phase and one which has been labelled as ‘Living with COVID’. Since January 2020 the city has made an unprecedented response to protect its citizens and reduce the risk of illness and death from the virus.

9.        It is inevitable that we will experience further peaks and troughs of cases of COVID as well as the likelihood of further variants of the virus. As such, there is a continuing need to be vigilant and for individuals and organisations to take measures to reduce the risk of further infection from COVID.

10.    There remains the risk that, as we move into winter, the pressure on the health and social care system across York could be overwhelmed. If we are to mitigate risk and reduce adverse health outcomes for our population, a system wide effort will be needed.

Main/Key Issues to be Considered

11.    At this stage in the pandemic the frequency of data reporting has been reduced and a comprehensive update is now published monthly. The cessation of most COVID testing also means that we no longer have detailed and accurate information on the number of positive cases. The most recent COVID data for York are shown below.

Diagnosed cases / episodes

12.    For the period 27.9.22 to 3.10.22 it is estimated that 3.2% of York’s population (about 1 in 30) would test positive for COVID-19. The trend in the modelled percentage of the York population testing positive for COVID-19 since November 2019 is shown in the chart below:

13.    As at 29.9.22 CYC residents have had a total 70,807 COVID episodes since the start of the pandemic, a rate of 33,556 per 100,000 of population. The cumulative rate in York is below the national (35,312) and regional (34,818) averages.

14.    The provisional rate of new COVID episodes per 100,000 of population for the period 27.9.22 to 3.10.22 in York is 60.2 (127 episodes). (Using data published on Gov.uk on 27.10.22).

15.    The latest official “validated” rate of new COVID episodes per 100,000 of population for the period 16.10.22 to 22.10.22 in York was 81.5 (172 episodes). The national and regional averages at this date were 83.2 and 81.8 respectively (using data published on Gov.uk on 27.10.22).

16.    The chart showing the data up to the specimen date of 22.10.22 is shown below:

17.    The rate of new COVID cases per 100,000 of population for the period 18.9.22 to 24.9.22 for people aged 60+ in York was 154.3 (77 cases). The national and regional averages were 114.3 and 115.4 respectively.

18.    Case rates in York are currently highest in the following age ranges: 90+ (329 per 100,000); 85-89 (259 per 100,000) and 80-84 (224 per 100,000). The age breakdown by 5 year age bands is shown below.

 

COVID Bed Occupancy in York Hospital

19.    As at 31.10.22 there were 69 confirmed COVID patients in General/Acute beds.  The peak number was 158 on 28.3.22.

20.    As at 31.10.22 there were 3 confirmed COVID patient in the Intensive Treatment Unit. The peak number for people in ITU was 19 on 10.5.20.

R Number

21.    The ‘R’ value (the number of people that one infected person will pass on a virus to, on average) for the North East and Yorkshire area on 12.10.22 was estimated to be in the range 1.1 to 1.3. Modelled estimates uses data from hospitalisations, deaths, testing, waste water sampling and longitudinal studies to come with as accurate a picture as possible.

Vaccinations

Vaccinations for People aged 16+ (1st dose, 2nd dose and Booster)

22.    As at 2.10.22 a total of 158,935 CYC residents aged 16+ have had the first dose of the vaccine.  This represents 89.1% of the estimated (16+) population of York.

23.    As at 2.10.22 a total of 153,246 CYC residents aged 16+ have had both doses of the vaccine.  This represents 85.9% of the estimated (16+) population of York.

24.    As at 2.10.22 a total of 125,756 CYC residents aged 16+ have received the booster vaccine. This represents 70.5% of the estimated (16+) population of York.

Vaccinations for People aged 12-15 (1st and 2nd dose)

25.    As at 2.10.22 a total of 5,638 CYC residents aged 12-15 have had the first dose of the vaccine.  This represents 67.3% of the estimated (12-15) population of York.

26.    As at 2.10.22 a total of 4,523 CYC residents aged 12-15 have had both doses of the vaccine.  This represents 54.0% of the estimated (12-15) population of York.

Vaccinations for People aged 5-11 (1st dose)

27.    As at 2.10.22 a total of 2,871 CYC residents aged 5-11 have had the first dose of the vaccine.  This represents 19.1% of the estimated (5-11) population of York.

Source: PHE Covid-19 Situational Awareness Explorer.  

Vaccinations by Age / Category and Ward

28.    The chart below shows the percentage of CYC residents age 12+ in each ward who have had the vaccine.

Source: NHS NIMS Covid Vaccine Uptake Report

Deaths

29.    Two key sources about deaths from COVID at Local Authority level are ONS data and local registrar data. They are derived from the same source (civil registration data).  ONS data is more comprehensive as it includes deaths of York residents which have occurred and been registered outside York.  Local registrar data provides a breakdown by age and gender. For both data sources a death from COVID is said to have occurred when COVID-19 has been recorded on the death certificate.   The most recently available data is summarised below: 

30.    ONS Weekly data:  In the most recent period (2022 Week 42: 15.10.22 to 21.10.22) 2 COVID deaths were recorded as having occurred for CYC residents. There were a total of 41 deaths from all causes in that week.  Please note that due to lags in death registration, weekly totals are subject to revision.

31.    ONS Cumulative data:  Since the start of the pandemic, we have been monitoring all deaths, including deaths due to COVID. The graph below shows deaths occurring from the start of the pandemic up to 21.10.22

Source: The excess deaths data is obtained from the ONS release: Deaths registered weekly in England and Wales, Provisional. Deaths which have occurred up to 11 days prior to the data release and have been registered up to 3 days prior to the data release are included.  Weekly totals are subject to revision. COVID-19 deaths are those deaths registered where COVID-19 was mentioned on the death certificate. 

 

Recovery and Living with COVID

32.    The data above provides evidence that we now have to adjust to living with COVID with public health scientists predicting that in the medium to long term the virus will become endemic, the expectation being that the virus will become more stable and predictable, but we will still see some community transmission.

33.    Living with COVID will mean the continuing need to work to reduce vaccine inequalities, to understand why there are areas across York where vaccine uptake needs to increase to reduce the risk to vulnerable people and mitigate outbreaks. We will also need to work with our population to continue with personal behaviours which reduce risk such as hand hygiene and ‘catch it, bin it, kill it’ actions. This will be especially meaningful as we head into winter and the flu season.

34.    Whilst we want our citizens to have confidence in working and socialising it is important to understand that there still remains a level of uncertainty around transmission because of waning immunity, vaccine inequality and the risk of new variants. It is therefore still pertinent that the following advice is communicated and supported :

•           Be aware of symptoms

•           Stay at home if you think you might have COVID

•           Get vaccinated if eligible

•           Wear a face mask when appropriate, particularly in crowded indoor places

•           Meet outside if possible, good ventilation is important

•           Good hand and respiratory hygiene

 

35.    As with all communicable diseases the position in York will continue to be monitored by the Director of Public Health working closely with the UK Health Security Agency (UKHSA) and wider system partners to respond to outbreaks and work on prevention.

 

Consultation

36.    Not applicable.

 

Options

 

37.    The report is for information.   

 

Strategic/Operational Plans

 

38.    York’s Joint Health and Wellbeing Strategy 2022 to 2032. This report links to all areas in the above strategy across the life course.

 

39.    CYC Health Protection Assurance Framework strategic objective to ensure local authority and partners are supporting the preventative actions to protect the health of the population.

 

Implications

 

40.    There are no specialist implications

 

Risk Management

 

41.    There remains the risk that, as we move into winter, the pressure on the health and social care system across York could be overwhelmed. If we are to mitigate risk and reduce adverse health outcomes for our population, a system wide effort will be needed. In particular there needs to be a shared focus on delivering a successful COVID and seasonal flu vaccination programme with maximum uptake across all eligible groups.

 

        Recommendations

42.    The Health and Wellbeing Board are asked to:

i.             receive the report and highlight any key issues for further consideration.

Reason: To keep the board updated in relation to COVID-19.

 

Contact Details

Author:

Anita Dobson

Nurse Consultant in Public Health

anita.dobson@york.gov.uk

 

Chief Officer Responsible for the report:

Sharon Stoltz

Director of Public Health

Sharon.stoltz@york.gov.uk

 

 

 

Report Approved

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Date

01/11/2022

 

 

 

 

 

 

 

Wards Affected: 

All

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For further information please contact the author of the report