Coronavirus UK: 357 new deaths amid worries of R rate rise

SAGE said the overall rate remained between 0.7 and 0.9 across the UK as a whole but admitted it may be a little higher in England

The UK’s official coronavirus death toll today surpassed 40,000 as health chiefs announced 357 more Brits have lost their lives to the disease and scientists suggested the R rate has now risen to above the dreaded number of one in two regions of England.

Department of Health data shows 343 deaths occurred in England, followed by nine in Scotland, four in Wales and one in Northern Ireland – taking the official Covid-19 death toll to 40,261.

But the true number of coronavirus victims is known to be thousands higher. The Government only includes laboratory-confirmed cases in its daily update, meaning patients who are suspected to have died but never got tested for the infection aren’t included.

It comes as separate estimates produced by experts at Public Health England and Cambridge University today suggested the R-rate – the average number of people each Covid-19 patient infects – is above the danger level of one in the North West and South West. It must stay below one or Britain will face another crisis. 

The data – fed into No 10’s scientific panel SAGE – suggested the R rate was falling before lockdown was imposed and has been creeping back up since the darkest days of the outbreak at the start of April. SAGE said the overall rate remained between 0.7 and 0.9 across the UK as a whole but admitted it may be a little higher in England. 

One leading Cambridge statistician – who was not involved with the latest modelling – warned the findings were the regional update that everyone has been ‘eager to have’ but admitted they were the ‘opposite of reassuring’ and added: ‘No wonder members of SAGE are worried.’

The PHE/Cambridge team – whose model is based on death data from NHS England and regional health officials, antibody surveillance sampling and mobility reports – also estimated 17,000 people were still being struck down with Covid-19 across England every day. And they warned the true figure could be as high as 25,000.

This was three times the estimate from a separate government-run Covid-19 surveillance testing scheme. Office for National Statistics (ONS) figures released today – based on swabs taken of nearly 20,000 people – suggested England’s outbreak has shrunk by half in the past week and is infecting around 5,500 people each day.

In tonight’s Downing Street press conference, Health Secretary Matt Hancock urged protesters to avoid going to George Floyd demonstrations across the country ‘for the safety of loved ones’. He also announced that face masks will be compulsory for all medical staff in hospitals and visitors and outpatients must wear coverings from June 15.

In other developments to Britain’s coronavirus crisis today:

• Questions were asked about whether the lockdown was ever necessary as another study suggested the outbreak was under control before the draconian measures were imposed on March 23; 
• Tony Blair urged Number 10 to set up a mass testing programme which would see the bulk of the UK population checked for coronavirus as he suggested that is the only way to prevent a second outbreak;
• Fears of a second wave were sparked after Iran became the first country in the world to report another cluster of coronavirus infections after easing its lockdown; 
• Half of Britons are shunning Chinese products and two-thirds would like the government to impose more tariffs on imports from the communist state, according to a poll;
• Pharmaceutical giant AstraZeneca revealed it is already manufacturing Oxford University’s experimental vaccine in India, the UK and Europe amid plans to distribute 2billion doses as early as September if it works;
• TV presenter Kate Garraway broke down in tears as she revealed critically-ill husband Derek Draper thanked her for ‘saving his life’ before he slipped into a coma during his 10-week battle with coronavirus.

It comes as separate estimates produced by experts at Public Health England and Cambridge University today suggested the R-rate – the average number of people each Covid-19 patient infects – is at the danger level of one in the South West

Separate data showed the R rate was around 0.94 in the East of England and was only slightly higher in London (0.95)

The estimates from the Public Health England and Cambridge University team suggested the R rate was currently the lowest in the Midlands (0.90) and the North East and Yorkshire (0.89)

However, the academics fear the R rate in the North West is 1.01 – meaning an outbreak will continue to increase. And they said the reproduction number in the South East is likely to be 0.97

Department of Health figures released this afternoon show that 207,231 tests were carried out yesterday, including antibody tests for frontline NHS and care workers. It is the highest number of daily tests since the disease – which has killed almost 400,000 people worldwide and struck millions – began spreading on British soil in February.

But officials have once again refused to reveal exactly how many people were tested, meaning the number of Brits who have been swabbed for the coronavirus has been a mystery since May 22, when data showed up to 2.1million people had already had samples taken from their nose and throat. 

Separate figures released by the Department of Health show that 1,650 more people tested positive for Covid-19, taking the official size of the UK’s outbreak to 283,311 cases. However, the true scale of the crisis is estimated to be in millions.

The 357 Covid-19 deaths announced today is more than double the 176 registered yesterday – health chiefs have yet to explain why there was a slight blip in Thursday’s figure. Historical data also shows it is 10 per cent higher than the 324 recorded last Friday and ever so slightly more than the 351 registered exactly a fortnight ago. 

The figure does not show how many people died in the last 24 hours, instead it is only how many fatalities have been reported. This is the reason there is always a much lower figure on Sundays and Mondays followed by a spike on Tuesdays when the recording lag at weekends is taken account for. 

Geographical breakdown of the Department of Health data shows 343 deaths occurred in England, followed by nine in Scotland, four in Wales and one in Northern Ireland. However, the figures do not always match the updates provided by each of the home nations.

For example, Scotland’s health board announced 14 new deaths today and nine yesterday. But the official government tally has a different time cut-off, meaning the daily updates from Scotland as well as Northern Ireland are always out of sync. Wales is not affected. 

The death figures come as a PHE/Cambridge team updated their real-time estimates of the coronavirus outbreak in England, estimating that 5.62million people across the country – or 10 per cent of the population – has already had the coronavirus. 

The rate is similar to data seen from a separate antibody surveillance scheme carried out by PHE, which suggested the rate was 8.5 per cent.  But it is higher than data from a separate ONS sample, which puts the national level of infection at around 6.78 per cent. 

Analysis of the PHE/Cambridge data showed London has been, by far, the worst-hit region of England (17 per cent).  At the peak of the capital’s crisis – said to be the same day lockdown was imposed – 154,000 are thought to have caught the infection.

In comparison, only 4 per cent of people in the South West are thought to have been struck down by the coronavirus. 

The team claim between 10,700 and 25,300 people caught the virus across England on June 3 and that the rate has been fairly stable since the start of May.  

The team calculated that the crucial ‘R’ reproduction rate fell to just 0.4 in the capital in the aftermath of the lockdown being introduced.  However, the rate in London – as well as other regions – slowly began to creep up to between 0.7-0.8 before moving closer to one in the past few weeks.  

At the beginning of the outbreak London was the worst affected region but the latest numbers suggest it is now ahead of all but one region in terms of recovery. The data, published by the university, shows London is recording 1,310 cases each day – behind only the South West (778). 

In contrast, the North West of England is recording 4,100 daily infections and has an R rate of 1.01, the highest for any region in the country.  The South West also has an estimated R rate of 1. While the North East and Yorkshire is the only area to still be in the 0.8s. 

Meanwhile, the team’s modelling shows only one death occurs in every 113 cases – giving it an infection-fatality rate of around 0.88 per cent. Studies conducted around the world have produced a similar figure, suggesting it is up to eight times deadlier than seasonal flu. 

The PHE/Cambridge team admitted the actual infection-fatality rate could be as low as 0.77 or as high as 1 per cent. 

And the study showed huge variation between different age groups, warning the virus has an infection-fatality rate of around 23 per cent for over-75s. But it is below 0.024 per cent for anyone under the age of 44 – the equivalent of one death for every 4,100 cases.

For people between the ages of 45 and 64, the team said the death rate was around 0.36 per cent while the rate was approximately 2.3 per cent for people aged between 65 and 74. 

It comes as separate figures released by the ONS this morning predicted that there are now only 53,000 people in England who currently have Covid-19 – 0.1 per cent of the population.

The estimate – based on swab tests of nearly 20,000 people picked at random to give ministers a clearer picture as to the true scale of the crisis in Britain – is a massive drop on the 133,000 people (0.24 per cent) thought to the have the illness in the same data last week.

And the ONS says that around 39,000 people per week are catching the infection – 5,500 per day, which is a drop from 54,000 per week between May 16 and May 23. This means that only around one in every 1,000 people are actually carrying the virus, down from one in 400 at the latest estimate.

The ONS report said: ‘As the proportion of those testing positive in England is decreasing over time, it is likely that the incidence rate is also decreasing. However, because of the low number of new positive cases, we cannot currently measure a reduction.’ 

Different data from blood antibody tests, published yesterday by Public Health England, suggested that around 8.5 per cent of the country has had the virus already – some 4.76million people.

In a separate report published today the ONS confirmed that more than a quarter of the 46,380 ‘excess’ deaths that happened between March 7 and May 1 were not directly linked to Covid-19.

That data showed that the number of people dying in care homes of any cause rose by a staggering 60 per cent in March and April, while it rose 43 per cent in private homes. Hospitals, meanwhile, saw 21 per cent fewer deaths than usual. 

As well as a lack of testing, possible explanations for more people dying without even catching the virus were down to them avoiding medical care out of fear, that increased stress caused by the pandemic was killing people, and that hospitals had less capacity to help people.   

As part of a nationwide swab testing scheme to find out what proportion of people would currently test positive for the disease, 19,723 people were tested between May 17 and May 30.

Those people came from 9,094 households. A total of 21 of them, from 15 different households, tested positive during that time – 0.1 per cent.

The test data covers a two-week period meaning last week’s and this week’s share one of the same weeks, but the ONS’s estimate based on its data has dropped significantly. 

Data from the Office for National Statistics shows a downward trend in the number of people testing positive for the coronavirus over the course of May

The promising signal from the ONS ties in with testing data from the Department of Health which shows officials are finding it harder to track down positive cases.

Numbers of people getting diagnosed with Covid-19 through the official testing programme has fallen significantly this week despite more tests being carried out.

In the seven days up to yesterday, June 4, 13,335 people tested positive across the UK, compared to 18,219 in the seven days before that – a 36 per cent drop. 

Professor Keith Neal, an epidemiologist at the University of Nottingham, said: ‘The rate of infection continues to decline and is half what it was two weeks ago. Changes over a longer period are now statistically significant. 

‘This is highly compatible with the fall in diagnosed cases. The contact tracing service has more than enough staff to cope with the current level of infection. 

‘The main problem is people not getting tested for COVID-19 when they have symptoms.’

He added: ‘The main limitation of the study is the small numbers testing positive gives wide confidence intervals. 

‘No study is perfect but by following the same group of people it is a very powerful tool to identify the trend.’

A separate report published today by the ONS aimed to try and explain why there have been so many ‘excess’ deaths during the coronavirus crisis in England and Wales.

It calculated that, between March 7 and May 1, 46,380 more people died than average. Some 12,900 of them (27.8 per cent) were not direct victims of Covid-19.

That period, when NHS hospitals were urged to turf out as many patients as they could who didn’t need urgent treatment, saw a 21 per cent drop in hospital deaths, the report said. 

But the number of people dying in care homes soared by a massive 60 per cent, and in private homes it rose by 43 per cent. 

The report said the largest increase in deaths was seen in people with dementia and Alzheimer’s disease.  

Nick Stripe, the head of health analysis at the ONS, said in a tweet: ‘Dementia increases are so sharp it’s implausible that they are unrelated to Covid-19.

‘They generally affect the very old, they would tend to impact women to a greater extent than men simply due to pop[ulation] structure. Especially once care home epidemics took hold with [limited] testing.’  

The ONS said that, although many of the deaths among elderly people were not attributed to Covid-19, large numbers of undiagnosed cases of the disease were a ‘likely explanation’. 

Dementia and Alzheimer’s disease and other symptoms linked to old age accounted for two thirds of the total number of non-Covid-19 excess deaths in England and Wales from March 7 to May 1, the ONS said. 

There were 5,404 more deaths than expected among dementia and Alzheimer’s disease patients – a rise of 52 per cent compared to average. 

And 1,567 excess deaths occurred due to ‘symptoms signs and ill-defined conditions’ – a 77.8% rise from the five-year average.  

Undiagnosed Covid-19 could ‘help explain the rise’ in the deaths of frail elderly people with underlying conditions, particularly women and those in care homes, the ONS added. 

It said: ‘The absence of large rises in deaths due to this cause that mention conditions that could exhibit similar symptoms to Covid-19 suggests that if Covid-19 is involved in the increase in deaths due to dementia and Alzheimer disease, the usual symptoms of Covid-19 were not apparent. 

‘This could fit with recent clinical observations, where atypical hypoxia [low blood oxygen] has been observed in some Covid-19 patients. 

‘In someone with advanced dementia and Alzheimer disease, the symptoms of Covid-19 might be difficult to distinguish from their underlying illness, especially with the possibility of communication difficulties.

‘Care home residents have experienced changes to their usual routine as a result of measures to tackle the coronavirus pandemic. Adverse effects of such changes cannot be discounted as another possible explanation of the increase in the number of deaths in care homes.’ 

Friday’s release is the first detailed analysis from the ONS looking at the increased number of deaths during the pandemic where coronavirus was not mentioned on the death certificate. 

The highest number of excess non-Covid-19 deaths have taken place in care homes, with a weekly maximum of 2,975 of these deaths being registered in the seven days to April 17. 

Non-Covid-19 deaths in private homes saw a separate peak in the week ending April 24, when 1,760 were registered. 

The ONS said that if patients have been discharged from hospital sooner than they may have been typically, because of pressure on the NHS’s resources, this ‘could have resulted in some deaths occurring in care homes or private homes that would have otherwise occurred in hospital’.  

It added that the reported lower rates of testing in all settings outside hospitals ‘could lead to some deaths in other locations involving Covid-19 not having Covid-19 listed on the death certificate as a contributory factor, leading to apparently higher non-Covid-19 excess deaths’. 

Up to 5.6million people in England – 10% of the country – may have already had the coronavirus, government antibody sampling scheme reveals 

Up to 5.6million people in England could have already had the coronavirus, according to results of a government-run surveillance scheme. 

Blood samples taken from almost 8,000 people suggest up to 10 per cent of the country have antibodies specific to Covid-19, showing they have had the disease in the past. 

Public Health England’s best estimate is that 8.5 per cent of people in England have already had the coronavirus – 4.76million people. But this, it admitted, could be as high as 10 per cent (5.6m) or as low as 6.9 per cent (3.864m).

Regional variations show that the rate of infection has been considerably higher in London, with 15.6 per cent of the city’s population already affected. And it has been lowest in the South West, where only 2.6 per cent of people are thought to have had the virus.

The national prevalence of antibodies suggests that, with around 43,000 deaths from a population of 56million people, the true death rate of Covid-19 is 0.9 per cent – nine times deadlier than the flu. 

This suggests it kills one in every 111 people who catch the disease will die with it. The death rate was again lower in London, where it appeared to be 0.57 per cent.

PHE’s data was based on blood tests taken from 7,694 people across England in May, of which around 654 tested positive. It chimes with other estimates which suggest similar numbers. 

The Office for National Statistics (ONS) put the national level of past infection at 6.78 per cent – around 4.5million people in the UK – while Health Secretary Matt Hancock had previously announced early PHE results suggesting it was only five per cent nationwide.

Data from Public Health England showed that London has the largest proportion of its population already infected with the coronavirus, while the fewest people were infected in the South West of England

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The death rate calculations are based on a total 43,353 deaths in England, which is composed of the 42,210 recorded by May 22 by the Office for National Statistics, plus a further 1,143 announced by NHS England since then.

Government data records mean non-hospital deaths specifically for England cannot yet be counted between May 22 and June 4.

And the estimate for London’s death rate follows the same formula – the ONS announced 8,034 by May 22 and 78 have died in hospitals since then: a total 8,112. 

Scientists say that the reason for a lower death rate in London is that the city has a younger average age than other regions.

Covid-19 is known to be worse for elderly people, who are more likely to die if they catch the virus. It has killed one in every 57 over-90s in the country already.

Professor Keith Neal, an epidemiologist at the University of Nottingham, said: ‘I would consider the average of Londoners to be younger than outside.

‘If people in London were seven years younger then there would be a 50 per cent lower death rate just from this measure alone. Also land is expensive in London so probably fewer care homes than outside per head of population.’ 

London’s rate may also be lower because it has had far more infections, meaning more will have been among healthier people in the community. In areas with fewer coronavirus cases, there is a chance a greater proportion of the cases were caught in hospitals or care homes by people who were more likely to die – this would artificially increase the death rate.

Antibody testing is a method of sampling people’s blood to look for antibodies, which are made by the body so it can remember how to fight off certain diseases.

Only someone who has already had Covid-19 will have antibodies in the blood.

By running blood samples through a machine which contains a part of the virus, scientists can monitor whether the blood reacts in a way that shows it knows how to fight the virus – this indicates they have had the illness in the past and recovered.

PHE’s data gives regional breakdowns of the levels of antibodies it has found in blood samples so far.

The numbers are still based on relatively small samples so must be treated with caution.

These were the approximate regional proportions of people who have had the virus already:

• England 8.5 per cent
• London: 15.6 per cent
• North West: 10 per cent
• East of England: 8 per cent
• North East: 6.1 per cent
• Midlands: 5 per cent
• South East: 4 per cent
• South West: 2.6 per cent  

Data from the antibody tests should be taken with a pinch of salt because the tests can produce large margins of error, even if they are highly specific, and studies have suggested that some people produce barely-detectable levels of antibodies.

PHE’s figures show that men are more likely to have had the virus than women – 9.4 per cent of men tested positive for antibodies compared with 7.6 per cent of women.

And they were also more likely to be found in younger people. 

People aged between 17 and 29 were most likely to have had the disease anywhere in England, with an estimated infection rate of 10.2 per cent.

The lowest rate of past infection was in the oldest age group included in the data – the 60 to 69-year-olds, of whom 6.3 per cent had antibodies.

Prevalence became gradually higher as the age groups got younger, with a rate of 7.8 per cent among people in their 50s, 7.9 per cent in people in their 40 and 9.3 per cent in people in their 30s. 

Officials said that the effect of lockdown meant the antibody data did not appear to have changed much. Only massively bigger sample sizes might changes this.

The report said: ‘Adjusted prevalence estimates vary across the country and over time. 

‘Given that antibody response takes at least two weeks to become detectable, those displaying a positive result in week 18 [April 27 to May 3] are likely to have become infected before mid-April. 

‘The plateauing observed between weeks 18-21 demonstrates the impact of lock down measures on new infections.’

Today’s report comes after the Office for National Statistics estimated last week that around seven per cent of the country had had the virus already.

That data, which had not been published before, was based on 885 blood tests to look for signs of coronavirus-specific antibodies in members of the public. 

The tests were analysed by researchers at the University of Oxford and the University of Manchester from people who have provided blood samples since April 26.

Their finding that 6.78 per cent of the sample had the antibodies suggest the same rate of infection has been experienced across England, at least. It is reasonable to scale that to the entire of the UK, suggesting around 4.5million people have been infected.

On how this could affect the death rate of the virus in Britain, Cambridge University statistician Professor David Spiegelhalter said: ‘As a back-of-envelope calculation, the latest ONS survey suggests around 6.8 per cent of 56million people in England have been infected, which is around four million, and there’s been around 40,000 deaths in England linked to COVID. 

‘So this suggests that infection has carried around a 1 per cent average mortality rate. Which is impressively close to the much-disputed estimate of 0.9 per cent made by the Imperial College team back in March.’