COVID-19 Wales situational report: 1 July 2021

Key points to note 

Wales is at Alert Level 1.

Overall transmission of COVID-19 is rapidly increasing in many areas across Wales. The SAGE consensus estimate of the reproduction number for Wales is between 1.0 and 1.4, while PHW's estimate is between 1.4 and 1.6. Source: SAGE, PHW, 21 June 2021. Note that SAGE's estimate is typically lagged by 2-3 weeks while PHW, which uses a different methodology, is lagged by around 1 week. The case incidence and percentage of people testing positive for COVID-19 has also increased. Slide 3, Source: PHW

Overall transmission of COVID-19 is rapidly increasing in many areas across Wales. The SAGE consensus estimate of the reproduction number for Wales is between 1.1 and 1.5, while PHW's estimate is between 1.8 and 1.9. Source: SAGE / PHW (30/6/21). Note that SAGE's estimate is typically lagged by 2-3 weeks while PHW, which uses a different methodology, is lagged by around 1 week. The case incidence and percentage of people testing positive for COVID-19 has also increased. Slide 3, Source: PHW

COVID-19 pressure on the NHS remains stable at the lowest levels since reporting began, although if cases continue to rapidly rise hospital admissions are likely to follow. Slide 4, Source: NHS Wales Operational data

As at 29 June, Wales has 1,749 confirmed cases of the more transmissible Delta variant (an increase of 961 from the previous week) making Delta the dominant variant of COVID-19 in Wales. Of the 1,749 cases detected to date, 54% of cases were in unvaccinated individuals, 32% received 1 dose and 14% had received 2 doses. Note that this data may include vaccinations that have not yet been given the 14-21 days necessary to provide maximum protection against Covid-19. Of the 1,749 cases 28, or 1.6%, were hospitalised. Source: PHW

On vaccination, as at 29 June 2021, a total of 3.92 million (+0.10 million) doses of COVID-19 vaccine have been given in Wales, of which 2.25 (+0.01) million were first doses and 1.66 million (+0.09) were second doses. Based on SAGE's estimate of an immunity coverage requirement of at least 80% for the delta variant, current coverage will not offer population level protection in the absence of other protective behaviours. Source: PHW, SPI-M-O

Key indicators

Several key indicators are beginning to show an increase, following a period of low transmission in April and May. 

Please note that the arrows represent a change in comparison for the last week.

1. Latest Covid Infection Survey data is taken from the 20 June 2021 to 26 June 2021.

2. Seven day rolling average to the current date of confirmed COVID-19 patients – does not include COVID-19 suspected or recovering.

3. Latest ONS deaths data is to 18 June 2021 (rather than 26 June 2021) for the current value. Data to 11 June 2021 is used for the change since previous week.

At a Wales level, on 25 June, 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) is between 1.1 and 1.5 (as at 30 June 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 1.8 and 1.9 for Wales. PHW estimate a national doubling time of 6.5 days. At a health board level, all areas are close to or above an R of 2, with the exception of Hywel Dda UHB and Powys THB. Doubling times are in a range of 4.3 to 8.5 days. Source: PHW 

7-day cumulative case incidence in Wales has more than doubled in the last week. Case incidence has risen to 64.8 per 100,000 population in Wales compared with 32.2 per 100,000 population last week. 

Case incidence is increasing in all local authorities. 10 of 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 Flintshire and Wrexham at 155.7 and 131.7 per 100,000 population, respectively. 

Over the past week, case incidence has risen sharply for those aged 20 – 29. Case incidence is highest for those aged 10–19 and 20-29. 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. 

Note these are now doubling times, not halving times

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 30 June 2021 unless otherwise specified

COVID-19 pressure on the NHS has generally stabilised and is now at the lowest levels since reporting began. As at 30 June 2021, there were 86 COVID-19 related patients (Suspected, Confirmed and Recovering) occupying a hospital bed. This compares to 114 (28 fewer occupied beds) on 23 June 2021. Confirmed patients accounted for 26 of the total occupied beds, and are at similar levels to early May 2021.

There are 2 patients with Suspected or Confirmed COVID-19 in critical care beds in Wales. This is 162 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 147, 5 fewer than the historic maximum critical care capacity of approximately 152.

The situation with care homes remains stable with a relatively low number of care home incidents reported across Wales. 

In the 7 days up to 16 June 2021, 12 (1.1%) adult care homes in Wales notified CIW of one or more confirmed cases of COVID-19, in staff or residents. This is 1 more notification compared to the last 7 days up to 9 June 2021. The number of notifications is similar to the lowest levels since the beginning of the reporting period 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 21 June to 27 June reported that the incidence of clusters in child care settings remains low. 

3 new clusters were reported to be associated with childcare settings over 3 health boards, this compares to 2 new clusters reported last week, across 2 health board areas.

Schools

35 new clusters were associated with schools last week. This is a sharp increase on the 7* new clusters reported the week before. The incidence of clusters reflects local community transmission and IMTs reported that case incidence is driven by increased social contact outside the school setting. Only a small proportion of transmission is associated with the school setting. Source: National SBAR.

Weekly COVID-19 incidence per 100,000 population for school age children and young adults in Wales (data as at 1pm 30 June 2021)

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Schools with more than one COVID-19 case identified within the last 21 days, excluding 151 schools with 1 COVID-19 case 

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Epidemiological curve of cases in all staff and pupils linked to a school between 01 September 2020 to 28 June for all Wales maintained schools

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School Attendance

An average of 87% of all pupils were present in school over the week of 21 June to 25 June. This information is provisional and will be revised on 7 July. There is no data for the week of 31 May to 4 June due to the school holidays. Source: Stats Wales

Pupils present by day in Wales, from 07 September 2020

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Further Education (FE)

The latest National SBAR reported 11 new clusters associated with FE settings for the period 21 June to 27 June compared to 1 reported the previous week. All 11 were reported by one LA and reflect the current high incidence rates in the area. Source: National SBAR.

Higher Education Institutions (HEIs)

HEIs report cases notified to them by students and staff. From 1 February 2021 most HEIs have changed the way in which they report data, with positive cases referring only to students or staff attending campus or returning to the local area for study (with the exception of University of Wales Trinity St David's who are unable to split cases on this basis). 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

We now also capture data via the National SBAR from local IMTs. There were no new clusters and 2 ongoing clusters associated with HE settings last week compared to 4 new clusters and 6 ongoing clusters last week. Source National SBAR

7 day rolling average of positive cases in Welsh universities 27 September to 27 June 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 the overall arrivals (approximately 8.4%). The increase in overall arrivals is from amber list arrivals. Positives, remain steady at 0.2% with both red and green list arrivals also remaining low. 

Spain and Portugal both feature in the top 3 countries for arrivals. 
Updated changes to the Red, Amber and Green list for international travel has been published.

•  3,836 total for this week (3,540 last week)
  • Amber: 3,450 (3,170 last week) 
  • Red: 182 (140 last week)
  • Green: 168 (191 last week)
• There were 7 positive arrivals (0.2%) 
• In the same period 478 (483 last week) of 3,836 travellers marked themselves as exempt (12.5%)

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Source: Home Office, as at 24 June 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.

Mobility data up to 25 June shows small reductions from the previous week. In some cases mobility remains above the baseline - but lower than in half term week. 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 18 – 22 June for Wales shows that those who reported making essential trips only was the lowest since the survey began in March 2020, whilst those ensuring they were more than 2m apart from others increased from the last survey wave 2 weeks prior. It should be noted that this is self-reported adherence and will be affected by individuals understanding of the rules and the circumstances that apply to them. 

The latest results from the Public Engagement Survey on Health and Wellbeing during Coronavirus Measures for the period 7 to 13 June show that 88% of people say they understand the current restrictions in Wales ‘very well’ or ‘fairly well’ and 80% report fully or majority compliance with coronavirus restrictions. Source: Survey of Public Views on COVID-19, 4 to 8 June 2021. Source: Survey of Public Views on COVID-19, 4 to 8 June 2021.

Results from the Coronavirus (Covid-19) Infection Survey, 20 June to 26 June

The highest estimated percentage of the population with COVID-19 was Scotland (0.68%), whilst Northern Ireland appeared to have the lowest (0.15%). 

In England, Wales and Scotland, the percentage of people testing positive has continued to increase. The trend remains uncertain in Northern Ireland.

It is estimated that an average of 6,800 people in Wales had COVID-19 (95% credible interval: 3,700 to 11,000), equating to around 1 in 450 people (1 in 280 to 1 in 820). This compares to around 1 in 260 people in England, around 1 in 220 people in Scotland, and around 1 in 670 people in Northern Ireland.

Source: Office for National Statistics COVID-19 Infection Survey.

Positivity rates (%) across UK countries up to 30 June 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 26 June 2021, 86% of people aged 16 and over had received at least one COVID-19 vaccine dose in Wales. 24% of people aged 16 and over had exactly one vaccine dose and 62% are fully vaccinated. 

Between 7 and 10 June 2021, the ONS COVID infection survey estimated that 88.7% of the community population aged 16 and over in Wales tested positive for COVID-19 antibodies.

As at 26 June 2021, it was estimated that 78% of people aged 16 and over in Wales had some immunity against COVID-19 infection. The lower and higher estimates of immunity are 60% and 87% of people aged 16 and over in Wales. If no vaccines had been administered, it is estimated that 33% of people aged 16 and over would be immune. These estimates do not account for waning immunity and assume all natural infections lead to immunity.

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 on 18 June 2021.). Note that the immunity estimate of 75% 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 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, on top of the impact of vaccines. 
• We currently use the 2020 ONS mid-year estimates whereas the ONS antibody estimates use the 2019 ONS mid year 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 100 per 100,000 between 11 July and 17 July is above 80% for 6 local authorities. The figure illustrates the probability (between 0 and 100%) of incidence being greater than 100 per 100,000. Source: Imperial College London.

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

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4 to 10 July and 11 to 17 July

Deaths per day

Projected to slightly increase over the next six weeks, but remain at a low level. Source: Modelled medium term projections, SAGE/SPI-M, 29 June

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Hospitalisations per day

Projected to increase over the next four weeks. Source: Modelled medium term projections, SAGE/SPI-M, 29 June

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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

COVID-19 pressure on the NHS has generally stabilised and is now at the lowest levels since reporting began.

Mortality

Low numbers of deaths in the most recent week.

Variants

Wales has 1,749 confirmed cases of the more transmissible Delta variant (an increase of 961 from the previous week) making Delta the dominant variant of COVID-19 in Wales.

Immunity and vaccines

3.92 million (+0.10 million) doses of COVID-19 vaccine have been given in Wales, of which 2.25 (+0.01) million were first doses and 1.66 million (+0.09) were second doses. 

International

There is a slight 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