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COVID-19 situation report summary

Key points to note

Wales is at Alert Level 3.

Overall transmission of COVID-19 is generally decreasing and relatively low. The consensus estimate of the reproduction number for Wales is between 0.8 and 1.0. Source: SPI-M/SAGE, 27 April 2021.

COVID-19 cases are generally decreasing across most of Wales. The percentage of people testing positive for COVID-19 has also decreased slightly. Source: PHW

Overall COVID-19 hospital admissions and COVID-19 related deaths remain at a relatively low level. These numbers are now comparable to those observed in mid- September 2020.  Source: NHS Wales Operational data

VOC-20DEC-01 (first identified in Kent) remains the dominant variant in Wales. SARS-CoV-2 is evolving antigenically. Some variants are less well neutralized by antibodies raised to current vaccines, and the vaccine efficacy against these variants is lower than for the existing predominant virus. There are three clades in the lineage B.1.617. The B.1.617.1 variant which is widespread in India and other parts of South Asia, has been designated a Variant under Investigation. There are currently 119 cases in the UK, all but 3 of which have been linked to travel. Source: SAGE

As of 5 May, in the previous seven days genomic sequencing of COVID-19 tests has identified 12 new confirmed cases of VUI-21APR-01 and 5 confirmed cases of VUI-21APR-02. Source: PHW

On vaccination, as of 6 May 2021, a total of 2.68 million doses of COVID-19 vaccine have been given in Wales and recorded in the COVID-19 Welsh Immunisation System. Of the 2.68 million doses given nationally, 1.88 million were first doses and 0.80 million were second doses. Current coverage will not offer population level protection in the absence of other protective behaviours. Source: PHW
 

Key indicators 

Most key indicators continue to decrease, following a period of high transmission in December and January. 

  Current value (03/05/21) Change since previous week
(24/04/21 – 01/05/21 unless stated otherwise)
Change since reported figures for previous Alert Level review
(17/04/21 – 01/05/21)
    Percentage change Value change Percentage change Value change
Confirmed case rate (rolling 7 day sum per 100k) 10 -18% (-2) -33% (-5)
Confirmed case rate for over 60s (rolling 7 day sum per 100k) 8 -24% (-3) -30% (-4)
Test positivity (7 day RA) 1.1% -22%   (-0.3 percentage points) -35% (-0.6 percentage points)
Population estimated to have COVID-19 (prevalence)1 0.05% -17%     (-0.01 percentage points) -55% (-0.06 percentage points)
Reproduction number (Rt)2 0.8 to 1.0 5% (+0.04) -1% (-0.01)
NHS capacity – Admissions3 5 -30% (-2) -28% (-2)
ONS deaths (7 day sum)4 9 -25% (-3) -31% (-4)
PHW deaths (7 day sum) 2 -67% (-4) -75% (-6)
  1. Latest Covid Infection Survey data is taken from the 26 April 2021 to 2 April 2021.
  2. Latest Rt value is as at 27 April 2021. Changes shown in table are based on the central estimate of Rt.
  3. Seven day rolling average to the current date of confirmed COVID-19 patients – does not include COVID-19 suspected or recovering.
  4. Latest ONS deaths data is to 23 April 2021 (rather than 1 May 2021) for the current value. Data to 16 April 2021 is used for the change since previous week and data to 9 April 2021 is used for the change since last Alert Level review.

What is the current status of the epidemic?

Cases per 100,000 population (7 day period ending 01 May 2021)
Local Authority Number % of All Wales Total Case Incidence per 100,000 Incidence threshold reached Change from previous week
Newport 40 12.9% 25.9 25 to < 50 -15%↓
Wrexham 24 7.8% 17.7 20 to < 25 -17% ↓
Cardiff 47 15.2% 12.8 Under 15 7%↑
Caerphilly 23 7.4% 12.7 Under 15 53%↑
Torfaen 11 3.6% 11.7 Under 15 57%↑
Swansea 28 9.1% 11.3 Under 15 -47%↓
Pembrokeshire 14 4.5% 11.1 Under 15 100%↑
Gwynedd 12 3.9% 9.6 Under 15 -48%↓
Rhondda Cynon Taf 22 7.1% 9.1 Under 15 47%↑
Neath Port Talbot 13 4.2% 9.1 Under 15 -46%↓
Flintshire 14 4.5% 9.0 Under 15 -12%↓
Merthyr Tydfil 5 1.6% 8.3 Under 15 67%↑
Carmarthenshire 13 4.2% 6.9 Under 15 -35%↓
Vale of Glamorgan 9 2.9% 6.7 Under 15 -18%↓
Isle of Anglesey 4 1.3% 5.7 Under 15 -20%↓
Bridgend 8 2.6% 5.4 Under 15 -50%↓
Monmouthshire 5 1.6% 5.3 Under 15 0%→
Conwy 5 1.6% 4.3 Under 15 -29%↓
Powys 5 1.6% 3.8 Under 15 -64%↓
Blaenau Gwent 2 0.6% 2.9 Under 15 -67%↓
Ceredigion 2 0.6% 2.8 Under 15 -50%↓
Denbighshire 0 0.0% 0.0 Under 15 -100%↓
Unknown 3 1.0% -   -25% ↓
Total 309 100.0% 9.8 Under 15 -18% ↓

At a Wales level, on 1 May, the 7-day rolling incidence of COVID-19 cases and the percentage of people testing positive for COVID-19 have decreased since last week. 

The SAGE/ SPI-M consensus estimate of Reproduction number (Rt) is 0.8 - 1.0 (as at 27 April 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 0.84 for Wales. At local health board level, there is considerable variation in the reproduction number (cases only) estimate. The central estimate of the reproduction number (cases only) is at or above 1.0 for the Cwm Taf, Aneurin Bevan and Hywel Dda Health Boards.

7-day cumulative case incidence is decreasing across most of Wales.  At a Wales level, cases per 100,000 is currently at 9.8 per 100,000 population. This is a slight decrease compared to the previous report (11.9 per 100,000 population). 

Incidence varies by local authority and age. Newport is the only local authority with a case incidence rate above the threshold of 25 cases per 100,000. However, the case incidence for Newport has decreased over the past week. 

The table below also provides estimates of doubling and halving times based on COVID-19 positive test data. In this table, halving times are positive, whilst doubling 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. 

Reproduction number (based on positive tests only) PHW data by Local Health Board as at 05 May 2021
Local Health Board Rt (cases) Halving time (days) 
All Wales 0.84 (0.8 to 0.9) 44 (13 to -35)
Swansea Bay UHB 0.6 (0.5 to 0.8) 9 (4 to -54)
CTM UHB 1.1 (0.8 to 1.4) 36 (5 to –8) DOUBLING
Aneurin Bevan UHB 1.1 (1.0 to 1.4) 66  (9 to –13) DOUBLING
Cardiff & Vale UHB 1.0 (0.8 to 1.2) 222 (10 to -11)
Hywel Dda UHB* 0.9 (0.6 to 1.2) 215 (8 to –9) 
Powys THB* 0.7 (0.4 to 1.0) 8 (5 to 39) 
Betsi Cadwaladr UHB 0.7 (0.6 to 0.9) 66 (9 to –12)
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Cases per 100k 7 day rolling sum (PHW data)
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Cases per 100k by age

What is the situation with the NHS and social care?

COVID-19 pressure on the NHS continues to improve and is back to the levels seen in mid-September last year. As at 5 May 2021 there were 187 COVID-19 related patients (Suspected, Confirmed and Recovering) occupying a hospital bed. Confirmed cases constitute 32 of the total, the lowest number since 2 May 2021 when there were 31.

COVID-19 patients in critical care beds is currently at three, this is 161 lower than the maximum COVID-19 position of approximately 164. Confirmed cases constitute one of the total, the lowest number since 3 May 2020 when there were also one. The total number of patients in critical care for COVID-19 and non-COVID-19 stands at 185, 33 more than the historic maximum critical care capacity of approximately 152.

Care homes data is reported to Incident Management Teams on a weekly basis. Those noted as red status have reported an outbreak or incident in the last five days. 

Up to 22 April 2021, 7 (0.7%) adult care homes in Wales notified CIW of one or more confirmed cases of COVID-19, in staff or residents, in the past 7 days. This is a decrease compared to 12 (1.1%) in the 7 days up to 15 April 2021. The number of notifications is now at the lowest since the guidance change on 17 December 2020.

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Confirmed hospital occupancy (7 day average)
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Overall invasive ventilated bed occupancy (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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Hospital bed occupancy for suspected and confirmed COVID-19 patients (7 day rolling average)

 

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

 

What is the situation with education, children and young adults?

Childcare settings

The latest national SBAR covering the week of 26 April to 02 May reported no new clusters in childcare settings with 2 ongoing clusters in 1 health board. 

Schools

At the time of writing for the national SBAR to 02 May, 2 new clusters and 15 ongoing clusters were reported to be associated with schools. In the seven days to 02 May, 77 new confirmed cases associated with schools were reported by PHW to Welsh Government: 65* among pupils and 12* among staff.  Source: National SBAR *Please note these totals only include data from Swansea Bay and Hywel DdaConfirmed case incidence remained stable in those aged under 20 years old in the most recent week ending 02 May. 

IMTs continue to report that infection observed in pupils and staff are commonly the result of community and social interactions outside the school setting, with the acknowledgement that the incidence associated with schools reflects wider community transmission.  

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Weekly COVID-19 incidence per 100,000 population for school age children in Wales (data as at 1pm 7/4/21)
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Schools with more than one COVID-19 case identified within the last 21 days excluding 72 schools with one 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 4 May 2021 for all Wales maintained schools

 

School Attendance

An average of 91% of all pupils were present in school over the week of 26 April to 30 April, the second highest rate of this academic year to date. This information is provisional and will be revised on 10 May. 

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Pupils present by day in Wales, from 7 September 2020

HEIs in Wales have, since January, prioritised a return to in person blended learning for those students with practical and qualification requirement where in person learning is necessary. University facilities, such as libraries, laboratories and study spaces, have been open for those who need access. 

From 12 April HEIs have fully opened for blended learning with all students invited to access online and in person learning. 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 4 positive COVID-19 cases for all HEI's.

There is currently Voluntary LFD testing of childcare staff, school staff, Further Education (FE) and Higher Education (HE) staff; FE and HE students, and older secondary school aged pupils. Detailed information on LFD test outcomes is not yet available.

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7 day rolling average of positive cases in Welsh universities 27 September 2020 to 30 April 2021

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.

What does the situation look like going forward?

Based on the current rates observed with current restrictions:

  • Cases - the probability of incidence greater that 100 per 100,000 remains low for all local authorities. The figure illustrates the probability (between 0 – 100%) of incidence being greater than 100 per 100,000. Source: Imperial College London
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Probability of greater than 100 per 100,000 cases by local authority
  • Deaths per day - continue to see small numbers over the next four weeks. Source: Modelled medium term projections, SAGE, 4 May
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Number of deaths per day, Wales

 

  • Hospitalisations per day - continue to decrease to 2 per day over the next four weeks. Source: Modelled medium term projections, SAGE, 4 May
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Hospitalisations per day, Wales

 

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. They are not forecasts or predictions.

Projecting forwards is difficult when numbers fall to very low levels, therefore SPI-M-O have decided to pause producing medium term projections where this is the case. The small numbers can also introduce apparent inconsistency as regions are aggregated.

Mobility data, adherence and UK comparison

The most recent mobility data shows a slowed growth in mobility following the initial sharp increase seen after the easing of restrictions in several areas relating to travel and re-opening of non-essential retail on 12 April, with some categories showing little change. 

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Mobility data by location of trip

Source: Google

Adherence

New IPSOS MORI data for the period 23 – 27 April for Wales shows reductions in some categories since the previous survey wave 4 weeks ago, most notably a large reduction in those making essential trips only. Social-distancing and wearing of face coverings remains steady. Note this is self-reported adherence and will be affected by individuals understanding of the rules and guidance. Source: IPSOS MORI
 

UK comparison

The percentage of people testing positive appears to have decreased in Wales in the most recent two weeks, with the rate now similar to levels seen last summer.

For the week of 26 April to 2 May, it is estimated that an average of 1,500 people in Wales had COVID-19 (95% credible interval: 400 to 3,400), equating to around 1 in 2,070 people. This compares to around 1 in 1,180 people in England, around 1 in 760 people in Scotland, and around 1 in 750 people in Northern Ireland.

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Positivity rates (%) across UK countries since 6 March 2021

Source: Office for National Statistics COVID-19 Infection Survey

Key risks and sources

Key risks

Transmissions, incidence and prevalence

Overall transmission is generally decreasing and relatively low.

NHS Capacity

Overall COVID-19 hospital admissions continue to fall with numbers now comparable to those observed in September 2020.

Mortality

Remains at a generally low level.

Variants

VOC-20DEC-01 (the Kent variant) is the dominant variant in Wales.

Immunity and vaccines

2.68 million doses of COVID-19 vaccine were given in Wales. Of the 2.68 million doses given nationally, 1.88 million were first doses and 0.80 million were second doses.

 

Key sources for this update

Technical Advisory Cell brief

COVID infection survey results

Public Health Wales

Hospital occupancy

Higher Education

School attendance

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