COVID-19 Wales situational report: 27 May 2021

Key points to note

Wales is at Alert Level 2.

COVID-19 cases are relatively low across most of Wales. The percentage of people testing positive for COVID-19 remains relatively low. Source: PHW

Overall transmission of COVID-19 is slightly increasing but relatively low. The consensus estimate of the reproduction number for Wales is between 0.8 and 1.0. Source: SPI-M/SAGE, 18 May 2021.

COVID-19 pressure on the NHS has generally stabilised and is now similar to the lowest levels since reporting began. Source: NHS Wales Operational data

A few more cases of the variant VOC-21APR-02 (B.1.617.2, first identified in India) have been identified in Wales, as at 27 May, bringing the total to 58 confirmed cases. Source: PHW  This variant is assessed as having an increased growth rate compared to the dominant variant B.1.1.7, which may lead to an eventual replacement of the dominant variant if allowed to spread.  There have been signs of exponential growth of this variant in some parts of the UK where it has been seeded, which includes both imported and domestically-acquired cases. There are insufficient data currently to assess the potential for immune escape, although there is early indication that there may be some loss of vaccine protection.

On vaccination, as at 26 May 2021, a total of 3.13 million doses of COVID-19 vaccine have been given in Wales. Of the 3.13 million doses given nationally, 2.12 million were first doses and 1.06 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 or remain stable, following a period of high transmission in December and January. 

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

1. Latest COVID Infection Survey data is taken from the 16 May 2021 to 22 May 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 14 May 2021 (rather than 22 May 2021) for the current value. Data to 7 May 2021 is used for the change since previous week.​
    

At a Wales level, on 21 May, the 7-day rolling incidence of COVID-19 cases and the percentage of people testing positive for COVID-19 have decreased slightly since last week. 

The SAGE/ SPI-M consensus estimate of Reproduction number (Rt) is 0.8 - 1.0 (as at 18 May 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 0.92 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 for the Swansea Bay and Cwm Taf Morgannwg. 

7-day cumulative case incidence remains low across Wales, with only Monmouthshire above 20 cases per 100,000 population. At a Wales level, cases per 100,000 is currently at 8.9 per 100,000 population. This is a slight decrease compared to the previous report (9.6 per 100,000 population). 

Incidence varies by local authority and age. Monmouthshire is the only local authority with a case incidence rate above the threshold of 20 cases per 100,000. However, the case incidence for Monmouthshire has increased over the past week. 

The second 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. 

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 26 May 2021 unless otherwise specified

COVID-19 pressure on the NHS has generally stabilised and is now similar to the lowest levels since reporting began. As at 26 May 2021, there were 179 COVID-19 related patients (Suspected, Confirmed and Recovering) occupying a hospital bed. This compares to 171 (8 more occupied beds) on 19 May 2021. Confirmed patients accounted for 8 of the total occupied beds, and are at similar levels to early September 2020.  

There are 3 patients with Suspected or Confirmed COVID-19 in critical care beds in Wales. This is 161 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 154, two more 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 20 May 2021, 6 (0.6%) adult care homes in Wales notified CIW of one or more confirmed cases of COVID-19, in staff or residents. This is 3 fewer notifications compared to the last 7 days up to 13 May 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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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 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 SBAR covering the week of 17 May to 23 May reported no new or ongoing clusters in childcare settings.

Schools

At the time of writing for the National SBAR to 23 May,  5 new clusters and 3 ongoing clusters were reported to be associated with schools. There were 5 incidents attributed to a school setting and 4 attributed to household, social or extra-curricular activities. Cluster prevalence in schools remains low and stable. Where clusters are identified, response is rapid and intensive to ensure containment. 

One IMT confirmed an on-going cluster associated with a primary school involving 28 cases to date, which is currently being investigated. Cases have been found in all school years tested and the remainder of the school is now being offered testing and the school is to remain closed for another week. There have been cases in staff and pupils. The cases are Kent variant. There is now a risk of spread into the local community. A further IMT reported one primary school associated with likely in-school transmission.  Initial case was household transmission and 2 further cases detected through testing of contacts on day 2 and 8. Source: National SBAR. 

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.

Weekly COVID-19 incidence per 100,000 population for school age children and young adults in Wales (data as at 1pm 26/05/21)

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Schools with more than one COVID-19 case identified within the last 21 days, excluding 54 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 24 May for all Wales maintained schools

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School Attendance

An average of 90% of all pupils were present in school over the week of 17 May to 21 May. This information is provisional and will be revised on 9 June. Source: Stats Wales.

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Further Education (FE)

There are no new or ongoing clusters within FE settings in Wales, C&V reported that vaccination of HE and FE students has now begun in C&V region. Source: National Situation Background Assessment Recommendation (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 1 positive COVID-19 cases for all HEI's. Source: Stats Wales.

We now also capture data via the National SBAR from local IMTs. There was 1 new cluster reported in an HE Setting – 2 cases in University Halls of Residences, this was under active management. There were 3 ongoing clusters reported over 2 health board areas. This compares to 2 new clusters and 6 on going clusters reported over the previous week. 

Testing is in place across all local HE as well FE institutions in C&V, but uptake has declined over recent weeks and remains low. C&V also report HEIs are putting in place support for students arriving from Amber list countries, in line with government guidance, to ensure that they adhere to the strict self-isolation requirements; this is being done in liaison with the Arriving Traveller Team (All Wales Surge Team). Source: National SBAR.

There is currently voluntary lateral flow device (LFD) testing of childcare staff, school staff, FE and HEI staff; FE and HE students, and older secondary school aged pupils. Detailed information on LFD test outcomes is not yet available.

7 day rolling average of positive cases in Welsh universities 27 September to 23 May 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.

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 to 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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• Deaths per day - continue to see small numbers over the next four weeks. Source: Modelled medium term projections, SAGE, 11 May

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• Hospitalisations per day - continue to decrease to under 1 per day over the next four weeks. Source: Modelled medium term projections, SAGE, 18 May

Hospitalisations per day, Wales

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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. 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.

Traveller numbers have seen small increases week on week. Positive amber cases remain low. However, early indications are that weekend travel is starting to increase more rapidly. 

Green arrivals have started to show in the data, although numbers are relatively low. We expect volumes to increase going into the half term period. There have been no green list positive cases.  

• There has been an increase of 140 in the overall arrivals compared to last week. 
• The arrivals for Friday and Saturday 21st and 22nd May showed a significant increase this week. 846 for this weekend compared to Friday and Saturday 14th and 15th May of 508. 
• There have been no positive cases from Green list countries.
• Positive amber cases remain low.
• Overall arrivals are now rising significantly.

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Positive travellers by health board

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Source: Home Office, as at 25 May 2021

Please note: Due to the limitations associated with data capture and legislation, some minor discrepancies may be present in the data. We are looking to develop this with local health protection officers.

The most recent mobility data up to 19 May, illustrate mostly small increases in the last week, with a larger increase in retail and recreation. During this period residential mobility (i.e people spending time at home) decreased slightly from 7% to 6% above the baseline. Workplaces rose slightly from 20% to 21% below the baseline. Retail & recreation mobility increased from 20% to 13% below the baseline and supermarkets & pharmacy increased from 9% to 11% above the baseline. Public transport and parks mobility also increased relative to the baseline. Source: Google

Mobility data by location of trip

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Source: Google

Adherence

The data from IPSOS MORI is the same as last week, which reported 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

Results from the Coronavirus (Covid-19) Infection Survey, 16 to 22 May

Rates continue to be low across all four UK countries for the week ending 15 May. In the most recent week, the positivity rate remained low in Wales. In comparison, the positivity rate appears to have increased in Scotland and there are early signs of a possible increase in England and Northern Ireland, although uncertainty is high.

During the most recent period, it is estimated that an average of 800 people in Wales had COVID-19 (95% credible interval: 100 to 2,200), equating to around 1 in 3,850 people. This compares to around 1 in 1,120 people in England, around 1 in 630 people in Scotland, and around 1 in 820 people in Northern Ireland.

Positivity rates (%) across UK countries since 28 March 2021

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Source: Office for National Statistics COVID-19 Infection Survey

Key risks

Transmissions, incidence and prevalence

Overall transmission is generally decreasing and relatively low.

NHS Capacity

COVID-19 pressure on the NHS continues to improve. Some fluctuations are likely to occur, due to low numbers.

Mortality

Remains at a generally low level.

Variants

More cases of VOC21APR-02 (Indian variant) have been detected in Wales, although numbers remain low. There is strong evidence of increased transmissibility and local intervention will likely be required to prevent uncontrolled growth and wider community transmission.  

Immunity and vaccines

3.13 million doses of COVID-19 vaccine have been given in Wales. Of the 3.13 million doses given nationally, 2.12 million were first doses and 1.06 million were second doses.

International

Traveller numbers have seen small increases week on week. Positive amber cases remain low. There have been no green list positive cases.

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