Covid cases are rising again, but deaths and hospital admissions remain very low

Good evening Millers. This is an update on the local Covid situation.

You are used to The Mill sending you long reads, but this post is short and intentionally so. There’s a huge amount of coverage of the latest spike in Covid cases and the problems in the testing system, much of it seemingly quite alarming. We thought it would be useful to send you five graphs that lay out the situation in the North West according to the latest data from Public Health England, the NHS and the Office for National Statistics. The graphs cover cases, hospital bed occupancy, and deaths.

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It’s understandable that some people are a bit alarmed by the current Covid outbreak in Greater Manchester and other parts of the North West. Cases are rising and the testing system has clearly been struggling in the past few days, with many people unable to book a test near where they live.

Local officials have been using words like “carnage” and some of the media coverage is not helping to calm nerves. The lead story on the MEN’s website this evening reads: “These are the latest coronavirus infection rates for Greater Manchester as number of cases increases by 50 per cent in ONE DAY and Bolton reaches grim milestone.” (The milestone is reaching 200 new cases per 100,000 residents in a week, a very high level).

So, how concerned should we be? Clearly the most important component of a disease outbreak is how many people are seriously unwell, and how many are dying. This time last week Andy Burnham said there had been a “significant” rise in hospital admissions with Covid last week - although in truth the rise was very small, from 16 admissions in Greater Manchester to 35. At today’s press conference he didn’t release the updated number, but said the situation had “stabilised” and told the press: “There hasn't been any further increase on what we reported last week.”

Nationally, cases have been rising in recent weeks (albeit less rapidly than around here), but deaths related to Covid remain extremely low - there were 10 Covid deaths in England on Monday. So what is the situation in the North West? I think the following five graphs help us to see what is going on. They all use data covering the entire region, because that’s how most of the agencies release the numbers. It also gives us a slightly wider picture on what is going on in this neck of the woods.

Here goes.

Cases have been rising in Greater Manchester again, after rising in July/August and stalling last month. Other bits of the North West have seen the same trend, and if you plot positive cases in the region, the graph looks like this:

(Source: Public Health England)

That looks really alarming. It gives the impression the current situation is as bad as it was in April and May, when hospitals were full of Covid patients and the number of people dying was far exceeding the average from past years. But despite the high number of positive tests, the number of people dying right now is actually extremely low. Look at this graph of Covid deaths in the North West since March.

(Source: Public Health England)

The number of people dying with Covid (the definition is people who died within 28 days of testing positive) is around 4 per day across the North West at the moment. That compares to the peak of deaths in mid-April, when we had a week where the average daily death toll was 148. That’s 35 times higher than we have now. If you look at the death numbers cumulatively, the graph looks like this:

(Source: Public Health England)

Why are so few people dying at the moment despite the high case numbers? The dominant theory seems to be that it’s because the virus is spreading more among younger people, but we don’t really know. It’s possible we are picking up a lot more cases than we were before because of increased testing - see our post from September 2nd.

The overall number of deaths in the North West has actually dipped below the five-year average, meaning we are not seeing any ‘excess deaths’ - which we had a lot of in April and May. This chart shows this very clearly. The blue line is total deaths in the region, the dotted grey line shows average deaths in the past five years, and the red line shows Covid deaths. The data goes up to September 4th, the most recent week published by the Office for National Statistics.

(Source: Office for National Statistics)

We also have a very low number of people in hospital with Covid at the moment. According to NHS data, in mid-April there were 3065 beds occupied by patients who had Covid in the North West. On September 3rd it was 130, having risen a little bit since August. That’s the most recent published day, and it means the peak in April was 23 times higher.

(Source: NHS England)

None of this means we shouldn’t be worried about the increase in cases, and the mis-firing testing system. And clearly in the weeks ahead we could start to see hospital admissions and deaths shooting up. But right now, this is how the data looks, and we should take some comfort from that.

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