COVID-19 Wales situational report: 17 June 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 consensus estimate of the reproduction number for Wales is between 1.0 and 1.4. Source: SPI-M/SAGE, 9 June 2021. The case incidence and percentage of people testing positive for COVID-19 has increased. Slide 3, Source: PHW

COVID-19 pressure on the NHS remains stable and is now similar to 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 16 June, Wales has 488 confirmed cases (an increase of 184 cases)  making Delta the dominant variant of COVID-19 in Wales.  139/184 of the new cases were not vaccinated (75.5%), and 3/184 cases were admitted to hospital 1.6%. Over 50% of new cases (97 in total) were in the younger age groups - those up to 29 years of age.  Source: PHW  

While case numbers in Wales are currently relatively low compared to other nations of the UK, analysis by PHE and SAGE continues to show a substantially increased growth rate for Delta of 40-80%, compared to the previously dominant Alpha variant. Estimates from PHE show a reduced vaccine effectiveness for the Delta variant, as well an in increase in risk of hospitalisation.

On vaccination, as at 16 June 2021, a total of 3.68 million (+0.2) doses of COVID-19 vaccine have been given in Wales, of which 2.23 (+0.04) million were first doses and 1.45 million (+0.16) were second doses. Current coverage will not offer population level protection in the absence of other protective behaviours. Source: PHW

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 6 June 2021 to 12 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 4 June 2021 (rather than 12 June 2021) for the current value. Data to 28 May 2021 is used for the change since previous week.

At a Wales level, on 11 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. 

The SAGE/ SPI-M consensus estimate of Reproduction number (Rt) is 1.0 - 1.4 (as at 9 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 1.7 for Wales. At local health board level, there is considerable variation in the reproduction number (cases only) estimate, with the central estimate above 1 for all health boards, and above 2 for Cwm Taf Morgannwg and Betsi Cadwaladr. 

7-day cumulative case incidence has increased across Wales at 22.2 per 100,000 population. This is an increase of 98% compared to the previous report (11.2 per 100,000 population). 

Case incidence is increasing in 21 of 22 local authorities. 6 of the 22 local authorities have a case incidence above the 25 per 100,000 population threshold. Case incidence is above 50 per 100,000 population for Conwy and Denbighshire and incidence increased in both local authorities over the past week. No local authority have seen a decline.

Incidence varies by health board and age. Over the past week, case incidence has risen sharply for nearly all age groups. The highest incidence is for those aged 20 – 29, almost doubling from 24.8 to 49.2 per 100,000 population as at 11 June 2021.  

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. 

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 16 June 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 16 June 2021, there were 132 COVID-19 related patients (Suspected, Confirmed and Recovering) occupying a hospital bed. This compares to 127 (5 more occupied beds) on 9 June 2021. Confirmed patients accounted for 29 of the total occupied beds, and are at similar levels to early May 2021.   

There is 1 patient with Suspected or Confirmed COVID-19 in a critical care bed in Wales. This is 163 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 156, 4 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 2 June 2021, 4 (0.4%) 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 26 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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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 7 June to 13 June reported no new clusters associated with child care settings this week. There remains 1 on-going cluster previously reported. 

Schools

The National SBAR for the above period reported 1 new cluster and 1 ongoing cluster associated with schools. There was 1 incident attributed to a school setting and 1 attributed to household, social or extra-curricular activities. Clusters associated with schools remain low but it is expected that these will increase over the next couple of weeks. A number of Local Authorities (LAs) report single positive cases only. Some experiences are outlined below: 

• One LA reported that 1 school has two bubbles affected associated with non-school transmission of the Delta variant and approximately 40 tests have been undertaken in this setting. All negative. Three other schools in the area each have one year group isolating due to single cases. One of these is associated with the Delta cluster, but no clear links have yet been found to other cases. Over 180 tests in this school have been undertaken, all negative. 

• In another LA, a primary school cluster was associated with a case of the Delta variant imported from SE England. This has resulted in 5 further cases in staff and 1 child of a staff member.  No children were present in the school at the time and the school remains closed this week with all staff going into self-isolation. Source: National SBAR. 

Weekly COVID-19 incidence per 100,000 population for school age children and young adults in Wales (data as at 1pm 16 June 2021)

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Schools with more than one COVID-19 case identified within the last 21 days, excluding 93 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 14 June for all Wales maintained schools

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School Attendance

An average of 89% of all pupils were present in school over the week of 7 June to 11 June. This information is provisional and will be revised on 23 June. 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)

There are no new or ongoing clusters within FE settings in Wales. Source: 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 5 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 2 new clusters and 5 on going clusters reported in HE settings last week. The 2 new clusters were reported by 1 health board. Of the 3 clusters in a single Halls of Residence, none relate to university activities. One of these clusters of 9 cases in a single Hall were potentially initiated following social activities in a local pub. One cluster on the university campus is of the Delta variant, initially imported into Wales and currently confined to the inhabitants of one flat. 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 13 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.

Based on the current rates observed with current restrictions:

• Cases – the probability of incidence greater than 100 per 100,000 is high for Conwy and Denbighshire and above 50% for Flintshire. The figure illustrates the probability (between 0 – 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

20 - 26 June and 27 June - 3 July

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SPI-M-O has not produced updated medium term projections this week. The delay between infection, the need for hospital care and death means SPI-M-O does not have confidence that their projections based on the current trends in the data fully capture the recent rapid spread of the Delta variant, and its likely impact on transmission over the coming weeks.

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. 

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.

There was another rise in travellers overall this week, although the upwards trend has slowed to 15%. Green travellers, have dropped by around 14% with Portugal being added back to the Amber list. Positive rates continue to remain low. ​

There is a levelling off of numbers following the sharp increases in bank holiday travel. Portugal has the highest volume of travel. Exemptions remain steady with fluctuations up or down of around 6% week on week. ​

• 3,882 travellers this week (compared to 3386 for last week – 15% increase)​
  Amber: 2,824 (2,240 last week) ​
  Red: 123 (120 last week)​
  Green: 884 (1,012 for last week)​
• There were low numbers of positive arrivals​
• 533 out of 3386 travellers marked themselves as exempt ​(13.7% - an increase of 6% compared to last week)​

​Source: Home Office, as at 10 June 2021

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Travellers by local authority (28 May - 10 June 2021) 

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Source: Home Office, as at 10 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 11 June shows a reduction in many categories following last week which included half term and a bank holiday. Note that the baseline for much of the data is during January-February 2020 and changes are relative to that period. 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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Source: Google

Adherence

The most recent adherence data from IPSOS MORI indicate that levels of adherence to key protective behaviours remain high. For example, more than four in five report wearing a face covering, while three in five report ensuring they are more than two metres apart from others. Similarly, around a third of those in employment are working from home and around half still report avoiding non-essential travel and non-essential use of public transport. 

However, as restrictions have been eased, there is emerging evidence of changing behaviours. Decreased proportions report mitigating behaviours, such as ensuring 2-metre distancing from others (from 74% in early-March to 62% in early-June). Source: Survey of Public Views on COVID-19, 4 to 8 June 2021    

Results from the Coronavirus (Covid-19) Infection Survey, 6 June to 12 June

In England, the percentage of people testing positive has continued to increase in the most recent week. In comparison, the positivity rate remains low in Wales, whilst the trend is uncertain in Scotland and Northern Ireland in the most recent week. 

During the most recent period, it is estimated that an average of 2,000 people in Wales had COVID-19 (95% credible interval: 700 to 4,200), equating to around 1 in 1,500 people. This compares to around 1 in 520 people in England, around 1 in 600 people in Scotland, and around 1 in 610 people in Northern Ireland.
Source: Office for National Statistics COVID-19 Infection Survey

Positivity rates (%) across UK countries up to 12 June 2021

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Source: Office for National Statistics COVID-19 Infection Survey

Key risks

Transmissions, incidence and prevalence

Overall transmission, percentage of people testing positive is increasing since last week. Trends vary across health boards and local authorities.

NHS Capacity

COVID-19 pressure on the NHS remains stabilised at a relatively low level. Some fluctuations are likely to occur, due to low numbers.

Mortality

Remains at a generally low level.

Variants

Additional cases of Delta variant (B.1.617.2, first identified in India) have been detected in Wales and have begun to increase rapidly, although from a low level and numbers remain low in comparison to other parts of the UK. Local intervention will likely be required to prevent uncontrolled growth and wider community transmission in Wales. 

Immunity and vaccines

3.68 million doses of COVID-19 vaccine have been given in Wales. Of the 3.68 million doses given nationally, 2.23 million were first doses and 1.45 million were second doses.

International

There is a levelling off of travellers numbers following the sharp increases in bank holiday travel. Portugal has the highest volume of travel. 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