UKHSA and ONS have published the latest data from the Winter Coronavirus (COVID-19) Infection Study, known as the Winter CIS
Winter COVID-19 Infection Study shows a continued decline in COVID-19 in England and Scotland.
The latest data from the Winter COVID-19 Infection Study, an epidemiological study run in partnership by the UK Health Security Agency (UKHSA) and the Office for National Statistics (ONS), shows a clear decline in the prevalence of SARS-CoV-2 in England and Scotland in the 2 weeks up to 10 January.
Analysis by UKHSA suggests that prevalence in the community is 2.3%, or around one in every 43 people. This represents a decrease in prevalence from 3.1% (one in every 32 people) in the previous report.
Positivity data from the ONS indicates that of the approximately 26,000 participants who reported LFD test results in the last reporting period, 1.9% tested positive for COVID-19, compared to 2.7% in the last report.
The most recent data shows a clear decline in prevalence in Scotland and most of the regions in England. This decline was also observed for the age groups between 18 to 74.
Professor Steven Riley, Director General for Data and Surveillance at UKHSA said: “This week’s data confirms the early signs of a decline in COVID-19 across the country that we saw in last week’s report.
“While this is welcome, it is important to recognise that this does not mean that the risk of becoming ill with COVID-19 has gone away.
“In previous years, we have sometimes seen a decline in early January followed by an increase over the next few weeks, so it remains important that we continue to do what we can to reduce transmission.
“Those people who are most at risk of severe illness from COVID-19 can still receive a seasonal vaccination until the end of this month, and we urge anyone eligible who has not already done so to come forward. You can get a vaccine through your GP, by booking with a local NHS vaccination service, or you can find a COVID-19 vaccination walk-in site.
“If you are showing symptoms of COVID-19 or other respiratory illnesses, you should try to limit your contact with other people as much as possible, especially those who are older or more vulnerable.”
Since the beginning of 2023, the number of extensively-antibiotic resistant Shigella cases has increased by 53%. Much of this increase has been driven by a cluster of extensively-antibiotic resistant Shigella sonnei, of which there have been 97 cases in 2023 (up to and including November), compared to just 4 cases last year.
The strain is difficult to treat because it does not respond to the antibiotics typically used to treat Shigella. Cases have been diagnosed in all regions of England, but cases are concentrated in London (45), the North West (21) and South East (12).
In January 2022, there was a similar rise in cases of extensively antibiotic-resistant Shigella sonnei infections caused by another outbreak strain.
Cases of Shigella have been rising since the easing of COVID-19 restrictions in July 2021, with annual cases now higher than the average before the pandemic. The month with the highest number of reported Shigella diagnoses prior to the COVID-19 pandemic was 392 in September 2019, which increased to 485 in September 2023 – representing a 24% increase.
Shigella is a gut infection that causes diarrhoea (sometimes mixed with blood), stomach cramps and fever. It is caused by bacteria found in faeces.
It can be passed on through the faecal-oral route during sex, either directly or via unwashed hands and only a tiny amount of bacteria can spread the infection. Symptoms are typically seen between 1 and 4 days after exposure and are commonly mistaken for food poisoning.
Dr Gauri Godbole, Consultant Medical Microbiologist at UKHSA, said: “This is a concerning rise in cases of this antibiotic resistant strain, meaning treatment can be very difficult.
“One of the best ways to protect yourself and your partners is to practice good hygiene after sex. Avoid oral sex immediately after anal sex, and change condoms between anal or oral sex and wash your hands with soap after sexual contact.
“It’s important that gay, bisexual, and other men who have sex with men (GBMSM) do not dismiss their symptoms and speak to their GP or sexual health clinic, mentioning Shigella, if they are unwell.
“GBMSM with Shigella may have been exposed to other sexually transmitted infections (STIs) including HIV, so a sexual health screen at a clinic or ordering tests online is recommended.”
Shigella is very infectious. Although symptoms can be unpleasant, in most cases they will subside within a week, but some individuals need hospitalisation and require intravenous antibiotic treatment. Effective antibiotic treatments are limited for this extremely resistant strain.
Antibiotic treatment is recommended in cases with severe symptoms, those requiring hospital admission, those with prolonged diarrhoea (beyond 7 days) or in those who have underlying immunodeficiency.
If you have been diagnosed with Shigella, give yourself time to recover. Keep hydrated and get lots of rest. Don’t have sex until 7 days after your last symptom and avoid spas, swimming, jacuzzis, hot tubs and sharing towels as well as preparing food for other people until a week after symptoms stop.
Reducing transmission is key to protecting more vulnerable groups. You can find out more information about Shigella and get advice on other topics at Sexwise or by calling the free National Sexual Health Helpline at 0300 123 7123.
COVID-19 case rates continued to increase this week compared to our previous report. A total 9.7% of 4,288 respiratory specimens reported through the Respiratory DataMart System were identified as COVID-19. This is compared to 7.1% of 4,303 from the previous report.
The overall COVID-19 hospital admission rate for week 34 was 3.37 per 100,000 population, an increase from 3.00 per 100,000 in the previous report.
Intensive care units (ICU) admission rates have increased to 0.11 per 100,000 compared to 0.08 per 100,000 in the previous report.
Hospital admission rates have increased in most age groups.
Those aged 85 years and over continue to have the highest hospital admission rates; these have increased to 34.15 per 100,000 from 32.63 per 100,000 in the previous report. Admission rates among those aged 75 to 84 years have increased to 17.66 per 100,000 from 15.71 per 100,000 in the previous report.
Dr Mary Ramsay, Head of Immunisation at the UK Health Security Agency (UKHSA), said: “Over the last 2 weeks, we have seen an increase in some COVID-19 indicators. This includes hospital admissions and ICU admissions, but these have all stabilised over the last week. While case rates have continued to rise, rates remain low overall, and we will continue to monitor them closely.
“If you are experiencing any symptoms of respiratory illness, you should avoid mixing with other people, especially those who are vulnerable. This will help combat the spread of COVID-19.
“This week, the Department of Health and Social Care (DHSC) announced that the winter vaccination programme has been brought forwardas a precautionary measure to deliver greater protection against the potential impact of BA.2.86 variant. We urge everyone eligible to take up the vaccine when offered.”
New BA.2.86 variant found in Scotland
Scotland has detected its first case of a new Covid variant that is being closely monitored by the World Health Organization.
The BA.2.86 variant is not yet considered a variant of concern but it has a high number of mutations.
Scotland’s winter vaccination programme starts on 4 September, but in response to the new cases PHS and Scottish government are now working to bring winter vaccinations forward for those at the highest risk of becoming seriously ill from flu and Covid-19.
The UK Health Security Agency (UKHSA) has published an initial risk assessment of the SARS-CoV-2 variant BA.2.86.
This variant was detected in the UK yesterday (Friday 18 August), and has also been identified in Israel, Denmark and the US. It has been designated as V-23AUG-01 for the purpose of UKHSA monitoring.
The newly identified variant has a high number of mutations and is genomically distant from both its likely ancestor, BA.2, and from currently circulating XBB-derived variants.
There is currently one confirmed case in the UK in an individual with no recent travel history, which suggests a degree of community transmission within the UK. Identifying the extent of this transmission will require further investigation.
There is currently insufficient data to assess the relative severity or degree of immune escape compared to other currently-circulating variants.
Dr Meera Chand, Deputy Director, UKHSA said: “V-23AUG-01 was designated as a variant on 18 August 2023 on the basis of international transmission and significant mutation of the viral genome. This designation allows us to monitor it through our routine surveillance processes.
“We are aware of one confirmed case in the UK. UKHSA is currently undertaking detailed assessment and will provide further information in due course.”
UKHSA will continue to monitor the situation closely and will publish the results of our analysis when they are available.
Testing to be based on clinical need in hospitals, care homes and prisons
Routine COVID-19 testing in hospitals, care homes and prisons is to be substantially reduced following clinical and scientific advice.
Due to the success of the vaccination programme and improved treatments, Public Health Scotland and Antimicrobial Resistance & Healthcare Associated Infection Scotland have recommended a return to pre-pandemic testing.
This means testing will be based on person-centred clinical decisions, rather than a routine policy for all individuals. Routine testing will continue for patients moving from hospitals to care homes and will be reviewed based on future advice and outbreaks. Tests will also continue to be available for those eligible for antiviral treatment.
The new guidance will come into effect by 30 August 2023.
Chief Medical Officer Professor Sir Gregor Smith said: “Due to the success of vaccines in protecting people, and the availability of improved treatments, now is the right time to revise the advice on routine COVID-19 testing across health and social care settings and prisons. This will ensure the testing regime remains effective and proportionate.
“Routine testing will remain when patients are discharged from hospital to care homes, to provide additional reassurance for these settings, and testing will still be required when clinically appropriate.
“The clinical advice tells us that focusing on the risk to individuals under general infection control procedures will allow our hospital, social care and prison staff to better protect those in their care and that there is no longer a requirement to apply separate COVID-19 guidance across the board when so many are now protected from its worst harms.”
COVID CASES ON THE RISE
This UK Health Security Agency fortnightly flu and COVID-19 report brings together the latest surveillance data along with the latest public health advice.
The latest report was produced on 3 August:
COVID-19 case rates continued to increase this week compared to our previous report. 5.4% of 4,396 respiratory specimens reported through the Respiratory DataMart System were identified as COVID-19. This is compared to 3.7% of 4,403 from the previous report.
The overall COVID-19 hospital admission rate for week 30 was 1.97 per 100,000 population, an increase from 1.17 per 100,000 in the previous report.
ICU admission rates have decreased to 0.05 compared to 0.07 in the previous report.
Those aged 85 years and over continue to have the highest hospital admission rates; these have increased to 20.49 per 100,000 from 9.8 per 100,000 in the previous report.
Admission rates among those aged 75 to 84 years have increased to 9.45 per 100,000 from 5.54 in the previous report.
Dr Mary Ramsay, Head of Immunisation at the UK Health Security Agency (UKHSA), said: “We continue to see a rise in COVID-19 cases in this week’s report. We have also seen a small rise in hospital admission rates in most age groups, particularly among the elderly.
“Overall levels of admission still remain extremely low and we are not currently seeing a similar increase in ICU admissions. We will continue to monitor these rates closely.Regular and thorough hand washing helps protect you from COVID-19 and other bugs and viruses.
“If you have symptoms of a respiratory illness, we recommend staying away from others where possible.
“The NHS will be in contact in autumn 2023 when the seasonal vaccine is available for those who are eligible due to health conditions or age, and we urge everyone who is offered to take up the vaccine when offered.”
As further poliovirus has been detected in sewage, JCVI recommends that polio vaccine booster doses should be offered to children across London.
Following the discovery of type 2 vaccine-derived poliovirus in sewage in north and east London, the Joint Committee on Vaccination and Immunisation (JCVI) has advised that a targeted inactivated polio vaccine (IPV) booster dose should be offered to all children between the ages of 1 and 9 in all London boroughs.
This will ensure a high level of protection from paralysis and help reduce further spread of the virus.
Nationally the overall risk of paralytic polio is considered low because most people are protected from this by vaccination.
Many countries globally provide an additional dose of polio-containing vaccine as part of their childhood vaccination schedule. The NHS in London will contact parents when it’s their child’s turn to come forward for a booster or catch-up polio dose – parents should take up the offer as soon as possible.
The programme will start with the areas affected, where the poliovirus has been detected and vaccination rates are low. This will be followed by rapid rollout across all boroughs.
This booster dose will be in addition to the NHS childhood vaccination catch-up campaign across London, where childhood vaccination uptake is lower than the rest of the country. It’s important all children aged 1 to 9 – even if up to date with their vaccinations – accept this vaccine when offered to further strengthen their protection against the poliovirus.
Following the findings earlier this year of type 2 poliovirus (PV2) collected from the Beckton sewage treatment works, further upstream sampling undertaken by the UK Health Security Agency (UKHSA) and the Medicines and Healthcare products Regulatory Agency (MHRA) has now identified at least one positive sample of the poliovirus, currently present in parts of the following boroughs:
Barnet
Brent
Camden
Enfield
Hackney
Haringey
Islington
Waltham Forest
The sampling has also detected the virus in lower concentrations and frequency in areas adjacent to the Beckton catchment area to the South (immediately below the Thames) and to the east of Beckton. However, it is not clear whether the virus has established itself in these areas or if the detections are due to people from the affected area visiting these neighbouring areas.
The level of poliovirus found and the high genetic diversity among the PV2 isolates suggests that there is some level of virus transmission in these boroughs which may extend to the adjacent areas. This suggests that transmission has gone beyond a close network of a few individuals.
A total of 116 PV2 isolates have been identified in 19 sewage samples collected in London between 8 February and 5 July this year, but most are vaccine-like virus and only a few have sufficient mutations to be classified as vaccine derived poliovirus (VDPV2).
VDPV2 is of greater concern as it behaves more like naturally occurring ‘wild’ polio and may, on rare occasions, lead to cases of paralysis in unvaccinated individuals.
UKHSA is working closely with health agencies in New York and Israel alongside the World Health Organisation to investigate the links between the poliovirus detected in London and recent polio incidents in these 2 other countries.
Dr Vanessa Saliba, Consultant Epidemiologist at UKHSA, said: “No cases of polio have been reported and for the majority of the population, who are fully vaccinated, the risk is low.
“But we know the areas in London where the poliovirus is being transmitted have some of the lowest vaccination rates. This is why the virus is spreading in these communities and puts those residents not fully vaccinated at greater risk.
“Polio is a serious infection that can cause paralysis but nationally the overall risk is considered low because most people are protected by vaccination. The last case of polio in the UK was in 1984, but decades ago before we introduced the polio vaccination programme around 8,000 people would develop paralysis every year.
“It is vital parents ensure their children are fully vaccinated for their age. Following JCVI advice all children aged 1 to 9 years in London need to have a dose of polio vaccine now – whether it’s an extra booster dose or just to catch up with their routine vaccinations. It will ensure a high level of protection from paralysis. This may also help stop the virus spreading further.”
Jane Clegg, Chief Nurse for the NHS in London said: “While the majority of Londoners are protected from polio, the NHS will shortly be contacting parents of eligible children aged 1 to 9 years old to offer them a top-up dose to ensure they have maximum protection from the virus.
“We are already reaching out to parents and carers of children who aren’t up to date with their routine vaccinations, who can book a catch-up appointment with their GP surgery now and for anyone not sure of their child’s vaccination status, they can check their Red Book.”
UKHSA, working with MHRA, has already increased sewage surveillance to assess the extent of spread of the virus and are currently sampling 8 sites across London.
A further 15 sites in London will start sewage sampling in mid-August, and 10 to 15 sites will be stood up nationally to determine if poliovirus is spreading outside of London.
The UK Health Security Agency’s (UKHSA) heat-health alert service is designed to help healthcare professionals manage through periods of extreme temperature. The service acts as an early warning system for periods of high temperatures that may affect the public’s health.
The alert will be in place from midday Tuesday 9 August to 6pm on Saturday 13 August for all regions of England.
Temperatures are not forecast to reach the record-breaking levels of the most recent heatwave but are expected to rise throughout the week, potentially reaching mid-30 degrees Celsius on Friday and Saturday in the South East, London, the South West, and the East and West Midlands.
Dr Agostinho Sousa, Head of Extreme Events and Health Protection at the UK Health Security Agency (UKHSA), said: “Temperatures will feel very warm again this week, particularly in southern and central parts of the country.
“We want everyone to enjoy the warm weather safely when it arrives but remember that heat can have a fast impact on health. It’s important to ensure that people who are more vulnerable – elderly people who live alone and people with underlying health conditions – are prepared for coping during the hot weather.
“The most important advice is to ensure they stay hydrated, keep cool and take steps to prevent their homes from overheating.”
Met Office Deputy Chief Meteorologist, Tony Wardle, said: “Heatwave criteria look likely to be met for large areas of the UK later this week, with the hottest areas expected in central and southern England and Wales on Friday and Saturday. Temperatures could peak at 35⁰C, or even an isolated 36⁰C on Saturday.
Elsewhere will see temperatures widely into the high 20s and low 30s Celsius later this week as temperatures build day-on-day through the week due to an area of high pressure extending over much of the UK.
Coupled with the high daytime temperatures will be continued warm nights, with the mercury expected to drop to only around low 20s Celsius for some areas in the south.
look out for those who may struggle to keep themselves cool and hydrated – older people who may also live alone, and those with underlying conditions are particularly at risk
stay cool indoors by closing curtains on rooms that face the sun – and remember that it may be cooler outdoors than indoors
drink plenty of fluids and avoid excess alcohol
try to keep out of the sun between 11am to 3pm, when the UV rays are strongest
walk in the shade, apply sunscreen and wear a wide-brimmed hat, if you have to go out in the heat
avoid physical exertion in the hottest parts of the day
make sure you take water with you if you are travelling
check that fridges, freezers and fans are working properly
check medicines can be stored according to the instructions on the packaging
never leave anyone in a closed, parked vehicle, especially infants, young children or animals
High temperatures also present a risk of wildfires, especially after long dry periods. People with pre-existing heart and lung conditions such as asthma are most susceptible as breathing wildfire smoke may worsen their symptoms. Children and older people may also be susceptible to health impacts.
If wildfire smoke affects your area, avoid or reduce your exposure to smoke by staying indoors with the doors and windows closed.
Where possible avoid smoky areas. If you should travel through a smoky area, ensure that the vehicle windows are closed and the air conditioning is switched to recycle or recirculate if possible.
Listen out for local news reports and information from the emergency services who will provide advice on the precautions you should take.
The UK Health Security Agency (UKHSA) has published the latest technical briefing, which shows early signs that the outbreak is plateauing.
As of 4 August, there are 2,859 confirmed and highly probable cases of monkeypox in the UK.
Analyses of the current UK outbreak shows that monkeypox continues to be transmitted primarily in interconnected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM). The median age of confirmed cases in the UK was 37 years old. In England, 73% are known to be London residents over the course of the outbreak.
In the past few weeks, there have been a small number of women confirmed to have monkeypox but there is not enough evidence currently to suggest that there is sustained transmission outside of interconnected sexual networks. Twenty-two cases in women have been identified and 99% of all UK cases are male.
A small number of cases with no known travel history during their incubation period have been detected prior to 6 May, pre-dating the previous first-known report of a monkeypox case in the UK. This is not unexpected given our understanding of the outbreak to date.
Dr Meera Chand, Director of Clinical and Emerging Infections, UKHSA, said: “While the most recent data suggests the growth of the outbreak has slowed, we cannot be complacent. Be vigilant of and check yourself for monkeypox symptoms, including rashes and blisters.
“If you are concerned that you may have monkeypox symptoms, take a break from events, meeting with friends or having sexual contact. Instead, stay at home and contact 111 or your local sexual health service for advice.
“The smallpox vaccine is being offered to individuals at higher risk of coming into contact with monkeypox in order to offer them protection and to reduce the spread of disease.”
The briefing now includes monkeypox genomic surveillance data from the UK. As is described globally, the majority of outbreak cases in the UK belong to a distinct genetic lineage (B.1) which has mutations of unknown significance when compared with the closest previously characterised monkeypox virus genomes.
UKHSA will continue to publish regular technical briefings as the response to the outbreak continues.
Up to 25 July 2022, there were 2,367 confirmed and 65 highly probable monkeypox cases in the UK: 2,432 in total.
To expand the UK’s capability to detect monkeypox cases, some NHS laboratories are now testing suspected monkeypox samples with an orthopox polymerase chain reaction (PCR) test (orthopox is the group of viruses which monkeypox is part of).
Since 25 July 2022, the monkeypox case definition recognises those who are orthopox-positive as highly probable cases, and those who test positive on a monkeypox PCR test as confirmed cases.
Dr Sophia Makki, National Incident Director at UKHSA, said: “Monkeypox cases continue to rise, with the virus being passed on predominantly in interconnected sexual networks.
“Before you have sex, go to a party or event, check yourself for monkeypox symptoms, including rashes and blisters.
“If you have monkeypox symptoms, take a break from attending events or sex until you’ve called 111 or a sexual health service and been assessed by a clinician.
“Vaccination will further strengthen our monkeypox response and so we urge all those who are eligible for the vaccine to take it up when offered. It will help protect yourself and others you have had close contact with.
“While the infection is mild for many, it can cause severe symptoms and hospitalisation in some.
“Please remember that the vaccine may not provide complete protection against monkeypox, so it is still important to be alert for the symptoms of monkeypox and call 111 or a sexual health clinic if you develop any.”
The NHS will provide the vaccine to those eligible, so please wait until you are contacted.
While anyone can catch monkeypox, the majority of monkeypox cases in the UK continue to be in gay, bisexual and other men who have sex with men (MSM), with the infection being passed on mainly through close contact between people in interconnected sexual networks.
Before you go to a party or event, check yourself for monkeypox symptoms, including rashes and blisters.
If you have monkeypox symptoms, take a break from attending events or sex until you’ve called 111 or a sexual health service and been assessed by a clinician.
It can take up to 3 weeks for symptoms to appear after being in contact with someone with monkeypox, so stay alert for symptoms after you have skin to skin or sexual contact with someone new
UK Health Security Agency (UKHSA) releases level 3 heat-health alert for parts of UK
Forecasters warn temperatures will continue to climb and soar past 30 degrees C in some parts of the country
TUC calls on employers to make sure staff are protected from the sun and heat
The TUC has urged employers to make sure their staff are protected from the sun and heat after the UK Health Security Agency (UKHSA) issued a heat-health alert yesterday.
A Level 2 heat-health alert has been issued for the South West, East Midlands, West Midlands, North West and Yorkshire and the Humber regions.
And a Level 3 alert has also been issued for the East of England, South East and London regions.
Both alert levels are in place until 9am on Friday (15 July), with warm weather forecast across the country throughout the course of next week.
Climate change means that the UK will be subject to more frequent and intense heat waves – putting workers at greater risk.
Health warning
Working in hot weather can lead to dehydration, muscle cramps, rashes, fainting, and – in the most extreme cases – loss of consciousness. Outdoor workers are three times more likely to develop skin cancer.
The TUC says employers can help their workers by:
Sun protection: Prolonged sun exposure is dangerous for outdoor workers, so employers should provide sunscreen.
Allowing flexible working: Giving staff the chance to come in earlier or stay later will let them avoid the stifling and unpleasant conditions of the rush hour commute. Bosses should also consider enabling staff to work from home while it is hot.
Keeping workplace buildings cool: Workplaces can be kept cooler and more bearable by taking simple steps such as opening windows, using fans, moving staff away from windows or sources of heat.
Climate-proofing workplaces: Preparing our buildings for increasingly hot weather, by installing ventilation, air-cooling and energy efficiency measures.
Temporarily relaxing their workplace dress codes: Encouraging staff to work in more casual clothing than normal – leaving the jackets and ties at home – will help them keep cool.
Keeping staff comfortable: Allowing staff to take frequent breaks and providing a supply of cold drinks will all help keep workers cool.
Talking and listening to staff and their union: Staff will have their own ideas about how best to cope with the excessive heat.
Sensible hours and shaded areas for outdoor workers: Outside tasks should be scheduled for early morning and late afternoon, not between 11am-3pm when UV radiation levels and temperatures are highest. Bosses should provide canopies/shades where possible.
The law
There’s no law on maximum working temperatures. However, during working hours the temperature in all indoor workplaces must be ‘reasonable’.
Employers have a duty to keep the temperature at a comfortable level and provide clean and fresh air.
The TUC would like to see a change in the law so that employers must attempt to reduce temperatures if they get above 24 degrees C and workers feel uncomfortable. And employers should be obliged to provide sun protection and water.
The TUC would also like ministers to introduce a new absolute maximum indoor temperature, set at 30 degrees C (or 27 degrees C for those doing strenuous jobs), to indicate when work should stop.
With climate change bringing higher temperatures to the UK, the government needs a plan on how to adapt and keep workers safe.
TUC General Secretary Frances O’Grady said:“We all love it when the sun comes out. But working in sweltering conditions in a baking shop or stifling office can be unbearable and dangerous.
“Indoor workplaces should be kept cool, with relaxed dress codes and flexible working to make use of the coolest hours of the day.
“And bosses must make sure outdoor workers are protected with regular breaks, lots of fluids, plenty of sunscreen and the right protective clothing.”
