UK COVID-19 Update: R Number Increases but Infection Rates Fall

Peter Russell

April 23, 2021

These are the UK coronavirus stories you need to know about today.

R Number Up But UK-wide Decline in Positive Tests

The latest R number for England increased slightly from between 0.7 and 1.0 to between 0.8 and 1.0. The Scientific Advisory Group for Emergencies estimated a growth rate of between -5% to -1%.

The small uptick came as estimates by the Office for National Statistics (ONS) suggested that 90,00 people in the UK would have tested positive for COVID-19 in the week to April 16, down from 129,000 a week before.

The national breakdown showed this would translate as:

  • 1 in 610 people in England

  • 1 in 840 people in Wales

  • 1 in 660 people in Northern Ireland

  • 1 in 560 people in Scotland

The percentage of people testing positive in England has decreased in those aged 2 to those in the last year of primary school, and for those over the age of 35 For all other age groups, the trend was uncertain.

The percentage of people testing positive with cases of the B.1.1.7 variant decreased in England, while there were signs of a possible increase in Wales. The trend was uncertain in Northern Ireland and Scotland.

Sarah Crofts, senior statistician, said: “In England, the infection rate is now around a twelfth of the level seen at the start of the year."

Experts said the latest figures were encouraging.

Prof James Naismith, director of the Rosalind Franklin Institute, commented to the Science Media Centre: "It is safe to conclude that the re-opening we have seen [thus] far, has not triggered a resurgence."

Vaccines 'Effective After One Dose'

COVID-19 infections fell significantly after a first dose of either the Pfizer/BioNTech or AstraZeneca/Oxford vaccines, latest research found.

Vaccination was found to be just as effective in people over 75, or with underlying health conditions, as in those under 75 or without comorbidities.

Data from the COVID-19 Infection Survey by the University of Oxford and the Office for National Statistics suggested that everyone showed some response to both vaccines.

Vaccines were found to be effective against the B.1.1.7, or UK/Kent variant.

The research, contained in two preprints, was based on more than 1.6 million swab results from 373,402 participants aged 16 and over between December 1,2020 and April 3, 2021.

The first study found that the odds of new SARS-CoV-2 infection were reduced by 65%, 21 days or more after a first dose of either vaccine. Symptomatic infections were reduced by 74%, and asymptomatic infections by 57%.

The largest reduction in odds of new infection (70%) and symptomatic infection (90%) was seen after a second dose.

There was no evidence that either of the two vaccines differed in their ability to reduce infection rates, despite them leading to slightly different immune responses, the researchers said.

Two doses of the Pfizer/BioNTech vaccine offered similar levels of protection against COVID as previous infection with SARS-CoV-2. It was not possible to measure this with the AstraZeneca/Oxford vaccine because too few people had received a second dose.

Dr Koen Pouwels, senior researcher in Oxford University's Nuffield Department of Population Health, said: "The protection from new infections gained from a single dose supports the decision to extend the time between first and second doses to 12 weeks to maximise initial vaccination coverage and reduce hospitalisations and deaths.

"However, the fact that we saw smaller reductions in asymptomatic infections than infections with symptoms highlights the potential for vaccinated individuals to get COVID-19 again, and for limited ongoing transmission from vaccinated individuals, even if this is at a lower rate."

The second study, involving 45,965 people, compared how antibody levels changed after a single dose of either the AstraZeneca/Oxford or Pfizer/BioNTech vaccines, or two doses of the Pfizer vaccine.

In participants who had not had COVID-19 before, antibody responses to a single dose of either vaccine were lower in older individuals, especially those over 60.

Although antibody levels rose more slowly and to a lower level with a single dose of the AstraZeneca vaccine, they dropped more quickly with a single dose of the Pfizer, particularly in older people.

David Eyre, associate professor at the Big Data Institute at the University of Oxford, said: "In older individuals, two vaccine doses are as effective as prior natural infection at generating antibodies to the SARS-CoV-2 virus that causes COVID-19 – in younger individuals a single dose achieves the same level of response.

"Our findings highlight the importance of individuals getting the second vaccine dose for increased protection."

Vaccine Confidence Persists

Confidence in COVID vaccines has remained high, with 93% of adults saying they had either received a vaccine or would be likely to have one if it was offered. Last week's figure was 94%.

The data from the Office for National Statistics (ONS) found that vaccine confidence among people aged 16 to 29 dipped to 83% compared with 88% last week. There was an increase in the proportion of people in this age group who said they were unlikely to accept a vaccine if offered – up from 4% to 8%.

However, statisticians said positive sentiment towards COVID vaccines among 16 to 29 year olds remained higher than the 63% recorded in December.

The indicators from the Opinions and Lifestyle Survey covered the period April 14 to 18.

It showed that more people were leaving home following a further easing of lockdown restrictions, with 20% of people saying they shopped for items other than basic necessities, compared with 14% last week. The proportion of people leaving home to pursue leisure activities rose from 8% to 12%.

The ONS found that 54% of adults met up with someone outside their household, childcare, or support bubble, slightly down from 57% last week. Of the 54%, 43% met outdoors only, 8% met both indoors and outdoors, and 3% socialised indoors only.

Compliance with most measures to stop the spread of COVID-19 remained high, with 87% of adults reporting handwashing when returning home, and 97% using a face covering.

The data also showed that personal well-being levels remained relatively stable, with life satisfaction at 6.9 of 10, compared with 7.3 in February last year.

Pandemic Drinking Rates Up, Smoking Down

Almost a half of adults said they were drinking more alcohol now than a year ago when lockdown restrictions began.

A preprint study by University College London (UCL)  found that although most adults (65.6%) reported unchanged alcohol consumption compared with a year ago, among those who did report a change, 49.1% of people said they were drinking more now than in March and April last year. However, 50.9% said they were drinking less.

Men were more likely than women to have boosted their alcohol intake, as were people in higher income households.

The results from the COVID-19 Social Study also found that 12.9% of people who wer smoking in March and April 2020 said they had now quit altogether.

Dr Elise Paul from UCL's Institute of Epidemiology & Health, said: "Our report shows that during the pandemic, alcohol consumption has increased for many. This could be due to a wide range of factors, including using alcohol to cope with stress, and the absence of other ways in which to demarcate home and work life when working from home during the lockdown.

"The closure of non-essential shops and restriction of activities will also have had an impact, with people drinking more for lack of anything else to do, rather than due to a conscious decision to increase alcohol consumption."

Other Developments

  • Most travellers from India have now been banned from entering the UK. The move comes as India's healthcare system came under huge strain, with reports of 332,730 new cases, and 2263 deaths within 24 hours.

  • The Welsh Government confirmed a further relaxation of COVID restrictions, with resumption of indoor supervised activities for children, indoor organised activities for up to 15 adults, and the re-opening of community centres being brought forward by 2 weeks to May 3. From this Saturday, the 'rule of 6' will allow for up to six people from six households to meet outdoors in Wales.

  • Northern Ireland hairdressers were among businesses allowed to reopen today as Stormont eased COVID restrictions. Outdoor hospitality businesses and non-essential shops will be allowed to open next Friday.

  • The cost of measures to support the economy during the pandemic pushed Government borrowing to £303.1 billion in the 12 months to March – the highest level since the end of World War Two, the BBC reported. Compared with the previous year, borrowing was nearly £250 billion higher, it said.

  • Falling COVID cases in the UK have led Roche to look for another location to carry out trials of its AT-527 anti-viral pill to treat people with COVID-19.  Bill Anderson, head of Roche's pharmaceutical division, said a combination of lockdown and the vaccine rollout meant "there's just simply not enough patients to enrol".

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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