State of the Epidemic in Scotland – 7th May 2021
This report summarises the current situation on the COVID-19 epidemic in Scotland. It brings together the different sources of evidence and data about the epidemic in Scotland at this point in time, why we are at that place, and what is likely to happen next. This summarises the data up to and including the 6 May 2021 on COVID-19 in Scotland. This updates the previous publication published on 30 April 2021. The information in this document helps the Scottish Government, the health service and the wider public sector respond to the epidemic and put in place what is needed to keep us safe and treat people who have the virus.
This edition of the state of the epidemic, summarises current data on COVID-19 at a national level, at a local level and how Scotland currently compares to the rest of the UK. It looks at the vaccination program in Scotland and the effects which are beginning to be seen from this. Information is provided about variants of concern and what impact these may have. Bringing this information together in one place gives the opportunity to better understand the current state of the epidemic in Scotland.
- The reproduction rate R in Scotland is currently estimated as being between 0.7 and 1.0. The lower bound is lower than last week.
- An average of 164 cases were reported per day in the 7 days to 6 May, which is a 9% decrease in reported cases since the 29 April.
- There were 21 weekly cases per 100,000 in the week to 3 May, which is a decrease since last week. This compares to 302 weekly cases per 100,000 on 8 January and is similar to the weekly case rate observed in early September.
- Case rates saw a decline amongst all age bands with the sharpest decrease in those aged 80+ this week.
- The estimated proportion of people becoming infected with Covid in Scotland has continued to decrease in the most recent week and is currently above England and Wales but in line with Northern Ireland as determined through the latest weekly ONS survey.
- Latest modelled estimates suggest there are currently between 1 and 14 new daily infections per 100,000 people in Scotland.
- Deaths involving coronavirus have declined most in those aged 15-44 over the 3 weeks to 2 May, having gone down by 100% (from 1 to 0 deaths). Deaths in those aged 65-74, 45-64 and 85+ have declined by 78%, 71% and 40%, respectively, over the same period. Deaths have increased by 29% (from 7 to 9) in the 75-84 age group in the 3 weeks to 2 May. However this is normal expected variation when death numbers are very low.
- Average daily deaths per 100,000 population in Scotland (0.00) are below England (0.02), Northern Ireland (0.02) and Wales (0.01).
- Moray currently has the highest weekly case rates in Scotland reporting 79 cases per 100,000 in the last week, while Angus, Argyll and Bute, Dundee, East Lothian, Inverclyde, Midlothian, and Scottish Borders reported fewer than 10 weekly cases per 100,000 each in the same time. Na h-Eileanan Siar, Orkney, and Shetland had 0 cases per 100,000 in the last week.
- At a national level hospital bed and ICU occupancy are projected to fall over the next few weeks, but this depends on the future impact of full schools reopening and other relaxations of non-pharmaceutical interventions.
- Over 2.8 million people in Scotland have been given a first vaccine against SARS-CoV-2, and over 1.4 million have now received a second dose.
- The current UK variant of concern remains the dominant strain.
This report brings together a wide range of publically available figures from a range of data sources. These include publications by Scottish Government, Public Heath Scotland, National Records of Scotland, Office for National Statistics along with scientific publications and SAGE summaries where appropriate to summarise the state of the epidemic in Scotland in a given week. We also provide information on public attitudes to the virus from weekly YouGov polling surveys.
The national picture
The latest R value for Scotland (published on 7 May) was between 0.7 and 1.0 (Figure 1), with a growth rate of between -5% and -2%.
As Scotland started to move out of national level stay at home measures, an average of 164 cases were reported per day in the 7 days to 6 May. This is a 9% decrease from the daily average cases recorded a week earlier to 29 April. Average daily cases reported are now under a tenth of the peak of 2,323 in the week to 7 January. Our current position is 21 weekly cases per 100,000 in the week to 3 May. This compares to 302 weekly cases per 100,000 on 8 January (see Figure 2) and is similar to the weekly case rate observed in early September .
The number of locations where the levels of Covid in wastewater are monitored has increased to 103 sites around Scotland. In contrast to COVID-19 case records, virus shedding into wastewater is a biological process. This means that wastewater data is unaffected by factors that impact whether testing is done. The overall level of wastewater Covid-19 has continued to decline from levels reported two weeks ago at a national level.
Case rates saw a decline amongst all age bands with the sharpest decline in those aged 80 and over this week (Figure 3).
Not everyone who has the virus will be tested, as many people do not realise they have COVID, or have mild symptoms and do not come forward. Latest modelled estimates suggest there are currently anywhere between 50 and 800 people infected in Scotland each day. This means that as of 5 May there were between 1 and 14 new daily infections per 100,000 people.
The number of people in hospital with confirmed Covid for less than 28 days is declining. After peaking at 2,053 on 22 January, this figure has decreased and as of 6 May there were 58 patients in hospital with COVID-19. In addition, there was a fall in daily hospital admissions for people with Covid from a peak of 241 on 11January to 7 on 2 May.
There were 19 deaths registered where Covid was mentioned on the death certificate in the week to 2 May. This is a 17% decrease on the week before, and 97% lower than the peak in April 2020 (663 deaths). The proportion of deaths in care homes has decreased from 60% in April 2020 and was 37% in the week to 2 May 2021. Deaths involving coronavirus have declined most in those aged 15-44 and have gone down by 100% (from 1 to 0 deaths) in this age group over the 3 weeks to 2 May (Figure 4). Deaths in those aged 65-74, 45-64 and 85+ have declined by 78%, 71% and 40%, respectively, over this period. Deaths have increased by 29% (from 7 to 9) in the 75-84 age group in the 3 weeks to 2 May. However this is normal expected variation when death numbers are very low.
How Scotland compares with the rest of the UK
The latest ONS survey estimates that the proportion of the population infected in the community in Scotland (0.13% people currently testing positive for Covid-19 from 26 April to 2 May) has continued to decrease in the most recent week. However this is still above England (0.08%) and Wales (0.05%), yet in line with Northern Ireland (0.13%). In the week to the 2 May the estimated rate of community infection was 1 in 760 people in Scotland, compared to 1 in 1,180 for England, 1 in 2,070 for Wales and 1 in 750 for Northern Ireland. Average daily deaths in Scotland (0.00 per 100,000 in the week to 6 May) are below England (0.02), Northern Ireland (0.02) and Wales (0.01). The Coronavirus Infection Survey estimated that in the week to 11 April, 57.8% of the adult population in Scotland would have tested positive for antibodies against Covid-19, as a result of having the infection in the past or being vaccinated. This compares to 68.3% in England, 61.0% in Wales and 62.5% in Northern Ireland.
Situation by local authority within Scotland
Moray currently has the highest case rates in Scotland with 79 weekly cases reported per 100,000 in the week to 3 May, which is a 73% increase from the week to 26 April. There are mostly low levels of cases across Scotland, with moderate levels of cases observed across the central belt and high case rates seen in Moray (Figure 5). Angus, Argyll and Bute, Dundee, East Lothian, Inverclyde, Midlothian and Scottish Borders each had fewer than 10 weekly cases per 100,000 in the week to 3 May. Na h-Eileanan Siar, Orkney and Shetland had 0 cases per 100,000 in the last week.
The most recent modelling predicts that for the week ending 22 May, there are no local authorities with at least a 75% probability exceeding 50 cases per 100,000 population (Figure 6). This is unchanged from last week.
Children and Education
The majority of children and young people had returned to full time education by the 19 April. Over the last week there was a slight decrease in the total number of COVID- 19 cases in young people, which has gone down from 388 cases in the week to 25 April to 351 cases in the week ending 2 May. This is the lowest number since week ending 13 September. 7 day cases per 100,000 have increased slightly in 2-4 and 5-11 year olds in the week ending 2 May, and the highest proportion of cases is still observed in those under 12 (181 cases).
However, there was a sharp fall in 7 day cases per 100,000 in those aged 18-19 (Figure 7). There has also been an increase in testing amongst 2-4, 5-11 and 12-15 year olds, but a decrease amongst 16-17 and 18-19 year olds in week ending 2 May. Test positivity rates have fallen in all age groups this week. Overall, the proportion of school, early learning and childcare settings with incidents remains low.
Changes in patterns of mixing and adherence to restrictions will impact on future case numbers. The Scottish Contact Survey measures times and settings that people mix where they could potentially spread Covid. From this survey we can say that average contacts have increased by 16% in the last two weeks (comparing surveys pertaining to 8th – 14th April and 22nd - 28th April), to a current level of 3.9 daily contacts. This is the highest number of daily contacts reported since the end of December. Contacts within the work and other setting (contacts outside of the school, home or work settings) have increased in the last two weeks by 55% and 12%, respectively. Individuals 40 and over have increased their contacts in the last two weeks, largely driven by contacts within the work setting for those aged between 40 and 69. Average contacts for those aged under 40 have remained level or have shown a decrease over the same period.
Self-reported compliance with the current regulations and guidance has decreased since January but remains at a high level. On 4-5 May, 66% of people reported 'complete' or 'almost complete' compliance.
Hospital bed and ICU occupancy are projected to fall over the next few weeks, but this depends on the future impact of full schools reopening and other relaxations of non-pharmaceutical interventions (Figure 8).
Vaccinations are continuing across the priority groups and 63% of the adult population in Scotland has now been vaccinated with the first dose. The first vaccines were administered on Tuesday 8 of December and 2,860,635 had received their first dose by 6 May 2021, a 2% increase from the 29 April. By the 6 May over 35,000 residents in care homes had received their first vaccination along with over 53,000 care home staff. In older adult care homes over 91% of residents have now received their second dose. By age group, almost 100% of individuals aged 55+ and 92% of those aged 50-54 had received their first vaccination (Figure 9). 93% of the over 75s, 92% of those aged 70-74 and 79% of those aged 65-69 have received their second dose. Overall, 1,400,296 (almost 31%) of those aged 16 and over had received their second dose by 6 May. There are now low levels of hospitalisations and deaths among those groups vaccinated first (Figure 4).
The proportion of people surveyed who said they would be likely to be vaccinated for COVID-19 remains high. 59% of all respondents have already received at least their first vaccine dose. Of those not vaccinated, 71% report they are likely to be vaccinated when a vaccine becomes available to them.
How the virus is changing
The variant of the virus commonly known as the UK variant (VOC-20DEC-01) remains the dominant strain in Scotland. This new variant of Covid is more transmissible. It is likely that infection with this variant is associated with an increased risk of hospitalisation and death compared to infection with non-VOC viruses.
Other variants of concern (VOCs) are being monitored by sequencing of SARS-CoV-2 samples (Figure 10). To date there are five VOCs and eight variants under investigation. Up to 5 May, there have been 34 genomically confirmed cases of the variant VOC-20DEC-02 (first seen in South Africa) detected in Scotland. There have been 10 confirmed cases of the variant VOC-21JAN-02 (first identified from Brazil). There have also been a number of cases of other variants, which are currently under investigation, including 31 cases of VUI-21FEB-03 (first seen in Nigeria) (up 1 from last week) and 14 cases of VUI-21APR-01 (first identified in India), an increase of 1 in the past week. There is some concern, that some of these new variants may partially escape immunity, from both natural infection and from vaccines currently being deployed, and we are monitoring the evidence on this  .
The Scottish Government continues to work closely with Public Health Scotland to monitor the course of the epidemic using several data sources. Each week this report will provide an overview of current COVID-19 situation in Scotland. This will include real time data on case rates, hospitalisations and deaths and how Scotland's figures compare to those from the rest of the UK. Modelling can tell us where the epidemic is likely to be heading. Local data and data by age group can highlight where problem arise, which can help in addressing some of these issues. In the coming weeks the roll out of the vaccine will continue to be monitored along with the impact of this on case rates and deaths among different age cohorts. Investigations are ongoing by NERVTAG, SPI-M, SAGE, Public Health England and Public Health Scotland regarding the impact of new variants and of vaccination, this will be reflected here as work is undertaken.
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