Coronavirus statistical update: Leicester hotspot revealed by more detailed data

Leicester is now in lockdown, but it only became clear that it was a coronavirus hotspot when a glaring deficiency in the provision of local data was remedied. The more detailed data reveal that the extent of infections at local authority level has been underestimated around the country, including in Hastings, Rother and East Sussex. Text by Nick Terdre, research and graphics by Russell Hall.

Accurate localised data is fundamental to the success of the test-and-trace system on which we rely as we seek a safe way to social and economic recovery. In the last few days a big step has been taken towards achieving that, though it is unclear why it should have taken so long – test-and-trace has been up and running for five weeks now.

What has been lacking in local level data until the last few days?

The estimate of infections given in the government’s daily statistics is based on the sum of Pillar 1 and Pillar 2 testing – Pillar 1 being swab testing in Public Health England (PHE)  labs and NHS for those with a clinical need and health and care workers and Pillar 2 swab testing by commercial partners for the wider population.

As of 4 July, such testing had identified a total of 284,900 cases of infection. That includes some who have recovered and some who have died, as well as those who currently have it.

Overall most cases have been identified by Pillar 1 – 197,734 against 87,166 by Pillar 2. However, while Pillar 1 was previously predominant, over time Pillar 2 has begun to find more cases – in the 24 hours to 9am on 4 July it was responsible for identifying 461 of the total of 624 new cases, against 163 for Pillar 1.

This development indicates how the spread of the virus is increasingly taking place in the community rather than in hospitals and care homes.

Even when made aware of the true state of infection of their city, Leicester’s local authorities, along with other local authorities, were hamstrung in taking action because they did not have postcode level data to guide test-and-trace activities. The simple signing of a data protection agreement by the local authorities should now have enabled this obstacle to be overcome.

Now that the data deficiency has been remedied, Leicester appears to be out on its own, with 3,673 cases and an incidence or rate of 1,034 cases per 100,000 inhabitants – in other words, more than one person in every 100 having the virus.

It’s easy to spot Leicester on this interactive map of Covid-19 cases – it’s the red spot in the middle of England. Why is it such a hotspot? It’s an ethnically diverse town with many multi-generational households living in crowded conditions – factors associated with a high incidence but which also apply in many other places. It is also the home of a large garment manufacturing industry which has stayed at work during lockdown, with some workplaces reportedly paying little heed to the need for safety measures.

Closer to home it is clear that the cumulative number of infections is much greater – in some cases more than twice as many – than previously publicised. Here are the numbers as of 2 July for the constituent parts of East Sussex with the Pillar 1 estimates in brackets.

Hastings 126 (58)
Rother 176 (110)
Eastbourne 381 (166)
Lewes 356 (217)
Wealden 437 (234)

The incidence of the virus in Hastings, Rother and East Sussex is still comparatively low – Hastings has the seventh lowest number of cases per 100,000 of population out of 316 lower tier authorities and Rother the 16^th lowest.

Just north of Hastings and Rother, however, lies Ashford which, with 1,260 cases and a rate of 974.6, lies second only to Leicester in incidence of infection.

Among upper tier authorities East Sussex had 1,476 cases as of 2 July, giving it a rate of 266.1 which ranked it 132^nd out of 150. Kent meanwhile ranks 53rd, with 7,551 cases and a case rate of 481.4. Regionally the south-west, especially Devon, ranks low and the north-west and north-east high.

The rate at which the infection is spreading is shown in the map of Covid-19 weekly infection rate increase. In the week 25 June to 1 July, Hastings’ rate rose by 1.1 to 135.7, putting it in 210^th place out of 316, while Rother’s rate was up by 3.1 to 184, putting it in 106^th place. These are increases from a low base, so the resulting rate is still relatively low. Ashford’s weekly rate change of 18.5 to 974.6 is much higher, and leaves it in ninth place in the rankings.

Leicester was still way out in front with a rate of 141.3. There are other towns with relatively high levels of infection, particularly in Yorkshire – Bradford 45.8, Barnsley 35.1, Rochdale 35 – but none anywhere close to Leicester.

In the week ending 28 June, East Sussex had a rate increase of 4.51, putting it in 75^th place out of 350. West Sussex is 99th highest after a weekly rate increase of 2.91, while Kent’s weekly rate increase of 10 put it in 26th place.

Test-and-trace

Latest statistics on test-and-trace show that in the week to 24 June, 5,185 people tested positive for coronavirus. However, 6,183 people were referred to the contact racing system – this includes some people tested in the previous week but whose results only became available the following week.

Of these, 4,639 (75%) were reached and asked to provide details of recent close contacts. Three quarters of these – 3,497 – provided details of recent close contacts while 1,142 (24.6%) said they had had no recent close contacts.

One quarter of infected cases could not be contacted – attempts to reach 1,383 (22.4%) failed while 161 (2.6%) had provided no contact details.

A total of 23,028 were identified as close contacts of the infected cases, of whom 16,804 (73%) were reached and asked to self-isolate. The remaining 27% – 6,224 – who may have picked up the virus, continue to circulate, as do the 1,544 confirmed cases who could not be contacted.

Meanwhile on 3 July the R value – the average number of people an infected individual infects – stood unchanged at 0.7-0.9 for the UK, but slightly higher for England – 0.8-0.9. For the South East the range was 0.7-1. Elsewhere the higher end of the range was at most 1, except in London, which had a range of 0.8-1.1.

It is disappointing that R has not been reduced over time, especially as the country moves into a further phase of relaxation of the lockdown restrictions, with the likelihood of greater social activity bringing the risk of new infections. While younger people are thought most likely to be at risk of catching the virus in these circumstances, it is the older people who may catch it from them who are most at risk of being seriously affected or dying.

 

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