Currently as many as one in 100 people are infected with Covid-19 in north-west England, but there are signs that the rise in infections is now slowing, an interim report from a large testing programme in the community suggests.
Even in the least-affected regions, approximately one in 400 people are carrying the virus, after a fourfold increase in infections since late August to early September. However, the R value – the average number of people an infected person infects – appears to have fallen and now stands at around 1.1, indicating that social distancing measures introduced last month are beginning to have an effect.
The latest round of testing by the Imperial College React-1 study analysed swabs from more than 80,000 people out of a total of 150,000 taken between 18 and 26 September and found infections had risen substantially across all age groups and regions.
Timeline What the UK government said on Covid testing
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1 September 2020
Boris Johnson
“Not only are we getting the pandemic under control, with deaths down and hospital admissions way, way down, but we will continue to tackle it, with local lockdowns and with our superlative test-and-trace system.”
9 September 2020
Boris Johnson
“NHS Test and Trace is doing a heroic job, and today most people get an in-person test result within 24 hours, and the median journey is under 10 miles if someone has to take a journey to get one … [To Keir Starmer] We make the tough calls – all he does is sit on the sidelines and carp.”
9 September 2020
Boris Johnson
[On the ‘moonshot’ proposal for mass, near-instant testing:] “We are hopeful this approach will be widespread by the spring and, if everything comes together, it may be possible even for challenging sectors like theatres to have life much closer to normal before Christmas.”
16 September 2020
Boris Johnson
“We don’t have enough testing capacity now because, in an ideal world, I would like to test absolutely everybody that wants a test immediately … Yes, there’s a long way to go, and we will work night and day to ensure that we get there.”
17 September 2020
Matt Hancock
“Of course there is a challenge in testing … We have sent tests to all schools to make sure that they have tests available. But of course I also recognise the challenges in getting hold of tests … Tests are available, even though it is a challenge to get hold of them.”
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Based on the swabs, the researchers estimate that more than one in 200 people across England now have Covid-19 – 0.55% of the population, up from 0.13% in the previous round of testing.
However, “it’s as high as approximately one in 100 in the north-west and then it doesn’t go any lower than one in 400 in any region,” said Steven Riley, the study’s author and a professor of infectious diseases at Imperial.
The proportion of infected people is the highest the study has recorded, with new cases in the over-65s rising sevenfold. A similar increase was seen in the 55-64 age range. Young people continued to have the most infections, with about 1% estimated to be infected.
“This reinforces the need for protective measures to limit the spread of the disease and the public’s adherence to these, which will be vital to minimise further significant illness and loss of life from Covid-19,” said Prof Paul Elliott, the director of the React study. “It’s a really critical period, and we really need to get on top of this now.”
The study found that the R value of the epidemic had fallen from 1.7 to 1.1, although Elliott stressed there was a large error margin around the figure. This suggests the rate of new infections has decreased, but with an R just above one, infections would continue to rise.
“It is not a flattening of the curve,” Riley emphasised. “To use one of the prime minister’s metaphors, if this epidemic is walking up and down a hill then what the study shows is that [from late August to the current period] it was a steep hill, and we have climbed quite a high way up. The preliminary evidence is that the gradient of the hill has definitely come down a bit, but we do not know that it’s flat and we do not know that we’ve reached the summit.”
However, it does suggest that some of the measures that have been put in place to slow the transmission of the virus are working. “The combination of measures may well have slowed the rate of rise, and that’s the first step in getting the virus down, which is what we’ve got to do,” said Elliott.
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Boris Johnson warns of ‘further measures’ if Covid pandemic worsens – video
The React-1 study tracks Covid-19 in the community by analysing nose and throat swabs from more than 150,000 randomly selected people every month over a two-week period. Of 84,610 swabs analysed in the latest round of testing, 363 tested positive. Extrapolated to the whole population, this suggests 411,000 people have the virus.
The latest data, reported in a preprint that has yet to be peer-reviewed, showed that infection was most common in 18- to 24-year-olds, with 0.96% infected. In those aged 65 and above, prevalence increased sevenfold, from 0.04% in the last report to 0.29%.
Levels of infection are rising in across the country, with the north-west being hardest hit. Cases have also increased substantially in London, rising fivefold from 0.10% to 0.49%.
As seen in the last report from React-1, black and Asian people were found to be twice as likely to be infected compared with white people.
“These findings highlight that the situation in England is fast-moving, and demonstrate the need for continued engagement from the public to prevent unnecessary hospitalisations and deaths,” saidRiley.
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