CoronaWatch

Suffolk's CoronaWatch is the home of data and information produced under the Suffolk Joint Strategic Needs Assessment (JSNA). 

Please note: there are ongoing issues on the national COVID-19 data page. This will affect the data dashboard and other CoronaWatch products. We are updating when data is available.

This page will be frequently updated as we are able to analyse and publish more information. 

Unfortunately, we are unable to respond to individual requests for COVID-19 data at the moment. This is due to exceptionally large volume of requests we are receiving.  However, we will log and monitor all queries, and aim to answer them within our FAQs section as soon as we possibly can. You can submit a query via the Knowledge and Intelligence Team: knowledgeandintelligence@suffolk.gov.uk 

 


Below is a list produced by the Office for National Statistics that identifies common terms used as part of the COVID-19 response:

 

June 2020

National information

  • UK level data was released on the 12 June 2020 detailing deaths involving COVID-19 between 1 March and 30 April 2020.  This data found:
  • Deaths involving COVID-19 accounted for 25.8% of all UK deaths in March and April 2020
  • The overall Age Standardised Mortality Rate (ASMR) for deaths occurring in March and April 2020 in the UK was 1,364.9 deaths per 100,000 population.
  • This was statistically significantly higher than the five-year average rate for the same period (1,004.3 deaths per 100,000 population), and the difference is significant across both sexes. The age-specific mortality rate increased consistently with age.
  • Nationally, in all types of location, the numbers for 2020 were higher than the average, with care homes having 97.6% more deaths, home having 40.3% more deaths, hospitals having 22.9% more deaths, and those dying elsewhere having 9.1% more deaths.
  • Looking at deaths that have occurred in care homes over the period at a country level, England had the highest percentage of deaths above average, with 102.0% more deaths than the five-year average. Of these, 44.4% involved the coronavirus (COVID-19).
     

Cases in Suffolk care homes

While there is now a gradual decrease in the number of COVID-19 cases within Suffolk’s care homes and the number of associated deaths is reducing, providers are still very much in the response phase of this pandemic. Suffolk County Council remain acutely aware of the challenges still facing the care sector in relation to COVID-19 but do feel that the extensive work and support provided locally to the sector is having a positive impact. This work is ongoing. 

While the higher numbers of cases being reported in East Suffolk are, of course, of concern, it is also important to note that East Suffolk has both the largest and oldest population of the districts and boroughs within Suffolk, and also contains one of the most deprived areas. While this is in no way suggesting that higher numbers of cases are acceptable, it does perhaps suggest that there are more people at risk from COVID-19, and hence a likelihood of higher case numbers, in this area.

Outbreaks

Public Health England (PHE) data on outbreaks by setting is also available. To date in Suffolk, the settings with the highest numbers of infection outbreaks recorded by Public Health England (PHE) are care settings (residential care homes/nursing homes, extra care housing and supported housing), with care homes being the most affected.  Outbreaks in care homes are now reducing, as well as cases. An outbreak is ended 28 days after the last symptomatic case as per Public Health England care homes standard operating procedure.

It is worth noting that PHE’s method of recording care home outbreaks is cumulative. Once a care home is recorded as having had an outbreak, whether confirmed or only suspected and which may relate to only one suspected case, they are never removed from PHE’s outbreak list.  As part of gaining access to local testing arrangements in Suffolk, a very robust process was set up requiring homes to report suspected outbreaks to both Suffolk County Council and PHE simultaneously.

It may also be useful to note that in Suffolk, the care home sector generally has fewer providers with larger numbers of beds per home. In neighbouring counties, there are higher numbers of smaller homes.  This means that data for Suffolk can appear comparatively high when only the percentage of homes with outbreaks is compared, even though actual cases, rates and outbreak numbers across different areas may be similar.  Suffolk County Council have been working on developing an integrated response and to deliver “wrap around” support to care settings as required, and have been working in tandem with the care home sector.


Care home deaths

Despite care homes in Suffolk continuing to care for their residents with the utmost kindness and professionalism, data indicates a higher rate of COVID-19 related deaths within care homes in Suffolk compared to some other areas. The reasons for this are complex, but factors which we think are contributing to this include:

  • The relatively high number of nursing beds (as opposed to residential beds) that we have within care homes in Suffolk. These provide care for people with complex care needs who may be coming towards the end of their life.
  • More people choosing to, and then being supported to, die in their usual place of residence
  • The earlier and more extensive COVID-19 testing which took place in Suffolk compared to some areas, which enabled earlier, more accurate attribution of subsequent deaths to COVID-19.

The latest data indicates the rate of deaths from COVID-19 in care homes is Suffolk flattening. 

While Suffolk has a higher percentage of COVID-19 related deaths within care homes compared with some neighbouring areas, Suffolk also has a lower percentage of COVID-19 related deaths within hospitals than other areas. 

In Suffolk there are very good practices for providing end of life care. Dying within a care home setting is often reflective of a person’s wish to remain in their usual place of residence, in comfortable surroundings with people around them who are familiar, as opposed to being within a hospital setting. To help inform our understanding of this issue, which is complex and multi-factorial, SCC are currently working with CCG and primary care colleagues to audit GP records. These records relate to care home residents who have died from COVID-19, to determine whether they had end of life care plans (known locally as “yellow folders”) recording their wishes at the end of life, and whether those wishes were met.

When comparing data, it can also be helpful to compare to local authorities that are statistically similar to us: CIPFA nearest neighbours. Compared to CIPFA statistical neighbours, Suffolk is in the lower half of authorities in relation to the percentage of COVID-19 deaths in care homes for the year to date.  

Discharging from hospital

  • Over the last few months, the whole health care system in Suffolk has worked together more closely than ever before in response to the challenges presented by coronavirus.
  • One of its actions was to secure additional bed capacity at local care homes. The aim is to enable the discharge of all hospital patients who are medically fit to leave, leaving staff to focus on treating those patients who really need to be there.
  •  An extra 182 beds in care homes are now available for use, which is an increase of just under 9% of the beds that the council commissions. This has greatly strengthened the ability to cope with the extra demand. Fortunately, although demand has increased it has not been overwhelming, meaning not all the extra beds have been needed. Across Suffolk, occupation of all residential and nursing home beds stands at 82.5%.
  • As part of these beds, we have commissioned some specialist care provision for people who need admission to a care home but cannot be admitted. These step-down beds will be used where care homes cannot take in a person who is COVID-19 positive, but these individuals still need care and a period of isolation.  60 beds in three locations across Suffolk have been commissioned.

Data 

On 12 August, a new UK-wide methodology to record COVID-19 deaths was announced and the deaths data reported on the Government's Coronavirus (COVID-19) in the UK website changed as a result. This may affect reported figures and ability to compare areas or change over time. Suffolk CoronaWatch uses deaths data reported from the ONS, so the figures our local website are not affected by this change.

Local data dashboard 

View the data dashboard for Suffolk.

This includes data on: 

  • Confirmed cases of coronavirus (COVID-19)
  • Deaths from coronavirus 
  • Care home outbreaks 
  • Google social mobility data 

The data is refreshed on a daily basis. 

We would like to extend our thanks to Norfolk County Council for kindly sharing their dashboard so we could recreate this locally. If you are interested in viewing the Norfolk dashboard, you can find this on the Norfolk Insight website.  

National data dashboard information 

These links are nationally published dashboards that contain local information, and may be of use: 

 

Understanding a potential second wave of COVID-19 cases in Suffolk 

June 2020

What is a second wave of COVID-19 cases? 

Different parts of the world are experiencing different stages of the COVID-19 pandemic. Some areas, such as South America, are experiencing the first wave of cases. Other areas, such as Europe, have been through the first wave of cases and are now relaxing the lockdown measures that had been put in place to limit the spread of the virus. The relaxation of lockdown measures may result in a subsequent increase in the number of cases, known as a second wave. There could be multiple waves in the future as lockdown measures are relaxed and reinstated.  The likelihood that a second wave will occur seems high. 

Can mathematical models predict a potential second wave of COVID-19 cases in Suffolk? 

Mathematical models can accurately predict how an epidemic will play out under natural conditions when people behave as normal although as COVID-19 is a new disease, modelling has been more challenging than with a disease we are already familiar with. Because of lockdown most people are behaving differently, and this makes predicting the epidemic even more challenging. Evidence from around the world about how the disease behaves as lockdown eases is still developing.  

Many academic teams and institutions are working on the problem of modelling a second wave of COVID-19 cases, but there are not any high-quality models available to us to enable local modelling at the current time. Public Health Suffolk are liaising with Public Health England frequently about getting access to a high-quality model which can forecast a potential second wave in the future. When Public Health England are ready to recommend a suitable model, we will use this to aid our understanding of possible future outcomes in Suffolk.  

What is being done to monitor a potential second wave of COVID-19 cases in Suffolk? 

Public Health Suffolk currently have access to an earlier mathematical model created by NHS England, which forecasts the impact of lockdown measures on the COVID-19 epidemic (although it does not yet consider the impact of relaxing lockdown). We monitor the number of hospital admissions across Suffolk against the forecasts from this model; so far they suggest that the disease in Suffolk is at the level expected in an area where the population has successfully followed social distancing guidelines. We continue to monitor the real data against the NHS England model for any indication of an increase in COVID-19 related hospital admissions that may result from the relaxation of lockdown on a daily basis. 

Public Health Suffolk closely monitor COVID-19 testing, calls relating to COVID-19 to NHS 111, confirmed cases of COVID-19, hospital admissions due to COVID-19, deaths related to COVID-19 and outbreaks of the disease across Suffolk. We are monitoring both the overall numbers and the trends relating to all these indicators. We also monitor the regional R number (which reflects the rate at which the infection is spreading) which enables us to see quickly if the number of COVID-19 cases starts to increase again. Finally, we are now receiving data from Public Health England about the NHS Test and Trace scheme in Suffolk, which will help us to understand the presence of disease in the community. 

Is there evidence of a second wave in other countries? 

Some countries around the world, such as Iran, Israel and South Korea, have seen a surge in the numbers of COVID-19 cases because of relaxing lockdown measures and there is some evidence of governments reinstating lockdown measures when the number of cases start to rise. Public Health Suffolk will continue to monitor the international situation with interest. 

The following links contain information from the Office for National Statistics (ONS), Department for Work and Pensions (DWP), HMRC and other official sources.  These have all been produced by the Suffolk Office of Data and Analytics: 

Key findings have been compiled into short briefings on the following topics: 

Research Action Digest And Review

Latest RADAR 

Public Health Suffolk's weekly RADAR:

  • summarises COVID-19 related research evidence, published in the previous week, that is relevant to the Suffolk system,
  • makes recommendations for action, and
  • aims to ensure research evidence is rapidly disseminated and turned into local action.

Our approach will be to include "need to know" research and not "nice to know". We will not be including research specific to NHS healthcare as this is covered elsewhere, including nationally.

Key sources of information include (but is not limited to) the following peer reviewed journals and websites:

Each article we include has also been given a grading level based on GRADE. This is an internationally recognised grading system used by the American Medical Association/ Cochrane for consistency in grading evidence.  Articles are graded for Quality of Evidence and Strength of Recommendation.

Public Health England have just started producing a publicly available COVID-19 map that looks at neighbourhood level data on positive cases diagnosed in the last week (7 day rolling average).    

  • These neighbourhoods are technically known as Middle Super Output Areas (MSOAs).  MSOAs are a type of Census geography, and tend to have a population of between 5,000-15,000 people.  You can find more information out about MSOAs on the Office for National Statistics website. 
  • Enter your postcode to find your area, double click on the map, use the + and - buttons to zoom, or "drag and drop" to move around the map.
  • Select an MSOA (click on the area) and then click on the right arrow next to its name to see the number of cases for the period (shown in the top left hand corner) 
  • For areas such as Suffolk, the numbers of cases are low.  For data confidentiality reasons, cases are not published when they number 0,1 or 2 in a neighbourhood. This means a lot of the data on the map is shaded in grey.  
  • The shading bands are shown in the key (click on the 3 lines in the top right of the screen).
  • The data is updated on a weekly basis, and you can look at data for the whole of England. 

We are working on integrating this data with our data dashboard.

You can also find the information directly via the GOV.UK website

A COVID Symptom Study (CSS) app has been developed. Some estimates are published on maps on their website (to local authority level), and at a lower level to people who have signed up to share data on symptoms through the app. 

On 12 August, a new UK-wide methodology to record COVID-19 deaths was announced and the deaths data reported on the Government's Coronavirus (COVID-19) in the UK website changed as a result. This may affect reported figures and ability to compare areas or change over time. Suffolk CoronaWatch uses deaths data reported from the ONS, so the figures our local website are not affected by this change.

Office for National Statistics (ONS) data

Coronavirus (Covid-19) has spread across the vast majority of neighbourhoods in England and Wales. The ONS have produced an interactive map that allows you to see the number of deaths occurring in the period March to May 2020, where COVID-19 was mentioned as a cause on the death certificate. 

Public Health Suffolk are undertaking local analysis of this data.

This information is taken directly from the GOV.UK website. 
You can find a more detailed briefing on R as well as the latest data via the GOV.UK briefing on the R number and growth rate in the UK.

What is R? 

The reproduction number (R) is the average number of secondary infections produced by 1 infected person.

  • An R number of 1 means that on average every person who is infected will infect 1 other person, meaning the total number of new infections is stable.
  • If R is 2, on average, each infected person infects 2 more people.
  • If R is 0.5 then on average for each 2 infected people, there will be only 1 new infection.
  • If R is greater than 1 the epidemic is growing, if R is less than 1 the epidemic is shrinking.

R can change over time. For example, it falls when there is a reduction in the number of contacts between people, which reduces transmission.

What is a growth rate?

The growth rate reflects how quickly the number of infections are changing day by day It is an approximation of the change of number infections each day. If the growth rate is greater than zero (+ positive), then the disease will grow. If the growth rate is less than zero (- negative) then the disease will shrink.

The size of the growth rate indicates the speed of change. A growth rate of +5% will grow faster than one with a growth rate of +1%. Likewise, a disease with a growth rate of -4% will be shrinking faster than a disease with growth rate of -1%. Further technical information on growth rate can be found on Plus magazine.

How are growth rates different to R estimates?

R does not tell us how quickly an epidemic is changing. Different diseases with the same R can give epidemics that grow at very different speeds. For instance, a disease with R=2 with infection lasting years will grow much more slowly than a disease with R=2 with infection lasting days.

The growth rate provides us with information on the size and speed of change, whereas the R value only gives us information on the direction of change.

Work in Suffolk to identify vulnerable populations

Following the outbreak of Covid-19, the Suffolk Office of Data and Analytics (SODA) set out to identify which individuals and households in Suffolk may be particularly vulnerable to the impact of the Coronavirus.

A list of the clinically extremely vulnerable or ‘shielded’ residents was shared by central government. Emergency food parcels were sent out to those who indicated that they were struggling to get food supplies and support was offered through the Home But Not Alone service to those with care needs. 

In addition to residents on the shielding list, a team of analytical, data, information governance, and IT specialists was pulled together to identify other potentially vulnerable groups. A data-led exercise was conducted to identify people and households who may be particularly clinically, financially or socially vulnerable. Data from Suffolk County Council, the District and Borough Councils, and other organisations such as DWP was brought together to produce a list of individuals falling into these groups across Suffolk.

A list of the most vulnerable was produced and shared with the relevant local authorities. Each person on this list was contacted by the Home But Not Alone service in order to check their welfare and signpost to any relevant support services they may need.

The outputs of this work are sensitive and cannot be shared on the Healthy Suffolk website, however the tools below may also be of interest, and are in the public domain.

Tools that can help identify potentially vulnerable populations

In response to the COVID-19 (coronavirus) pandemic, many tools were produced nationally to help identify potentially vulnerable or high risk populations.

Can you tell me what households in my street have coronavirus?

  • Cases in Suffolk remain low, but we are continuing to monitor data on a daily basis.
  • Internally, we have access to anonymised postcode level data, that helps us to monitor cases, and enables early detection of potential increases in cases of coronavirus. This data is sensitive, and we cannot share it on the website.
  • We can share information at district and borough level through the CoronaWatch Dashboard, and Public Health England have just started producing a publicly available COVID-19 map that looks at neighbourhood level data on positive cases diagnosed in the last week (7 day rolling average).  
  • The links above are the most detailed publicly available data we can provide at this time.
     

Can you tell me if a specific care home has reported a coronavirus outbreak, or how many deaths there have been?

  • While there is now a gradual decrease in the number of COVID-19 cases within Suffolk’s care homes and the number of associated deaths is reducing, providers are still very much in the response phase of this pandemic. 
  • We are continuing to monitor data on a daily basis.
  • Internally, we have access to individual care home data, that helps us to monitor cases, and enables early detection of potential increases in cases of coronavirus. This data is sensitive, and we cannot share it on the website.
  • We can share information at district and borough level through the CoronaWatch Dashboard (this comes from the Public Health England report COVID-19: number of outbreaks in care homes – management information)
  • The links above are the most detailed publicly available data we can provide at this time.
     

What is the lowest geography I can get coronavirus case information at?

  • Public Health England have just started producing a publicly available COVID-19 map that looks at neighbourhood level data on positive cases diagnosed in the last week (7 day rolling average).    
  • These neighbourhoods are technically known as Middle Super Output Areas (MSOAs).  MSOAs are a type of Census geography, and tend to have a population of between 5,000-15,000 people.  You can find more information out about MSOAs on the Office for National Statistics website. 
  • For areas such as Suffolk, the numbers of cases are low.  For data confidentiality reasons, cases are not published when they number 0,1 or 2 in a neighbourhood. This means a lot of the data on the map is shaded in grey.  
  • The data is updated on a weekly basis, and you can look at data for the whole of England. 
     

What is the Suffolk mortality rate from COVID-19, can we divide the number of deaths directly into the number of cases?

  • This question is simple, but difficult to answer.
  • The case fatality rate is the number of confirmed deaths divided by the number of confirmed cases.
  • We cannot simply divide the number of deaths in Suffolk by the number of confirmed cases.
  • This not accurate because it relies on every case of COVID-19 being identified through testing. Evidence suggests that many cases of COVID-19 are not identified as at the start of the pandemic the availability of testing was limited, and quite a high proportion of people with COVID-19 are asymptomatic, and may therefore not know they need a test.
  • When there are people who have the disease but are not diagnosed, the case fatality rate will overestimate the true risk of death. With COVID-19, we think there are many undiagnosed people.
     

What is the infection mortality rate for Suffolk?

  • To more accurately estimate mortality from COVID-19 in Suffolk we need to calculate the infection fatality rate, which is the number of deaths from a disease divided by the total number of cases.
  • For example, if 10 people die from a disease, and 500 actually have it, then the infection fatality rate is 10 / 500 = 2%. The problem is that we don’t know how many people have had COVID-19 because not everyone has been tested.
  • Some estimates have been suggested for the proportion of people who have had COVID-19 and while these are not specific to Suffolk, we can use them to estimate the infection fatality rates.
  • One research group has estimated that 443,000 people in East of England have been infected with COVID-19.
  • Assuming that the rate of COVID-19 infection is the same across all counties within East of England, this would suggest around 53,780 people in Suffolk have had COVID-19. Using these figures we can estimate that the infection fatality rate is 558 / 53,780 = 1.04% i.e. 1 in 100 people with confirmed COVID-19 have died in Suffolk.
  • Note that even this is an estimate, and certain groups of people have higher risk of dying from COVID-19, so the risk of death varies depending on characteristics such as age, gender, ethnicity and underlying health conditions.
     

What proportion of people with COVID-19 end up in hospital and intensive care?

  • Preliminary data from the EU/EEA (from the countries with available data) show that around 20-30% of diagnosed COVID-19 cases are hospitalised and 4% have severe illness. Hospitalisation rates are higher for those aged 60 years and above, and for those with other underlying health conditions.
  • The World Health Organisation reported in March 2020 that around 1 in every 5 people who are infected with COVID-19 develop difficulty in breathing and require hospital care.
  • You may also find this paper from Imperial College London of interest.
     

How does UK mortality compare with other countries?

  • This information is taken directly from the June 2020 Office for National Statistics publication: Comparisons of all-cause mortality between European countries and regions: January to June 2020. This article looks at all-cause mortality as a comparable international indicator of the impact of the coronavirus (COVID-19) pandemic and does not specifically analyse deaths involving COVID-19; deaths are shown for the UK countries by date of registration.
    • There has been considerable interest in international comparisons of mortality during the coronavirus (COVID-19) pandemic.
    • The best way of comparing the mortality impact internationally is by looking at all-cause mortality rates by local area, region and country compared with the five-year average.
    • All-cause mortality avoids the problem of different countries recording COVID-19 deaths in different ways, and also takes into account the indirect impact of the pandemic, such as deaths from other causes that might be related to delayed access to healthcare.
    • The ONS found that whilst England did not have the highest peak mortality, it did have the longest continuous period of excess mortality of any country compared, resulting in England having the highest levels of excess mortality in Europe for the period as a whole.
    • The ONS have produced an interactive animation that allows comparison of Suffolk to other European areas.
       

Is the rate of COVID-19 higher in Suffolk compared to nationally?

  • Cumulative case rate data for COVID-19 can give an indication of how many cases there are in Suffolk compared to other areas. Based on data from August 2020 Suffolk has a statistically significantly lower rate of COVID-19 per 100,000 population compared to regional and national rates.
  • It is important to note that this is a crude rate, and whilst crude rates are more useful for comparisons than the raw case numbers, they do not take into account other factors that may affect the numbers of cases, such as the age of the population or the amount of testing carried out.​
     

What data do you have on ethnicity and COVID-19?

  • While some ethnicity data is shared with us, in the data we have received so far (at July 2020), the ethnicity of the patient has only been recorded for 8% of the confirmed cases of COVID 19 in Suffolk.
  • Therefore, this data is not robust enough to allow us to draw any firm conclusions.
  • We are exploring ways of obtaining better quality data in this regard, working with local health partners, which we hope will help to inform our work in the future, but are still working through both the analytical and information governance issues relating to this.