Covid – Past the peak?

Following a fall in the number of cases for a few days, most of the media are declaring we are past the peak.  They are probably right.

But we must remember that the peak was powered by a series of super spreader events, in particular the European cup, where people gathered in pubs and each others houses to watch the matches. These pushed the new case rate to over 60,000 per day. Cases then dropped to around 35,000, but the “Freedom day” celebrations pushed the figure back up to 48,000.

Since Freedom day we have had no other super spreader events so the new case rate is coming down.  The question is “at what level will it stabilise?” 

Deaths are not coming down yet.  We are losing around 90 people per day and the number is rising. The peak will occur in early August following the peak in cases on July 15th.

Over 800, and rising,  new covid patients are being admitted to hospitals every day. This should also peak in early August.

As for long covid,

Introduction

Long COVID, describing the long-term sequelae after SARS-CoV-2 infection, remains a poorly defined syndrome.

There is uncertainty about its predisposing factors and the extent of the resultant public health burden, with estimates of prevalence and duration varying widely.

Methods

Within rounds 3–5 of the REACT-2 study, 508,707 people in the community in England were asked about a prior history of COVID-19 and the presence and duration of 29 different symptoms.

We used uni- and multivariable models to identify predictors of persistence of symptoms (12 weeks or more). We estimated the prevalence of symptom persistence at 12 weeks, and used unsupervised learning to cluster individuals by symptoms experienced.

Results

Among the 508,707 participants, the weighted prevalence of self-reported COVID-19 was 19.2% (95% CI: 19.1,19.3). 37.7% of 76,155 symptomatic people post COVID-19 experienced at least one symptom, while 14.8% experienced three or more symptoms, lasting 12 weeks or more.

So 19.2% had symptoms for more than 12 weeks

This gives a weighted population prevalence of persistent symptoms of 5.75% (5.68, 5.81) for one and 2.22% (2.1, 2.26) for three or more symptoms.

Almost a third of people 8,771/28,713 (30.5%) with at least one symptom lasting 12 weeks or more reported having had severe COVID-19 symptoms (“significant effect on my daily life”) at the time of their illness, giving a weighted prevalence overall for this group of 1.72% (1.69,1.76).

The prevalence of persistent symptoms was higher in women than men (OR: 1.51 [1.46,1.55]) and, conditional on reporting symptoms, risk of persistent symptoms increased linearly with age by 3.5 percentage points per decade of life.

Obesity, smoking or vaping, hospitalisation , and deprivation were also associated with a higher probability of persistent symptoms, while Asian ethnicity was associated with a lower probability.

Two stable clusters were identified based on symptoms that persisted for 12 weeks or more: in the largest cluster, tiredness predominated, while in the second there was a high prevalence of respiratory and related symptoms.

Interpretation

A substantial proportion of people with symptomatic COVID-19 go on to have persistent symptoms for 12 weeks or more, which is age-dependent. Clinicians need to be aware of the differing manifestations of Long COVID which may require tailored therapeutic approaches. Managing the long-term sequelae of SARS-CoV-2 infection in the population will remain a major challenge for health services in the next stage of the pandemic.

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