HomeMy WebLinkAbout2.8.22 FW_ Covid-19 The Final Nail in the Vaccine Coffin
From:Clerk of the Board
To:Pickett, Andy; Ring, Brian; Alpert, Bruce; Reaster, Kayla; Valencia, Shyanne
Subject:FW: Covid-19 The Final Nail in the Vaccine Coffin
Date:Tuesday, February 8, 2022 7:39:19 AM
Attachments:22-01-19-covid19-winter_publication_report.pdf
This was sent to the full Board
Shaina Paulsen
Associate Clerk of The Board
Butte County Administration
25 County Center Drive, Suite 200, Oroville, CA 95965
T: 530.552.3304 | F: 530.538.7120
From: lance dreiss <lancedreiss@att.net>
Sent: Monday, February 7, 2022 7:55 PM
To: Connelly, Bill <BConnelly@buttecounty.net>; Lucero, Debra <DLucero@buttecounty.net>; Kimmelshue, Tod <TKimmelshue@buttecounty.net>; Ritter, Tami
<TRitter@buttecounty.net>; District Attorney <District_Attorney@buttecounty.net>; Waugh, Melanie <mwaugh@buttecounty.net>; Teeter, Doug
<DTeeter@buttecounty.net>; Clerk of the Board <clerkoftheboard@buttecounty.net>
Subject: Covid-19 The Final Nail in the Vaccine Coffin
.ATTENTION: This message originated from outside Butte County. Please exercise judgment before opening attachments, clicking on links, or replying..
Board of Supervisors, Clerk of the Board, Public Record, Sheriff Honea, DA Ramsey:
“The Covid-19 vaccines are officially dead. It’s over folks. Anyone who’s still promoting these products should be considered a danger to public health. The
data now shows that COVID vaccinated people have a 300% increased risk of COVID-19 infection as of January 2022. These experimental gene therapy
“vaccines” are doomed. Every COVID vaccinated person in the world just got hit in the stomach by this undeniable fact: It was all a complete waste. These
products have done absolutely nothing except harm your health. Learn this tough lesson and move on. Never trust these vaccine salesmen ever again!”
Stop ALL “vaccines” in Butte County.
Thanks,
Diana Dreiss
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Public Health Scotland
COVID-19 & Winter
Statistical Report
As at 17 January 2022
Publication date: 19 January 2022
Contents
Introduction ............................................................................................................................4
Main Points ............................................................................................................................6
Incidence of Variants of Concern and Variants Under Investigation ..................................7
COVID-19 Daily Data .........................................................................................................8
Lateral Flow Device Testing ............................................................................................. 12
-19 ................................................................... 17
Test and Protect ............................................................................................................... 22
COVID-19 Vaccine ........................................................................................................... 30
COVID-19 Vaccination Uptake ......................................................................................... 31
COVID-19 Vaccine Wastage ............................................................................................ 32
COVID-19 Vaccine Certification ....................................................................................... 33
COVID-19 Cases, Hospitalisations, and Deaths by Vaccine Status ................................ 34
Hospital/ Wider System Pressures ................................................................................... 52
Unscheduled Care ........................................................................................................... 52
Waiting Times .................................................................................................................. 55
Delayed Discharges ......................................................................................................... 56
Wider Impact of COVID-19 .................................................................................................. 57
Contact ................................................................................................................................ 58
Further Information .............................................................................................................. 58
Open Data ........................................................................................................................... 58
Rate this publication ............................................................................................................ 58
Early access details ............................................................................................................. 58
Appendices .......................................................................................................................... 59
Appendix 1: Background information ............................................................................... 59
Appendix 2: World Health Organisation (WHO): Contact tracing in the context of COVID-
19 ..................................................................................................................................... 59
Appendix 3: Hospital Admissions Notes ........................................................................... 60
Appendix 4: Contact Tracing ............................................................................................ 60
Appendix 5: Lateral Flow Device Testing ......................................................................... 61
Appendix 6: Data Sources and Limitations ...................................................................... 62
-19 ............................................... 64
2
This is a Management Information publication
Published management information are non-official statistics. They may not comply with the
Practice with regard to high data quality or high public
value but there is a public interest or a specific interest by a specialist user group in
accessing these statistics as there are no associated official statistics available.
Users should therefore be aware of the aspects of data quality and caveats surrounding
these data, all of which are listed in this document. Therefore, the data presented are
subject to change.
3
Introduction
Since the start of the Coronavirus-19 (COVID-19) outbreak Public Health Scotland (PHS)
has been working closely with Scottish Government and health and care colleagues in
supporting the surveillance and monitoring of COVID-19 amongst the population.
As part of our continuous review of reporting, as of 08 December 2021 Public Health
Scotland has implemented changes to the COVID-19 Weekly Report to support the reader
in drawing insights from a wider range of existing metrics around COVID-19 and winter
pressures.
Caution should be used when making comparisons between metrics; each metric is
calculated independently and may cover different time periods or cohorts of the population.
The consolidated report will include the following content weekly:
COVID-19
Summary of tests and cases
Contact Tracing
Hospital and ICU admissions
Testing in care homes
COVID-19 vaccination status cases, hospitalisations and deaths
Covid-19 vaccination uptake summary
Adhoc reporting on topics such as: Covid-19 and Vaccination in pregnancy, Equality
reporting etc.
Hospital/ Wider System Pressures
Unscheduled Care
Waiting Times
Delayed Discharges
Additional charts for a number of variables related to COVID-19 service use in the NHS,
including some metrics previously presented in the weekly COVID-19 report, are available
to view in our interactive dashboard. These include breakdowns by age, sex and
deprivation. The variables currently available on the dashboard include:
Positive cases per day and cumulative total
COVID-19 hospital admissions
COVID-19 patients admitted to ICU admissions
COVID-19 related contacts to NHS24 and the Coronavirus Helpline
Community Hubs and Assessment Centres
Scottish Ambulance Service incidents
Contact tracing
Health care workers
Care homes
Targeted community testing
Travel outside of Scotland
Quarantine Statistics
NHS Protect Scotland App
Lateral Flow Device (LFD) Testing
4
The Public Health Scotland COVID-19 Daily Dashboard publishes daily updates on the
number of positive cases of COVID-19 in Scotland, with charts showing the trend since the
start of the outbreak. From 26 February 2021 the Daily Dashboard also includes daily
updates on vaccinations for COVID-19 in Scotland.
There is a large amount of data being regularly published regarding COVID-19 (for
example, Coronavirus in Scotland Scottish Government and Deaths involving coronavirus
in Scotland National Records of Scotland). This report complements the range of existing
data currently available.
5
Main Points
As at 16 January 2022, there have been 1,097,158 confirmed COVID-19 cases by
PCR (polymerase chain reaction) only; 27,944 of these were recorded in the most
recent week, a decrease of 65.2% from the previous week
There has been a 7.1% increase in the number of Lateral Flow Device (LFD)
asymptomatic tests carried out in the last week. There have been 20,098,516 LFD
tests carried out in Scotland since 19 November 2020, of which 222,827 were
positive (1.1%)
In the last week from 08 January to 14 January 2022, in an age-standardised
population, the rate of acute COVID-19 related hospital admissions in individuals that
received a booster or third dose of a COVID-19 vaccine was between 2.3 to 3.9
times lower than in individuals who are unvaccinated or have only received one or
two doses of a COVID-19 vaccine
In the week ending 09 January 2022, 87,243 individuals were recorded in the contact
tracing software, from which 53,517 unique contacts have been traced
In the week ending 11 January 2022, there were 1,040 admissions to hospital with a
laboratory confirmed test of COVID-19, a decrease of 4% from the previous week.
The highest number of new admissions are now in those aged 80+
The proportion of all people who were admitted to hospital within 14 days of a
laboratory confirmed COVID-19 positive test has declined, from 12% in the week
ending 31 January 2021, to 1% in the most recent week ending 02 January 2022
In the week ending 16 January 2022 there were 31 new admissions to Intensive
Care Units (ICUs) with a laboratory confirmed test of COVID-19. This is a decrease
of 46.3% from the week ending 09 January 2022
6
Incidence of Variants of Concern and Variants Under Investigation
The Omicron variant was originally detected in South Africa and now represents the
dominant variant in Scotland.
Further information on previous Omicron reporting can be found here.
Public Health Scotland (PHS) continues to monitor COVID-19 Variants of Concern, in
collaboration with other Public Health Agencies in the UK.
The latest information on the number of such variants detected by genomic analyses across
the UK is published by UK Health Security Agency (UKHSA).
7
COVID-19 Daily Data
The Public Health Scotland COVID-19 Daily Dashboard publishes daily updates (5-days per
week, Monday to Friday) on the number of positive cases of COVID-19 in Scotland, with
charts showing the trend since the start of the outbreak.
The total number of people within Scotland who have, or have had COVID-19, since the
coronavirus outbreak began is unknown. The number of confirmed cases is likely to be an
underestimate of the total number who have, or have had, COVID-19. A person can have
multiple tests but will only ever be counted once. The drop in the number of confirmed
cases at weekends likely reflects that laboratories are doing fewer tests at the weekend.
On 05 January 2022, the Scottish Government announced that asymptomatic people who
return a positive lateral flow test (LFT) will no longer have to confirm their positive result
with a PCR test.
There have been 1,097,158 people in Scotland who have tested positive with a PCR
test, at any site in Scotland (NHS and UK Government Regional Testing centres), for
COVID-19 up to 16 January 2022
In the week ending 16 January 2022 there were 27,944 confirmed COVID-19 cases,
1
with a seven-day rolling average of 3,992 cases based on PCR test results only.
From 06 January 2022 to 16 January 2022 there have been 123,573 people in Scotland
2
who have tested positive for COVID-19 on either a PCR or LFD test.
Figure 1: Number of positive PCR cases per day with 7 day average
1.Correct as at 17 JanuaryCOVID-
19 Daily Dashboard
.
8
Figure 2: Number of positive cases by test type per day, 06 January 2022 to 16
January 2022*
e PCR result
*
within 48 hours will be excluded. Cases will only be counted once. The data may be subject to future revision as the new method for
counting combined PCR and LFD tests evolves.
9
PCR Cases
Figure 3 below shows the proportion of confirmed PCR COVID-19 cases by age group for
the most recent three weeks.
Figure 3: Proportion of confirmed PCR COVID-19 cases by age group, weeks ending
02 January 2022 16 January 2022
The daily dashboard also includes data on Hospital Admissions and ICU admissions for
patients with COVID-19:
In the week ending 11 January 2022, there were 1,040 admissions to hospital with a
laboratory confirmed test of COVID-19.
In the week ending 16 January 2022 there were 31 new admissions to Intensive Care
Units (ICUs) for confirmed COVID-19 patients.
The number of confirmed daily PCR COVID-19 cases decreased from 17,855 to 6,405
between 04 January 2022 and 10 January 2022. During this same time period, the daily
COVID-19 confirmed hospital admissions has decreased from 164 to 152 (seven-day rolling
average). The seven-day average of inpatients in hospital has increased by 43.0% (from
912 to 1,304).
10
Figure 4: Number of PCR Positive Cases, Admissions and Inpatients, as at 10
2
January 2022
2. Please refer to Appendix 3 - Hospital Admissions Notes for definitions of hospital admissions and inpatients.
Additional charts and data are available to view in the interactive dashboard accompanying
this report.
Data is also monitored and published daily on the Scottish Government Coronavirus
website.
11
Lateral Flow Device Testing
Across Scotland, there are numerous testing pathways being rolled out using Lateral Flow
Devices (LFD) - a clinically validated swab antigen test taken that does not require a
laboratory for processing. This test can produce rapid results within 45 minutes at the
location of the test.
Some of the areas using LFD tests are: schools, health and social care workers, care
homes and more. Public Health Scotland has collected the information on the number of
LFD tests carried out across Scotland and will now publish this information weekly. This
section is the totality of LFD across Scotland and across strategies. Sections focussing in
on specific topics such as Schools, Higher Education and Community testing can be found
later in the report.
On 05 January 2022, the Scottish Government announced that people who do not have
symptoms will no longer be asked to take a polymerase chain reaction (PCR) test to
confirm a positive Lateral Flow Device (LFD) result. Instead, anyone with a positive LFD,
who does not have symptoms, should report the result online as soon as the test is done. In
order to ensure that we continue to provide the most accurate information, changes have
been made to the national COVID-19 case definition to reflect this revised testing strategy.
Since 19 November 2020, there have been 20,098,516 LFD tests carried out in Scotland, of
which 222,827 were positive (1.1%). Figure 5 below shows the weekly trend of tests carried
out from week ending 29 November 2020 to 16 January 2022.
There has been a 7.1% increase in the number of tests carried out from the week ending 09
January 2022 to the week ending 16 January 2022. Table 1 shows the number of LFD tests
carried out in Scotland by testing group.
More detailed information can be found within the LFD section on our interactive
dashboard.
For additional details on Lateral Flow Device Tests, please see - Appendix 5 Lateral Flow
Device Testing
Figure 5: Trend of LFD tests carried out in Scotland from 29 November 2020 to 16 Jan
2022
12
10
Table 1: Number of LFD tests by Test group19 November 2020 16 January 2022
Number of
Test Number of % LFT
Test Reason positive
Group tests positive
tests
Care Care Home - Visiting
62,456 143 0.2%
Home Professional
Testing
Care Home - Visitor
8,33,805 1,021 0.1%
Care Home Staff
1,941,376 3,549 0.2%
Community Community Testing
105,058 954 0.9%
Testing
Education Combined School Staff
59,443 219 0.4%
Testing
ELC Staff
343,005 2,303 0.7%
Primary School Staff
1,615,349 7,123 0.4%
Secondary School Pupils
1,006,617 11,643 1.2%
Secondary School Staff
916,721 3,832 0.4%
University Staff
13,525 138 1%
University Students
52,266 626 1.2%
University Testing Site
97,175 387 0.4%
Healthcare Healthcare Worker
3,138,950 10,309 0.3%
Testing
Primary Care And
2,38,283 747 0.3%
Independent Contractors
Social Children, Young People
1,042 0 0%
Care and Mental Health
Testing
NSS Portal Social Care
773,941 2,318 0.3%
Residential Homes
16,441 47 0.3%
Support Services
39,117 554 1.4%
Universal Attend An Event
922,266 3,677 0.4%
Offer
High Cases In Local Area
667,822 16,026 2.4%
Lives With Someone
84,512 1,975 2.3%
Who Is Shielding
Travel Within UK
249,454 1,676 0.7%
Universal Offer
3,505,378 105,403 3%
Workplace Private Sector
28,395 135 0.5%
Testing
Public Sector
80,404 369 0.5%
Quarantine Hotel
5,339 151 2.8%
Staff/Security Personnel
Third Sector
4,406 28 0.6%
UK Gov Other
2,522,164 36,194 1.4%
Other Other
773,806 11,280 1.5%
Total Total
20,098,516 222,827 1.1%
Data extracted: 17 January 2022
Please note some of the data is suppressed due to disclosure methodology being applied to protect staff confidentiality.
13
COVID-19 Hospital Admissions
-19
Since the start of the pandemic Public Health Scotland have been reporting on the number
of people in acute hospitals with recently confirmed COVID-19. These admissions are
identified from Rapid and Preliminary Inpatient Data (RAPID) and defined as the following:
is after their date of discharge from hospital, they are not included in the analysis.
It is important to note, that the figures presented below may include patients being admitted
and treated in hospital for reasons other than COVID-19. Supplementary analysis on
COVID-19 related acute hospital admissions by vaccine status is also available within the
COVID-19 cases, acute hospitalisations, and deaths by vaccine status section of this report.
Figure 6 below shows the weekly trend of hospital admissions with COVID-19 from week
ending 05 January 2021 to 11 January 2022.
Figure 6-19 in Scotland
14
Table 2 below shows a breakdown of people admitted to hospital across all ages and by
age group for the most recent four weeks. Data from March 2021 is available on the Covid
Statistical Report website.
3
Table 2: COVID-19 hospital admissions by age as at 11 January 2022
Age 15 December 22 December 29 December 05 January
Band 21 December 28 December 04 January 11 January
58 77 119 115
Under 18
21 62 76 88
18-29
53 69 85 100
30-39
60 69 87 93
40-49
46 50 53 71
50-54
50 54 66 62
55-59
44 32 85 67
60-64
32 39 75 77
65-69
36 60 75 94
70-74
47 46 94 88
75-79
104 182 271 185
80+
551 740 1,086 1,040
Total
Source: RAPID (Rapid and Preliminary Inpatient Data)
3. Please refer to Appendix 3 Hospital Admissions Notes for explanatory notes regarding RAPID Hospital Admissions.
In the latest week, there has been a 4% decrease in the number of new admissions
compared to the previous week, with those aged 80+ years having the highest number of
admissions. Also, in the latest week approximately 49% of the hospital admissions related
to patients aged 60+.
In recent months, the proportion of all people who were admitted to hospital within 14 days
of a laboratory confirmed COVID-19 positive test has also declined, from 12% in the week
ending 31 January 2021 to 1% in the most recent week ending 02 January 2022 (Figure 7).
15
Figure 7: Proportion of weekly cases admitted to hospital within 14 days of a first
positive test
16
-19
On 07 January 2022, Public Health Scotland published an initial review of clinical audit data
on the causes of hospital admission for people with a recent COVID-19 diagnosis. At that
time, partial data were available from 2 NHS Boards, Grampian and Greater Glasgow and
Clyde. This interim report provides the complete set of data for these two Boards, and also
provides additional data from a third NHS Board, Dumfries and Galloway.
A final report containing data from at least one and possibly two additional Boards
will be published on 26 January 2022.
As previously noted, not all people hospitalised with a recent COVID-19 diagnosis will be
admitted because of their infection. However, knowing the proportion of people who are in
hospital because of their infection, as opposed to coincidental with it, can help signal
whether population-level changes in public health measures may be warranted, such as a
tightening or easing of restrictions. It can also help us to predict whether we are likely to see
future pressures on hospital systems based on recent patterns of COVID-19 infections in
the surrounding community. This information does not detract from the fact that regardless
of the cause of admission, any person in hospital with a recent COVID-19 diagnosis
requires appropriate management of their infection.
Public Health Scotland last published an analysis of the proportion of people in hospital
-19 infection on 01 December 2021. That analysis covered the
period of March - August 2021. To ascertain the primary reason for admission in the
previous analysis, patient discharge data from the national Scottish Morbidity Records
(SMR01 - acute inpatient and day case activity) dataset for six Boards were analysed.
Findings from the report concluded that, at a time when the Delta variant of COVID-19 was
responsible for nearly all circulating infections in Scotland, 68% of patients were in hospital
-19 infection.
In light of the recent rapid increase in Covid-19 case numbers in Scotland - of which more
than 90% are now estimated to be the new Omicron variant - it is important to update this
analysis. However, a limitation of the previously-published approach is that there is typically
a two to three-month lag in receiving SMR01 discharge summaries from NHS boards. A
different approach, such as one that uses clinical auditing of hospital admission records to
monitor the distbecause ofwith
COVID-19, offers an opportunity for a timelier understanding of the characteristics of people
in hospital with a recent COVID-19 diagnosis.
In accordance with the Caldicott confidentiality and data sharing agreement, Public Health
Scotland and NHS Greater Glasgow and Clyde conducted a clinical audit of case notes of
people admitted with a recent COVID-19 diagnosis at acute care hospitals during the first
four days of January 2022. NHS Dumfries and Galloway and NHS Grampian carried out a
similar review using daily admission data routinely provide by acute care hospitals in the
region over a longer period, between 30 December 2021 and 9 January for NHS Dumfries
and Galloway and 11 January 2022 for NHS Grampian.
The primary outcome of interest in this current investigation was whether a person was
-19 diagnosis of a
community-acquired infection. People admitted to hospital were included in the
investigation if they had a COVID-19 PCR confirmed diagnosis within 14 days prior to or in
17
the 48 hours following their admission date. Admissions that were either confirmed or
-19 include those who met a clinical definition or who were
admitted onto a COVID-19 ward, where available. Nosocomial infections, defined as a
positive PCR after the 48 hours following admission, or those infections with an unknown
PCR specimen date, were excluded from the analysis. A more detailed description of
methods and definitions are provided in Appendix 7.
Among the 396 hospital admissions records with a recent COVID-19 diagnosis, 70%
(n=279) were admitted because of or with community acquired COVID-19 infection.
During the investigation, there were on average 1.7 admissions per day in NHS Dumfries
and Galloway, 8 in NHS Grampian and 31.2 in NHS Greater Glasgow and Clyde with a
recent community acquired COVID-19 infection. The remaining 30% (n=117) admissions
had either a definite or possible hospital onset (n=66) or a yet unknown or indeterminate
onset date (n=51) and were excluded.
Numbers of hospital admissions because of or with COVID-19 (n=279)
Table 3 shows that across the 3 NHS Boards, 63% (n=175 of 279) of acute hospital
-19 as opposed to c
COVID--19 is lower than the previously
reported value of 68% based on SMR01 discharge summaries from six NHS Boards from
between March and August 2021.
Proportions in hospital because of
Dumfries and Galloway and Greater Glasgow and Clyde Boards, at 57% (17 of 30) and
54% (56 of 103) respectively. In Grampian, the proportion in hospital because of COVID-19
was markedly higher, at 70% (102 of 146).
Table 3: Number and proportion of hospital admissions within 14 days of a positive
community-acquired COVID--19,
selected NHS Boards, December 2021-January 2022*
Hospital Hospital
admissions admissions
Total
NHS Board
* Covid
Number (%) Number (%) Number (%)
Dumfries and Galloway 17 (57%) 13 (43%) 30 (100%)
Grampian 102 (70%) 44 (33%) 146 (100%)
Greater Glasgow and Clyde 56 (54%) 47 (46%) 103 (100%)
Total 175 (63%) 104 (37%) 279 (100%)
-19 includes probable and confirmed outcomes. Reporting dates as follows: NHS Board
Dumfries and Galloway between 30 December 2021 and 9 January 2022, NHS Board Greater Glasgow and Clyde between 1 and 4
January 2022, NHS Board Grampian between 30 December 2021 and 11 January 2022.
-19
-
COVID-19, who were between the ages of 19 and 44 years.
18
Figure 8 shows a marked difference in the age profile of amongst people in hospital
--19. People aged 65 and older account
for 42% of all hospital admissions for COVID-
COVID-19 diagnosis. People aged 80 years and older were more than twice as likely to be
in hospital because of their COVID-19 diagnosis as compared to those recently diagnosed
with COVID-19 but in hospital for a difference cause (21% versus 9%).
Figure 8: Proportion of community-acquired hospital admissions within 14 days of a
positive COVID--19 (n=101) by age group*,
selected NHS Boards, December 2021-January 2022*
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* Age unknown for 5 people;
-19 includes probable and confirmed outcomes. Reporting dates as follows: NHS Board
Dumfries and Galloway between 30 December 2021 and 9 January 2022, NHS Board Greater Glasgow and Clyde between 1 and 4
January 2022, NHS Board Grampian between 30 December 2021 and 11 January 2022.
.
Equal proportions of people in hospital because of-with COVID-19 were
fully vaccinated (Figure 9), defined as having a third dose or booster shot, although the
similarity in this distribution across these two groups may be confounded by differences in
the age and access to a third dose or booster.
19
Figure 9: Proportion of community-acquired hospital admissions within 14 days of a
positive COVID--19 (n=101) by vaccine
status*, selected NHS Boards, December 2021 - January 2022*
-19 includes probable and confirmed outcomes. Reporting dates as follows: NHS Board
Dumfries and Galloway between 30 December 2021 and 9 January 2022, NHS Board Greater Glasgow and Clyde between 1 and 4
January 2022, NHS Board Grampian between 30 December 2021 and 11 January 2022.
SARS-CoV-
COVID-19 (n=165)
S-gene target failure, a proxy for Omicron, and allele specific PCR results capable of
identifying a sample as Omicron or Delta, were available for 60% (165 of 279) of people
admitted to hospital with a community acquired COVID-19 infection (Table 4).
Table 4: Number of hospital admissions within 14 days of a positive community-
acquired COVID--19 by COVID-19 variant
(n=165), selected NHS Boards, December 2021- January 2022*
Hospital Hospital
admission admission
'because coincidental
COVID-19 of' COVID-'with'
NHS Boardvariant* 19** COVID-19 Total
Delta 2 1 3
Dumfries and Galloway
Omicron 9 6 15
Total 11 7 18
Delta 31 23 54
Grampian
Omicron 23 7 30
Total 54 30 84
Greater Glasgow and
Delta 7 4 11
Clyde
Omicron 23 29 52
Total 30 33 63
Overall Delta 40 28 68
Omicron 55 42 97
Total 95 70 165
* S gene target failure or Allele Specific PCR outcome used to identify the Delta or Omicron variant. Variant type was unknown as yet or
not possible to ascertain for 114 people;
-19 includes probable and confirmed outcomes. Reporting dates as follows: NHS Board
20
Dumfries and Galloway between 30 December 2021 and 9 January 2022, NHS Board Greater Glasgow and Clyde between 1 and 4
January 2022, NHS Board Grampian between 30 December 2021 and 11 January 2022.
Among those admissions with a known variant status, 83% (67 of 81) of people were
infected with Omicron in NHS Dumfries and Galloway and NHS Greater Glasgow and
Clyde. This is compared to just 36% (30 of 84) of cases in hospital in NHS Grampian. It is
likely that the lower proportion of Omicron admissions in NHS Grampian reflects the
differing pace of transmission of the new variant across Scotland. By 12 December 2021,
more than half of all people testing at Pillar 2 UK Gov labs in the Greater Glasgow and
Clyde region and surrounding areas were likely infected by the Omicron variant, whilst in
proportion Omicron variant rose from 48% over the first 7 days to 67% across the last 6
days of the investigation.
Available data also show that similar proportions of people with Omicron and Delta were
respectively). Across the three NHS Boards, a higher proportions of admissions due to
Omicron were observed in NHS Dumfries and Galloway and NHS Greater Glasgow and
Clyde, whereas the opposite was observed in Grampian. The latter likely reflects the small
but growing proportion of Omicron cases in NHS Grampian hospitals.
Although this most recent update to the 12 January report offers new data on Omicron
status and additional data from NHS Board Dumfries and Galloway, it should be noted that
this investigation was initially conducted during a period of public holidays during which
interruption to the supply of laboratory results on Allele Specific Primer and Whole Genomic
Sequencing were observed. Testing was also conducted primarily in hospitals, which do not
have access to testing platforms that allow for a proxy report of the Omicron or Delta variant
using S gene status. This explains the high proportion of admissions for which no
immediate assignation of variant type could be made, and unfortunately, limits the
conclusions that can be drawn on questions related to variant status.
Whilst clinical case audit reviews provide high-quality, near real-time results, there are other
limitations that must be considered when interpreting these findings. Because this method
takes a cross-sectional approach to determine whether a
COVID--19, it may miss people who may have initially been
-19 but who later go on to develop more severe COVID-19-related
symptoms during their stay. Conversely, it may also disproportionately capture more severe
infections since people with severe infections may stay in hospital longer. Other limitations
of this approach, including the substantial time and human resources required to review
cases and the challenges of generalising these results beyond these three Boards, are
described in Appendix 7.
Public Health Scotland will continue to work with NHS Health Boards to describe the
-19 using appropriate methods
to inform and improve the public health response in Scotland. A final update to the clinical
audit work will be published as part of the Public Health Scotland Weekly Report on 26
January 2022.
21
Test and Protect
reflect changing circumstances, variability in cases, and increasing proportion of the
population fully vaccinated since the roll out of the vaccination programme. The most recent
Strategic Framework issued by the Scottish Government in November 2021 sets out how
nt information
compiled in the weekly report. The information we produce will change over time to reflect
the most critical information to help understand, plan and deliver contact tracing at any
given point in time.
World Health Organisation (WHO) currContact tracing in the context of
COVID-19 focuses on targeted approaches to contact tracing based on transmission
patterns, engaging communities, and prioritising follow-up of high risk cases when it is not
possible to identify, monitor and quarantine all contacts. For further information please refer
to Appendix 2.
Please note, PHS has moved to weekly reporting of this data and cumulative data is
available in the interactive dashboard. Data for the most recent week, previously included
as provisional, is no longer included as this is variable due to cases which are still open
(either because contact tracing is still underway or the NHS Board is still managing the case
for a particular reason). Only finalised data will be included within the report going forward.
Further background information and definitions are available in Appendix 4.
Index cases
An index case is generated for each positive result with a test date on or after 28 May
2020. This includes tests derived from Scottish and UK Government, as well as self-
An individual is a unique person who has had a positive test. An individual can have
multiple positive tests which results in multiple cases within the test and protect system. In
these figures, each person is only counted once.
Contact Tracing figures for the week ending 09 January 2022 (based on test date), are
detailed in Table 5 below, which provides a recent time trend. A longer time trend is
available on the interactive dashboard.
Table 6 provides details of the status of the index cases for each week.
In the week ending 09 January 2022, there were 93,407 Index Cases, of which 35,930
(38.5%) had completed contact tracing by telephone or other digital methods, and a further
619 are in progress (0.7%).
There is a technical issue extracting at source (CMS) the status (New/Not yet started
and In progress) of cases for week ending 09 January 2022. A solution is currently
being applied and further work is under way to implement this for future
publications.
22
Table 5: Contact Tracing trend information, by week ending
05 Dec 12 Dec 19 Dec 26 Dec 02 Jan 09 Jan
1
20,649 27,054 43,724 69,423 131,851 93,407
Total Index Cases
2
19,736 25,940 41,630 66,165 126,369 87,243
Individuals
1.Does not include
within the contact tracing system.
2.A count of unique individuals with a positive test. An individual can have multiple positive tests which results in multiple cases within
the contact tracing system.
Table 6: Contact Tracing trend information by status, by week ending
05 Dec 12 Dec 19 Dec 26 Dec 02 Jan 09 Jan Cumulative
Status of
(from May
cases
2020)
New/ Not yet 1 0 1 0 556 1,098 1,693
1
started
% New/ Not 0.0 0.0 0.0 0.0 0.4 1.2
yet started
2
1 0 0 1 121 619 744
In progress
0.0 0.0 0.0 0.0 0.1 0.7
% In progress
3
18,088 22,730 35,964 43,516 59,236 35,930 855,749
Complete
87.6 84 82.3 62.7 44.9 38.5
% Complete
4
2,559 4,324 7,759 25,906 71,938 55,760 254,875
Incomplete
12.4 16 17.7 37.3 54.6 59.7
% Incomplete
1.New New/not yet started cases within the contact tracing system.
2.In progress The case is still in progress with either the case interview to be completed, or contacts related to the case to be
followed up.
3.Complete - The case is complete and all achievable contact tracing has been carried out.
4.Incomplete - Unsuccessful attempts to reach or carry out a case interview via the telephone, or for the index case to provide contacts
via digital contact tracing.
Method of Contacting Index Cases
The data within this section are based on the number of completed cases which are
recorded in the contact tracing software, these figures are preliminary and may be updated
in subsequent publications.
Public Health Scotland works closely with National Services Scotland (NSS) and the
Scottish Government to enable local NHS Boards and the National Contact Centre (NCC)
to carry out COVID-19 contact tracing effectively. The approach to contact
tracing has adapted as restrictions and policy have changed throughout the pandemic in
order to best meet the needs of the Scottish population. As numbers of new
cases have increased, the method has changed from attempting to phone all new cases
and contacts - to prioritising the highest risk cases for telephone calls and sending public
health advice by SMS text or email to all others, who have tested positive for COVID-19 and
their close contacts.
23
The introduction of SMS messaging was designed to get public health advice about
isolation to cases and contacts as quickly as possible, this is especially pertinent when daily
case numbers are very high. The approach was part of a deliberate decision to manage
resources through an agreed framework and is in keeping with the evidence-informed
advice of the European Centre for Disease Control.
All index cases will receive an initial SMS or email containing Public Health information and
advice, which will then be followed by contact either by telephone, additional SMS or email
messages containing further Public Health information and advice.
Table 7 below shows a breakdown of the methods used to contact completed index cases
over time.
Table 7: Contact method used for contact tracing of completed index cases trend
information
05 Dec 12 Dec 19 Dec 26 Dec 02 Jan 09 Jan
12,359 15,561 16,353 18,247 15,403 18,725
Telephone
68.3 68.5 45.5 41.9 26.0 52.1
% Telephone
5,729 7,169 19,611 25,269 43,833 17,205
SMS
31.7 31.5 54.5 58.1 74.0 47.9
% SMS
1.SMS includes those cases deemed low risk and have completed the Co3 online form, every other completed case is
categorised as Telephone
In the week ending 09 January 2022, 52.1% of index cases received a telephone call.
Time for a Positive Index Case to be Contact Traced
The data within this section are based on the number of completed cases which are
recorded in the contact tracing software, these figures are preliminary and may be updated
in subsequent publications.
The three measures shown are;
the time between a sample being taken and the positive individual being contacted
(i.e. interviewed by a contact tracer or completing the online tracing form)
the time between the record appearing in the CMS and the positive individual being
contacted (i.e. interviewed by a contact tracer or completing the online tracing form)
the time between the record appearing in the CMS and contact tracing being closed
(i.e. contacts have been interviewed, attempted to be interviewed or contacted
digitally).
These figures are now weekly measures, data are available for previous weeks within the
interactive dashboard.
Table 8 and Figure 10 below describes the timeliness of contact tracing by calculating the
hours between a test sample being taken and the index case being contacted by Test and
Protect either by phone or SMS.
24
Table 8: Time (hours) between date test sample taken(specimen date) and the
5
positive index case being contacted, for cases completed
Week Ending 09 January 2022
% of Total
Number of % of Total
Hours taken
Complete &
Complete Complete
Incomplete
Index Cases Cases
Cases
5,339 14.9 5.8
0-24
10,293 28.7 11.2
24-48
5,706 15.9 6.2
48-72
Over 72 6,216 17.3 6.8
7,505 20.9 8.2
Not recorded* - SMS
871 2.4 0.9
Not recorded* Phone
35,930 100
Total Complete Cases
55,760 60.8
Incomplete Cases
Total Complete & 91,690 100
Incomplete Cases
5 For further information and additional notes on Contact Tracing, please see Appendix 4 Contact Tracing
*Improvements into recording of times and dates are being investigated and technical
recordedThis will be
implemented February 2022.
25
Figure 10: Trend in time (hours) between date test sample taken(specimen date) and
the positive individual being called for cases completed; by week
Figure 10 shows that more positive cases were contacted over 72 hours after their test
sample was taken in June 2021, August 2021 and December 2021, which corresponds with
a rise in cases over the same periods.
Table 9: Time (hours) between case created in CMS and the positive individual being
5, 6
contacted
Week Ending 09 January 2022
% of Total
Number of % of Total
Hours taken
Complete &
Complete Complete
Incomplete
Index Cases Cases
Cases
0-24 20,522 57.1 22.4
3,632 10.1 4.0
24-48
2,128 5.9 2.3
48-72
1,278 3.6 1.4
Over 72
7,504 20.9 8.2
Not recorded* SMS
866 2.4 0.9
Not recorded* - Phone
35,930 100
Total Complete Cases
55,760 60.8
Incomplete Cases
Total Complete & 91,690 100
Incomplete Cases
5 For further information and additional notes on Contact Tracing, please see Appendix 4 Contact Tracing
6 Includes being interviewed by a contact tracer or submitting preliminary information via a CO3 form
*Improvements into recording of times and dates are being investigated and technical
recordedThis will be
implemented February 2022.
26
5, 7
Table 10: Time (hours) between case created in CMS to its closure
Week Ending 09 January 2022
% of Total
Number of % of Total
Hours taken
Complete &
Complete Complete
Incomplete
Index Cases Cases
Cases
15,439 43.0 16.8
0-24
5,477 15.2 6.0
24-48
7,379 20.5 8.0
48-72
Over 72 3,611 10.1 3.9
1,922 5.4 2.1
Not recorded* SMS
2,102 5.9 2.3
Not recorded* - Phone
35,930 100
Total Complete Cases
55,760 60.8
Incomplete Cases
Total Complete & 91,690 100
Incomplete Cases
5 For further information and additional notes on Contact Tracing, please see Appendix 4 Contact Tracing
7 Measured by the time taken to complete the final contact interview for high risk settings/contacts and those completed via SMS
*Improvements into recording of times and dates are being investigated and technical
solutions will be identified to reduce the recordedThis will be
implemented February 2022.
Incomplete index cases
Table 11 and Figure 11 below show the different reasons why an index case is categorised
as incomplete (previously referred to as failed) within the contact tracing system.
Incomplete cases are defined as: unsuccessful attempts to carry out a case interview via
the telephone, or for the index case to provide contacts via digital contact tracing. This
would include scenarios where the mobile/home phone/email address provided by the case
was incorrect and no other method of contact could be established; where SMS/telephone
call attempts to the case had been made but not been successful in eliciting a response
from the index case; where the index case has failed to pass relevant data protection
identity checks and where the index case has refused to participate in the contact tracing
process.
For operational purposes some index cases are categorised as incomplete because the
telephone process has started, but does not complete for the reasons outlined in Table X
below. Public Health information is typically sent by SMS to 99% of the incomplete index
cases.
27
Table 11: Number of incomplete index cases by reason
Week Ending 09 January 2022
Reason for Incompletion
Number of Index % of Incomplete
Cases Index Cases
Failed ID & verification 52 0.7
No response to call 14,608 26.2
No/incorrect phone number 486 0.9
Refused to provide contact details 21 0.0
Declined to participate / unable to 426 0.7
recall contacts
1
Timed out 40,167 72.0
Total incomplete cases 55,760 100.0
% incomplete as proportion of
all index cases
1.he
form within 5 days.
In week ending 09 January 2022, 26.2% of incomplete index cases were due to the index
case not responding to calls from Test and Protect.
Figure 11: Proportion of reasons for incomplete index cases
28
Contacts
The Test and Protect system ensures all positive index cases are asked to identify their
close contacts, whether they were contacted by telephone and/or SMS. Table 11 below
shows the recent trend information of contacts reported to Test and Protect by the index
case.
Table 12: Contact Tracing contacts trend information, by week ending
05 Dec 12 Dec 19 Dec 26 Dec 02 Jan 09 Jan
Total Primary 42,567 59,631 66,728 75,775 106,735 61,628
1
Contacts
Unique Primary 31,208 45,990 56,085 65,595 96,549 53,517
2
Contacts
Average number of 2.1 2.2 1.5 1.1 0.8 0.7
primary contacts
per case
1.Total number of primary contacts recorded in the contact tracing system.
2.Unique number of primary contacts each week. A contact may have been in close contact with multiple index cases.
The average number of primary contacts per case has remained stable over recent weeks.
Contacts not required to self-isolate
Following the Scottish Government announcement on 05 January 2022, from 06 January
2022 fully vaccinated adults and those under the age of 18 years and 4 months do not need
to self-isolate as long as they return a negative LFD test result for 7 consecutive days and
remain fever free. This applies to both household and non-household contacts. If any of the
LFD tests are positive the contact will be managed as an index case and will not need to
book a follow-up PCR to confirm the positive LFD result.
Since the beginning of contact tracing, a small proportion of primary contacts who were
successfully contacted were advised they did not need to isolate. Up to 09 January 2022, a
total of 3,454 cumulative primary contacts, pertaining to completed index cases, were not
advised to self-isolate. This represents 1.1% of the total 304,122 cumulative primary
contacts for which this information is known. Some reasons why contacts do not need to
isolate include; children under the age of 16, contact was wearing PPE or did not come into
close contact with a positive case.
In the week ending 09 January 2022, of the 53,517 unique contacts recorded, 4,613 (8.6%)
went on to test positive within ten days of their contact with an index case.
29
COVID-19 Vaccine
On 08 December 2020, a COVID-19 vaccine developed by Pfizer BioNTech was first used
in the UK as part of national immunisation programmes. The AstraZeneca (Vaxzevria)
vaccine was also approved for use in the national programme, and rollout of this vaccine
began on 04 January 2021. Moderna (Spikevax) vaccine was approved for use on 08
January 2021 and rollout of this vaccine began on 07 April 2021.These vaccines have met
strict standards of safety, quality and effectiveness set out by the independent Medicines
and Healthcare Products Regulatory Agency (MHRA).
For most people, a 2-dose schedule is advised for the vaccines. For the Pfizer BioNTech
(Comirnaty) vaccine, the second vaccine dose can be offered between 3 to 12 weeks after
the first dose. For the AstraZeneca (Vaxzevria) and Moderna (Spikevax) vaccine, the
second dose can be offered 4 to 12 weeks after the first dose.
Information on uptake across the vaccine programme is available on a daily basis via the
PHS COVID-19 Daily Dashboard, 5 days a week at 2pm (Monday to Friday). This provides
a cumulative picture of the position nationally and locally.
The dashboard provides total uptake nationally with breakdowns by Joint Committee on
Vaccination and Immunisation (JCVI) age based cohorts and non age based cohorts for
priority groups 1-9.
The vaccination content of this weekly publication is kept under continual review and
specific editions have contained more in-depth analyses of uptake by particular groups or
characteristics, including uptake by ethnicity and deprivation category, for teachers, for
prisoners and for pregnant women.
30
COVID-19 Vaccination Uptake
As of 17 January 2022, there has been over 11.7 million Covid-19 vaccine doses
administered in Scotland, since the programme began on 08 December 2020.
4.40 million people protected through their first dose of the COVID-19 vaccination;
93.3% of those aged 18 and over and 91.8% of those aged 12 and over.
4.09 million people provided with further protection by receiving their second dose, of
these, 89.4% are aged 18 and over and 85.4% of those aged 12 and over.
3.20 million people have received their booster/dose 3, of these, 71.9% are aged
over 18 and over and 67.0% of those aged 12 and over.
More detailed age information can be in Figure 12.
Daily Vaccination uptake information is available via the PHS Covid Daily Dashboard.
Figure 12: Covid-19 Vaccine uptake percentage coverage by age group in Scotland
31
COVID-19 Vaccine Wastage
Given the scale of the Covid-19 vaccination programme, some vaccine wastage has been
unavoidable for a variety of reasons including logistical issues, storage failure and specific
clinical situations.
The initial planning assumption for the vaccination programme was that there would be
around 5% vaccine wastage. Table 13 below shows the trend of the percentage of vaccines
wasted by calendar month between June December 2021.
In December 2021, the percentage of vaccines wasted was 0.6%. The top reasons for
doses wasted in this month were: excess stock (57%), particulate contamination (18%),
expired shelf life of stock (14%) other reasons (11%).
1,2,3,4,5
Table 13: Number of COVID-19 Vaccination doses wasted by Month
Measure July-21 Aug-21 Sept-21 Oct-21 Nov-21 Dec-21
Number of doses
641,177 568,203 303,931 884,381 1,017,131 1,369,363
1
administered
Number of doses
16,150 17,457 10,089 9,116 8,605 8,608
2
wasted
Percentage
2.5 2.9 3.2 1.0 0.8 0.6
3
wasted(%)
Source: NSS Service Now, COVID-19 Vaccine Wastage.
Data correct at 14/1/22
1. The number of vaccine doses administered (all doses).
2. The total number of vaccine doses which could not be administered and therefore wasted.
3. % Wasted is measured as:
(Number of Doses Wasted x 100) / (Number of Doses Wasted + Administered)
4.Excludes GP practice information.
5.Excludes wastage from clinical trials
32
COVID-19 Vaccine Certification
To show COVID-19 vaccine status, there are a number of options and individuals can
choose to use one or more of these:
Use the NHS Covid Status App
Request a paper copy of your COVID-19 Status
Download a PDF copy of your COVID-19 Status
The NHS Covid Status App was launched on 30 September 2021. It is free and offers
digital proof of vaccination via a QR code for each vaccination received. You can request a
ated in Scotland. The
record will not show any vaccinations given outside of Scotland.
As of midnight 15 January 2022 the NHS Covid Status App has been downloaded
2,431,409 times. It is important to note a single user may choose to download the App
on multiple devices, so this figure does not represent unique individuals
Between 03 September 2021 (introduction of QR codes) and midnight 08 January 2022
o 715,974 paper copies of COVID-19 Status have been requested. This may not
represent unique users if an individual requests a second copy (for example if
they have lost their paper copy)
o 1,736,949* PDF versions of COVID-19 Status have been downloaded. This
provides a measure of the total number of times a new QR code has been
generated via PDF. An individual can generate more than one successful QR
code so the figure does not represent unique users
*01, 02 and 03 October data for PDFs is missing due to a technical error, we can
reasonably estimate that there were 35,000 45,000 PDFs successfully generated PDFs in
total for those three days.
33
COVID-19 Cases, Hospitalisations, and Deaths by Vaccine Status
Vaccine Surveillance
Public Health Scotland has a COVID-19 vaccine surveillance strategy to monitor the
effectiveness, safety and impact of all approved COVID-19 vaccines in Scotland. The key
measure of the success of the vaccination programme in preventing infection,
hospitalisations and deaths is vaccine effectiveness.
The summary data presented in this chapter record the total number of COVID-19 cases,
COVID-19 related acute hospital admissions and confirmed COVID-19 deaths by their
vaccination status. This data should not be used to measure vaccine effectiveness.
Please note that this section only includes PCR confirmed COVID-19 cases, COVID-
19 related acute hospital admissions and confirmed COVID-19 related deaths. Lateral
flow device (LFD) cases are not included in this section and therefore will result in an
underestimation of recent case rate trends. Work is underway to include these data
in future publications.
PLEASE READ BEFORE REVIEWING THE FOLLOWING TABLES AND FIGURES
Interpretation of data
There is a large risk of misinterpretation of the data presented in this section due to the
complexities of vaccination data. A blog post by the UK Health Security Agency (UKHSA),
formerly Public Health England (PHE), provides a comprehensive explanation of the biases
and potential areas for misinterpretation of such data. They state that a simple
comparison of COVID-19 case rates in those who are vaccinated and unvaccinated
should not be used to assess how effective a vaccine is in preventing serious health
outcomes, because there are a number of differences between the groups, other than
the vaccine itself, and these biases mean that you cannot use the rates to determine
how well the vaccines work.
Below are examples of some of the complexities and biases that need to be taken into
consideration when interpretation these data.
Vaccinated individuals can still be infected with COVID-19
In Scotland, there has been a very high uptake of the COVID-19 vaccine. As of 17 January
2022, 89.4% of 18 years old and over have received a second dose and 71.9% have
received a third dose or booster of COVID-19 vaccine. No vaccine is 100% effective and
expected that cases, hospitalisations, and deaths from COVID-19 will occur in the
vaccinated population as well as the unvaccinated population.
The current evidence suggests that you may test positive for COVID-19, or be reinfected
even if you are vaccinated, especially since the emergence of the Omicron variant in the
UK. The major benefit of vaccination for omicron is to protect from severe disease. Follow
public health guidance and test yourself if you develop any COVID-19 like symptoms.
34
COVID-19 vaccines protect most people against severe outcomes, but some people
will get sick because no vaccine is 100% effective
Evidence suggests the COVID-19 vaccines are 90% effective at preventing a severe
outcome of COVID-19. COVID-19 hospitalisations and deaths are strongly driven by older
age, with most deaths occurring in those over 70 years old and having multiple other
illnesses. But overall, you are less likely to be hospitalised if you are vaccinated with a
booster.
Data and rates presented in this section are not a measure of vaccine effectiveness
Vaccine effectiveness is a scientific method used to measure how well a vaccine protects
people against outcomes such as infection, symptoms, hospitalisation and death in the
-
in the data and risk factors such as age, sex, prior infection, co-morbidities, socio-economic
status, and time since vaccination. This method is the most robust way to measure if a
vaccine is working.
The data and rates presented in this section do not account for these biases and risk
factors and should not be used to measure vaccine effectiveness. We include links to
vaccine effectiveness studies below.
There is likely to be systematic differences and biases between the vaccinated and
unvaccinated groups, such as behaviour, vulnerability and previous infection, that are
unaccounted for when comparing rates. As most of the population is vaccinated, these
differences become more evident and could create bias in case/hospitalisation/death rates
between vaccinated and unvaccinated population. For example, people who are vaccinated
may be more likely to follow other government guidance such as regular testing and
reporting for COVID-19, which makes them more likely to be identified as a case than
unvaccinated people, resulting in higher case rates in the vaccinated population.
Vaccine effectiveness wanes over time
COVID-19 vaccine effectiveness wanes over time. Within the first and second dose
population there will be a number of individuals that will have exceeded the recommended
time for their next vaccine dose. These people may be more susceptible to a severe
outcome and could result in higher COVID-19 case, hospitalisation and death rates in the
first and second dose vaccine groups. For example, some of the older individuals who have
exceeded the recommended time will have not received their next vaccine dose because of
their frailty or ill health. They are, therefore, more likely to be hospitalised or die if they get
COVID-19.
Difficulty knowing who is in the unvaccinated population
There is a lot of uncertainty about who is in the unvaccinated population, which makes
interpretation of COVID-19 rates in this group difficult. Everyone in Scotland who is
registered with a GP is assigned a unique CHI number. This number is how we estimate
Scottish residents for the analysis in this section, however it has its limitations when people
leave Scotland and do not inform their GP, resulting in an overestimate of Scottish
residents. To try and account for this issue, we also use COVID-19 vaccination records to
calculate the number of people in the vaccinated population. This helps determine whether
people are still resident in Scotland, however, those in the unvaccinated population have
35
not had recent contact with a vaccination centre and therefore we have to rely on GP
records, which are likely to be more out of date than vaccine records.
Summary of key results
Case rates have declined in the last week from 08 January 2022 to 14 January
2022. Caution should be taken when interpreting recent case trends due to the
change in policy from 06 January 2022 where an asymptomatic individual who
tests positive via a LFD test is not required to take a confirmatory PCR test.
This section of the report only includes PCR confirmed COVID-19 cases and
does not include cases confirmed by a LFD test
In the last week from 08 January 2022 to 14 January 2022, the seven-day rolling
average of COVID-19 related acute hospital admissions decreased from 126.57 to
114.00 admissions per day
In the last week from 08 January to 14 January 2022, in an age-standardised
population, the rate of acute COVID-19 related hospital admissions in individuals that
received a booster or third dose of a COVID-19 vaccine was between 2.3 to 3.9
times lower than in individuals who are unvaccinated or have only received one or
two doses of a COVID-19 vaccine
In the last week from 01 January 2022 to 07 January 2022, in an age-standardised
population, the death rate in individuals that received a booster or third dose of a
COVID-19 vaccine was between 16.1 to 25.9 times lower than individuals who are
unvaccinated or have only received one or two doses of a COVID-19 vaccine
36
COVID-19 cases by vaccination status
Recent studies have been released by UKHSA, looking into the effect of vaccination
against mild and severe COVID-19. UKHSA analyses show vaccine effectiveness against
symptomatic disease with the Delta variant to be approximately 65 to 70% with
AstraZeneca (Vaxzevria) and 80 to 95% with the Pfizer-BioNTech (Comirnaty) and
Moderna (Spikevax) vaccines. Data from the UKHSA shows that vaccine effectiveness is
waning, but remains high, against hospitalisation and death.
The first real world results of the effectiveness of the booster vaccination against
symptomatic disease shows very high vaccine effectiveness, higher than for the primary
course, at 93-94%. Analyses from Scotland show that the booster and third dose of the
COVID-19 vaccines are associated with 57% reduced risk of symptomatic infection with the
Omicron variant compared to those who are more than 25 weeks post-second dose of
COVID-19 vaccine.
Initial analysis of vaccine effectiveness against symptomatic disease with the Omicron
variant have been shown to be lower than compared to the Delta variant, with estimated
vaccine effectiveness of between 70 to 75% in the early period after the booster dose.
Although lower, this is still a substantial vaccine effect, and is higher than after one or two
doses of vaccine.
37
1,471.51)1,461.32)1,548.90)1,376.88)
827.45)590.03)771.10)490.26)
----
----
considered
(733.17 (497.93 (730.63 (472.73
(1,347.89 (1,325.60 (1,503.94 (1,345.20
standardised case rate standardised case rate
--
confidence intervalsconfidence intervals
per 100,000 with 95% per 100,000 with 95%
780.31543.98750.86481.49
AgeAge
1,409.701,393.461,526.421,361.04
out section are
-
1 Dose
Booster or 3 doses
357,752348,727341,481340,151
2,069,3562,429,0292,847,0272,982,132
PopulationPopulation
e data displayed within the greyed
1,8603,3873,0661,093
10,09230,04135,43613,566
by PCRby PCR
positive positive
No. tested No. tested
1,346.10)2,581.37)2,453.01)
563.08)990.68)952.70)435.18)891.67)
---
-----
38
(518.55 (926.37 (893.85 (390.36 (839.92
(1,310.47 (2,522.57 (2,383.69
standardised case standardised case
--
confidence intervalsconfidence intervals
individuals by week and vaccination status, 18 December 2021 to 14
AgeAge
540.82958.52923.27412.77865.79
rate per 100,000 with 95% rate per 100,000 with 95%
1,328.292,551.972,418.35
standardised case rates are per 100,000 people per week, standardised to the 2013 European Standard Population (see
2 Doses
-
Unvaccinated
998,045988,033979,617995,855
1,006,0251,866,4261,522,5611,121,214
PopulationPopulation
PCRPCR
5,5949,4969,1053,6019,363
32,62850,62234,327
No. tested No. tested
positive by positive by
24 31 24 31
standardised case rate per 100,000
07 14 07 14
----
-
----
: Age
WeekWeek
January 2022January 2022January 2022January 2022
01 January 08 January 01 January 08 January
December 2021December 2021December 2021December 2021
18 December 25 December 18 December 25 December
Table 14January 2022 Vaccination status is determined as at the date of PCR specimen date according to the definitions described in Appendix 6. Thpreliminary and are subject to change
as more data is updated. AgeAppendix 6).
The number of PCR confirmed COVID-19 cases and case rates have declined in the last
week from 08 January 2022 to 14 January 2022, this may be due to the change in policy
from 06 January 2022 where an asymptomatic individual who tests positive via a LFD
test is not required to take a confirmatory PCR test.
Individuals may test positive for COVID-19 even if vaccinated. Rates have increased for all
vaccine statuses since the emergence of Omicron in December. However, the data in Table
14 does not account for severity of the case such as presence of symptoms and may
include a number of asymptomatic individuals. Current evidence suggests that the vaccine
is very effective at preventing hospitalisations and deaths. The rates in Table 14 should not
be used as a measure of vaccine effectiveness due to unaccounted for biases and risk
factors. For more information, please see the Interpretation of data section above.
39
Figure 13: COVID-19 age-standardised case rate per 100,000 individuals by vaccine
status, seven-day rolling average from 10 May 2021 to 14 January 2022.
Vaccination status is determined as at the date of PCR specimen date according to the definitions described in Appendix 6. The data
displayed within the greyed-out section are considered preliminary and are subject to change as more data is updated. Age-standardised
case rates are per 100,000 people per week, standardised to the 2013 European Standard Population (see Appendix 6).
Age standardised rates are adjusted to only include individuals 10 years old and over and
are calculated by combining rates from different age groups relative to the European
standard age distribution population. These calculations have associated 95% confidence
intervals shown in the shaded areas of the figure. Smaller populations have wider
associated confidence intervals (see 1 dose age-standardised rate (ASR)) whereas larger
populations have narrower associated confidence intervals (see 3 doses or booster ASR).
The number of PCR confirmed COVID-19 cases and case rates have declined in the last
week from 08 January 2022 to 14 January 2022, this may be due to the change in policy
from the 06 January 2022 (shown by the dashed line) where an asymptomatic individual
who tests positive via at LFD test is not required to take a confirmatory PCR test.
40
Individuals may test positive for COVID-19 even if vaccinated. Rates have increased for all
vaccine statuses since the emergence of Omicron in December. However, the data in
Figure 13 does not account for severity of the case such as presence of symptoms and may
include a number of asymptomatic individuals. Current evidence suggests that the vaccine
is very effective at preventing hospitalisations and deaths. The rates in Figure 13 should not
be used as a measure of vaccine effectiveness due to unaccounted for biases and risk
factors. For more information, please see the Interpretation of data section above.
Note that the peak in the second dose category around the 11 October 2021 is likely due to
a small number of individuals vaccinated within the younger age group at this time.
41
COVID-19 related acute hospital admissions by vaccine status
A number of studies have estimated vaccine effectiveness against hospitalisation and have
found high levels of protection against hospitalisation with all vaccines against the Alpha
variant. A paper observed effectiveness against hospitalisation of over 90% with the Delta
variant with all three COVID-19 vaccines including AstraZeneca (Vaxzevria), Pfizer-
BioNTech (Comirnaty), and Moderna (Spikevax). In most groups there is relatively limited
waning of protection against hospitalisation over a period of at least five months after the
second dose.
A recent pre-print suggests that risk of hospitalisation is approximately 68% lower with the
Omicron variant than the Delta variant. However, these are initial findings - hospitalisation
numbers were still low and the majority of Omicron cases were in younger people.
From 01 September 2020 to 14 January 2022, there were a total of 1,464,651 acute
hospital admissions for any cause, of which 34,523 were associated with a COVID-19 PCR
positive test 14 days prior, on admission, the day after admission or during their stay. Using
the 90-day exclusion criteria between positive COVID-19 PCR tests associated with an
acute hospital admission, 35,739 individuals were admitted to hospital, of which 117 were
readmitted more than 90 days after their first admission.
42
Figure 14: Seven-day rolling average on a log scale: acute hospital admissions
where the individual had a COVID-19 positive PCR test 14 days prior, on admission
or during their stay in hospital, compared to all acute hospital admissions, 10 May
2020 to 14 January 2022.
Data displayed are on a log scale. The data displayed within the greyed-out section are considered preliminary and are subject to
change as more data is updated.
COVID-19 related hospital admissions have increased to similar levels observed in
September 2021, however, are small relative to all acute hospitalisations.
43
confidence
59.88)65.28)40.61)12.87)
19.49) 6.57)12.30)
11.13)
----
---
-
(2.13 (4.01 (9.88
(21.50 (26.91 (12.66 (8.23 (10.49
intervals)intervals)
5.29
9.68
10.8111.09
40.6946.1026.6411.68
standardised hospitalisation standardised hospitalisation
--
rate per 100,000 (95% confidence rate per 100,000 (95%
AgeAge
1 Dose
out section are considered
-
19 positive PCR test up
-
Booster or 3 Doses
261,362251,779242,843241,461
2,068,7902,428,2342,846,0222,981,022
PopulationPopulation
ndardised to the 2013 European Standard Population
12394931
No. No.
137296391424
hospitalisedhospitalised
44.09)67.55)54.51)41.44)31.36)48.66)71.76)54.35)
--------
44
(24.69 (40.55 (33.00 (23.48 (20.42 (33.36 (50.52 (36.00
intervals)intervals)
hospital, by week and vaccination status, 18 December 2021 to 14
34.3954.0543.7532.4625.8941.0161.1445.18
standardised hospitalisation standardised hospitalisation
--
rate per 100,000 (95% confidence rate per 100,000 (95% confidence
AgeAge
2 Doses
standardised hospitalisation rates are per 100,000 people per week, sta
according to the definitions described in Appendix 6. The data displayed within the greyed-
Unvaccinated
989,345
1,111,0231,105,6011,099,4171,093,6391,864,0171,518,9961,116,431
PopulationPopulation
No. No.
133164174130170228247191
hospitalisedhospitalised
24 31 24 31
standardised rates of acute hospital admissions where an individual had a COVID
-
07 14 07 14
----
----
2022
: Age
WeekWeek
15
January 2022January 2022January January 2022
01 January 08 January 01 January 08 January
December 2021December 2021December 2021December 2021
18 December 25 December 18 December 25 December
Table to 14 days prior, on admission, or during their stay in January 2022. Vaccination status is determined as at the date of positive PCR test preliminary and are subject to change
as more data is updated. Ageadjusted to only include individuals 15 years old and over (see Appendix 6).
, over
15
may differ from
19 hospital
15
-
19 vaccine compared to
-
19 illness requiring hospitalisation
-
19 was identified incidentally through
-
standardised hospitalisation rates are
-
9 related hospital admissions in Table
-
19 vaccine. In the last week from 08 January to 14
-
standardised rate of acute COVID
-
19 related hospital admissions in individuals that
-
19 symptoms.
-
19 vaccine.
-
45
OVID
routine operations) for whom COVID
section above.
ion, the rate of acute COVID
19 vaccine was between 2.3 to 3.9 times lower than in individuals who are
-
people who have received a booster or third dose of a COVID
. To align with the 2013 European Standard Population,15 years olds are now included in the
15
Interpretation of data
standardised populat
-
statistics do not differentiate between individuals in hospital with COVID
and Figure
are not requiring hospitalisation because of their COVID
please see the
in Table 15
should not be used as a measure of vaccine effectiveness due to unaccounted for biases and risk factors. For more
evious weeks reports which only included hospitalised individuals and denominators for 16 years and older. The rates in Table
To account for the different age distribution of individuals in each vaccine status, agereported number of acute hospital admissions and the population denominator. This means that
data presented in Table pr15information, In the past four weeks, from 18 December 2021 to 14 January 2022, the ageadmissions per 100,000 were lower for individuals that are unvaccinated
or have received one or two dose of a COVIDJanuary 2022, in an agereceived a booster or third dose of a COVIDunvaccinated or have only received one or two doses of a C From 08 January
to the 14 January 2022, of the post second dose acute COVID60% received their second dose of vaccine more than 6 months prior to test. Please note that these compared to those in hospital
for other reasons (e.g.testing but they
Figure 15: Age-standardised hospitalisation rate of acute hospital admissions where
an individual had a COVID-19 positive PCR test up to 14 days prior, on admission, or
during their stay in hospital, per 100,000 individuals by vaccination status, seven-day
rolling average from 10 May 2021 to 14 January 2022.
Vaccination status is determined as at the date of positive PCR test according to the definitions described in Appendix 6. The data displayed
within the greyed-out section are considered preliminary and are subject to change as more data is updated. 95% confidence intervals are
shown as the shaded regions. Age-standardised hospitalisation rates are per 100,000 people per week, standardised to the 2013 European
Standard Population adjusted to only include individuals 15 years old and over (see Appendix 6).
To align with the 2013 European Standard Population,15 years olds are now included in the
number of acute hospital admissions and the population denominator. This means that data
presented in Table 15 may differ from previous weeks reports which only included 16 years
and older. The rates in Figure 15 should not be used as a measure of vaccine effectiveness
due to unaccounted for biases and risk factors. For more information, please see the
Interpretation of data section above.
Age standardised rates are adjusted to only include individuals 15 years old and over and are
calculated values by combining rates from different age groups relative to the European
standard age distribution population. These calculations have associated 95% confidence
intervals shown in the shaded areas of the figure. Smaller populations have wider associated
confidence intervals (see 1 dose age-standardised rate (ASR)) whereas larger populations
have narrower associated confidence intervals (see 2 doses ASR).
The age standardised rate of acute hospital admissions for individuals with a booster or third
dose remains lower compared to people unvaccinated or who have only received one or two
doses of a COVID-19 vaccine.
Note that the peak in the booster or third dose category around 11 October 2021 is likely due
to a small number of individuals vaccinated and the prioritisation of the booster/third dose to
the clinically extremely vulnerable at the beginning of the booster programme.
Figure 16: Seven-day rolling average COVID-19 related acute hospital admissions by
vaccination status and by age group, 10 May 2021 to 14 January 2022
Vaccination status is determined as at the date of positive PCR test according to the definitions described in Appendix 6. Patient age is
determined as their age the date of admission. The data displayed within the greyed-out section are considered preliminary and are subject
to change as more data is updated.
47
The rates in Figure 16 should not be used as a measure of vaccine effectiveness due to
unaccounted for biases and risk factors. For more information, please see the Interpretation
of data section above.
Overall, the highest rates of acute COVID-19 related hospital admissions were in the oldest
age groups. In groups where a very large proportion of individuals have been vaccinated
(such as individuals over age 70), any small changes in COVID-19 related acute hospital
admissions will result in a larger change shown in the graph, for example in the over 70 1
48
Confirmed COVID-19 deaths by vaccination status
COVID-19 vaccines are estimated to significantly reduce the risk of mortality for COVID-19,
however a small number of COVID-19 deaths are still expected in vaccinated people,
especially in vulnerable individuals where the vaccine or the immune response may not have
been effective. Evidence has shown that vaccination is highly effective in protecting against
death from coronavirus (COVID-19). Data published by UKHSA have shown high levels of
protection (over 90%) against mortality with all three COVID-19 vaccines including
AstraZeneca (Vaxzevria), Pfizer-BioNTech (Comirnaty), and Moderna (Spikevax), and
against both the Alpha and Delta variants. Research from Public Health Scotland, University
of Edinburgh and University of Strathclyde, have shown two vaccine doses, whether the
AstraZeneca (Vaxzevria) or the Pfizer-BioNTech (Comirnaty) vaccine, are over 90 per cent
effective at preventing deaths from the Delta variant of COVID-19.
A recent paper on COVID-19 booster vaccine effectiveness against mortality found that
individuals over 50 years old who received a Pfizer-BioNTech (Comirnaty) booster dose of
COVID-19 vaccine five months after their first two doses had 90% lower mortality than those
who only received two doses more than five months previously.
49
out
-
9.17)27.69)1.05)0.33)0.49)0.34)0.65)
19 deaths. The
16.18)
-
-------
-
(0.00 (2.88 (0.00 (0.06 (0.16 (0.07 (0.26
(0.00
played within the greyed
3.910.360.200.330.210.46
7.38
Standardised Mortality
15.28
thin 8 days although in practice, the
confidence intervalsconfidence intervals
standardised mortality rate Rate per 100,000 with 95% Rate per 100,000 with 95%
Age Age Standardised Mortality
-
. The data dis
biases and risk factors. For more
1 Dose
age
19 vaccine on confirmed COVID
-
standardised mortality rates per 100,000 people per
-
Booster or 3 doses
NRS website
357,775348,750341,505340,177
2,069,3562,429,0302,847,0282,982,133
19 related death is defined as an individual who has tested
PopulationPopulation
-
unaccounted for
to
n be found on the
371389
1521
No. of No. of
confirmed COVID
deathsdeaths
poses of evaluating the impact of the COVID
3.16)9.30)9.28)16.64)
11.74) 12.85)10.31) 10.38)
----
----
(0.23 (0.55 (3.79 (7.14
(2.67 (2.38 (5.04 (3.85
.
1.704.936.54
7.217.62 7.687.11
11.89
confidence intervalsconfidence intervals
Rate per 100,000 with 95% Rate per 100,000 with 95%
Age Standardised Mortality Age Standardised Mortality
19 death data. Data are based on date of registration. In Scotland, deaths must be registered wi
-
2 Doses
19 listed as an underlying or contributory cause of death on the death certificate. Age
-
Unvaccinated
19 related deaths by vaccination status at time of test and
-
s COVID
Interpretation of data
995,855
1,567,7091,559,7291,549,7161,541,2981,866,4271,522,5611,121,214
PopulationPopulation
not be used as a measures of vaccine effectiveness due
68
181236242126
No. of No. of
deathsdeaths
should
2 at any time point and ha
-
16
CoV
-
17 24 31 17 24 31
07 07
------
: Number of confirmed COVID
WeekWeek
16
January
January 2022January 2022
rmation, please see section above
December 2021December 2021December 2021December 2021December 2021December 2021
01 January 01
11 December 18 December 25 December 11 December 18 December 25 December
Table per 100,000, 11 December 2021 to 07 January 2022 Vaccination status is determined as at the date of positive PCR test according to the definitions described in Appendix 6. A positive
by PCR for SARSweek, standardised to the 2013 European Standard Population (see Appendix 6). This definition is for the purnumbers reported in this section may differ from other published
COVIDaverage time between death and registration is around 3 days. More information on days between occurrence and registration casection are considered preliminary and are subject
to change as more data is updated.The rates in Table info
-
96.3%)
was 78
ved a booster
years old).
9
to 9
70.5
han fourteen days after receiving
standardised mortality rates were
-
2 more t
-
ed to their deaths and the mean age
CoV19 related deaths in Table 16, more than 95%
-
-
years old (IQR
individuals have received a booster or 3rd dose of
8.1
19 recorded as underlying or contributory cause of
-
7
3 million
was
19 related deaths with a positive PCR result and where COVID
-
ramme in Scotland to account for protection to develop after the
51
e death certificate.
standardised population, the death rate in individuals that recei
-
tested positive by PCR for SARS
19 vaccination programme over
(0.003%)
-
19 vaccine more than six months prior to their death. The majority of these individuals (
-
19 vaccine and subsequently died with COVID
19 was listed as an underlying or contributory cause of death on the death certificate (Table 16).
-
-
6 individuals
9
19 vaccine.
-
19 vaccine was between 16.1 to 25.9 times lower than individuals who are unvaccinated or have only received
-
19 vaccine. Of these,
-
To account for differences in population size and age of the vaccination status groups over time, agecalculated for deaths where COVIDIn the week from 01 January to 07 January 2022,
in an ageor 3rd dose of a COVIDone or two doses of a COVID From 29 December 2020 (21 days after the start of the vaccination progfirst dose) to 07 January 2022, there have been 5,790
confirmed COVID19 was recorded as an underlying or contributory cause on th In Scotland, from the beginning of the COVIDa COVIDtheir booster or third dose of COVIDdeath. The majority
of these individuals (99.0%) had several comorbidities which contributyears old (IQR 72 to 90 years old). From 11 December 2021 to 07 January 2022, of the post second dose confirmed
COVIDhad received their second dose of COVIDhad several comorbidities which contributed to their deaths and the mean age
Hospital/ Wider System Pressures
NHS services across NHS Scotland are subject to increased demand during the winter
period. The information presented in this section aims to support the reader in drawing
insights from a wider range of existing metrics around COVID-19 and winter pressures.
Unscheduled Care
As individuals in Scotland make contact with Unscheduled Care Services, data about who
they are, where they have come from, what is wrong with them and what happens to them
are collected, mainly to inform their care. This provides a good picture of the potential
unscheduled care journeys that an individual may travel through.
Pressures on unscheduled care services are a familiar sight during the winter. Increased
incidence of respiratory infections, alongside an increased acuity of illness and demands on
primary care leads to increased demand on unscheduled care.
standardised information on COVID-19 from a health perspective. Information is provided in a
range of languages and alternative formats (www.nhsinform.scot/coronavirus).
Additional information can be found on the wider impacts dashboard and also in our
interactive dashboard.
NHS 24
During COVID-19 there has been a rapid reconfiguration of primary and community care
services. As part of this 1 service has been reconfigured as an in-hours (as well
as out-of-hours) route for COVID-19 triage for rapid access to care via local COVID-19
assessment hubs. In addition to this, from 1st December 2020, the national Redesign of
Urgent Care Programme introduced new pathways from NHS 24 to Flow Navigation Centres,
with the aim of reducing the numbers of people attending A&E and diverting to more
appropriate care closer to home. This is available as part of a 24/7 service, further increasing
NHS 24 in-hours activity (Monday to Friday, 8am to 6pm).
Information on COVID-19 related contacts to NHS24 and the Coronavirus Helpline are
presented in our interactive dashboard which supplements this report.
Primary Care Out of Hours (OOH)
Across Scotland, NHS Boards provide Primary Care Out of Hours (OOH) services for
Wider
Impacts dashboard.
Scottish Ambulance Service (SAS)
Key statistics on unscheduled care operational measures across Scotland, including trends in
the number of unscheduled care incidents, responses, conveyances to hospital, response
times and hospital turnaround times is available from the Scottish Ambulance Service (SAS)
weekly unscheduled care operational statistics release.
Accident & Emergency (A&E) Activity
Additional information on Accident and Emergency (A&E) performance is available via the
weekly A&E activity and Waiting Times publication, which provides an update of key statistics
on attendances at Accident and Emergency (A&E) services across Scotland. Accident and
Emergency waiting times and activity reporting on performance against the 4 hour waiting
time standard, and the target to reduce attendances at Emergency Departments.
Large decreases in attendances at A&E services in NHS Scotland were observed in spring
2020 winter 2020/21 due to the measures put in place to respond to COVID-19. Since spring
2021 attendances at A&E have been rising and are getting closer to the pre-COVID levels.
However, from the summer of 2021 performance against the four hour standard has dropped
below 80% and has remained at this rate for a prolonged period of time.
Emergency Admissions
The information presented in this section aims to provide a better understanding of the
underlying trends in emergency admissions during this period.
Figure 17 below shows the overall weekly trend of emergency acute hospital admissions
(including COVID-19) from week ending 05 January 2021 to 11 January 2022. The number of
emergency admissions have generally been decreasing since week ending 09 November
2021.
Figure 17: Trend of all Emergency Acute Hospital Admissions in Scotland
53
Table 17 below shows a breakdown of Emergency Admissions to acute hospital across all
ages and by age group for the period 15 December 2021 to 11 January 2022
3
Table 17: Emergency Hospital Admissions by age as at 11 January 2022
Age 15 December 22 December 29 December 05 January
Band 21 December 28 December 04 January 11 January
1,342 1,087 1,062 1,005
Under 18
689 602 687 656
18-29
797 658 726 799
30-39
864 768 820 825
40-49
594 513 538 563
50-54
689 666 676 710
55-59
757 698 771 740
60-64
767 742 826 818
65-69
998 933 1,004 1,003
70-74
941 955 991 1,018
75-79
2,178 2,186 2,289 2,069
80+
10,616 9,808 10,390 10,206
Total
Source: RAPID (Rapid and Preliminary Inpatient Data)
3. Please refer to Appendix 3 Hospital Admissions Notes for explanatory notes regarding RAPID Hospital Admissions.
In the latest week, there has been a 1.8% decrease in the number of emergency admissions,
with those aged 80+ years having the highest number of admissions. Also, in the latest week
55.3% of the hospital admissions related to patients aged 60+.
54
Waiting Times
Waiting times are important to patients and are a measure of how the NHS is responding to
demands for services. Measuring and regular reporting of waiting times highlights where
there are delays in the system and enables monitoring of the effectiveness of NHS
performance throughout the country.
Public Health Scotland routinely publish a range of statistics on Waiting Times, including:
waiting times for diagnostic tests, new outpatient appointments, inpatient and day case
treatments.
These statistics continue to be affected by the COVID-19 (Coronavirus) pandemic. At the
start of the outbreak, many services were paused or reduced and there were fewer referrals.
Boards started to resume relevant services, from June 2020. However, as a second wave of
COVID-19 cases emerged through the Autumn and winter months, many Boards had to
temporarily pause non-urgent diagnostic tests during the months of January and February
2021. Access to services has generally increased since then but some Boards may have
been temporarily impacted by a return to high infection rates in recent months as lockdown
restrictions eased.
55
Delayed Discharges
Timely discharge from hospital is an important indicator of quality. It is a marker for person-
centred, effective, integrated and harm free care.
For most patients, following completion of health and social care assessments, the necessary
care, support and accommodation arrangements are put in place in the community without
any delay and the patient is appropriately discharged from hospital.
A delayed discharge occurs when a patient aged 18 years and over, clinically ready for
discharge, cannot leave hospital because the other necessary care, support or
accommodation for them is not readily accessible and/or funding is not available, for example
to purchase a care home place.
Public Health Scotland publish monthly statistics on Delayed Discharges in Scotland. These
figures provide the number of hospital bed days associated with delayed discharges and the
number of discharges from hospital following a period of delay. Information is also provided
on the number of people experiencing a delay in discharge from hospital at the monthly
census point.
Delayed Discharge figures in NHS Scotland have been affected by measures put in place to
respond to COVID-19. The marked fall in delayed discharges during 2020 is likely due to
patients being moved out of hospital to increase capacity.
56
Wider Impact of COVID-19
The COVID-19 pandemic has direct impacts on health as a result of illness, hospitalisations
and deaths due to COVID-19. However, the pandemic also has wider impacts on health,
healthcare, and health inequalities. Reasons for this may include:
Individuals being reluctant to use health services because they do not want to burden
the NHS or are anxious about the risk of infection.
The health service delaying preventative and non-urgent care such as some screening
services and planned surgery.
Other indirect effects of interventions to control COVID-19, such as changes to
employment and income, changes in access to education, social isolation, family
violence and abuse, changes in the accessibility and use of food, alcohol, drugs and
gambling, or changes in physical activity and transport patterns.
More detailed background information on these potential impacts is provided by the
Scottish Public Health Observatory in a section on Covid-19 wider impacts.
The surveillance work stream of the Public Health Scotland social and systems recovery
cell aims to provide information and intelligence on the wider impacts of COVID-19 on
health, healthcare, and health inequalities that are not directly due to COVID-19. The
wider impact dashboard can be viewed online and includes the following topics:
Hospital and unscheduled care
Accident and Emergency attendances
NHS 24 completed contacts
Out of hours cases
Scottish Ambulance Service
Excess deaths
Outpatient appointments
Healthcare for cardiovascular disease
Healthcare for mental health
Women booking antenatal care
Healthcare for birth and babies
Termination of pregnancy
Child health
Cancer
Substance use
Injuries
These analyses are based on a selected range of data sources that are available to describe
changes in health service use in Scotland during the COVID-19 pandemic. More detailed
information is available at NHS Board and Health and Social Care Partnership (HSCP) level.
57
Contact
Public Health Scotland
phs.covid19data&analytics@phs.scot
Further Information
COVID surveillance in Scotland
Scottish Government
Daily Dashboard by Public Health Scotland National Records of Scotland
UK and international COVID reports
Public Health England
European Centre for Disease Prevention and Control
WHO
Weekly National Seasonal Respiratory Report
Weekly national seasonal respiratory report - Week 1 2022 - Weekly national seasonal
respiratory report - Publications - Public Health Scotland
The next release of this publication will be 26 January 2022.
Open Data
Data from this publication is available to download from the Scottish Health and Social Care
Open Data Portal.
Rate this publication
Let us know what you think about this publication via the link at the bottom of this publication
page on the PHS website.
Early access details
Pre-Release Access
Under terms of the "Pre-Release Access to Official Statistics (Scotland) Order 2008", PHS is
obliged to publish information on those receiving Pre-Release Access ("Pre-Release Access"
refers to statistics in their final form prior to publication). Shown below are details of those
receiving standard Pre-Release Access.
Standard Pre-Release Access:
Scottish Government Health Department
NHS Board Chief Executives
NHS Board Communication leads
58
Appendices
Appendix 1: Background information
due to unknown cause in Wuhan City, Hubei Province.
In early January 2020, the cause of the outbreak was identified as a new coronavirus. While
human-to-human transmission is now occurring.
There are a number of coronaviruses that are transmitted from human-to-human which are
not of public health concern. However, COVID-19 can cause respiratory illness of varying
severity.
On the 30 January 2020 the World Health Organization declared that the outbreak
constitutes a Public Health Emergency of International Concern.
Extensive measures have been implemented across many countries to slow the spread of
COVID-19.
Further information for the public on COVID-19 can be found on NHS Inform.
Appendix 2: World Health Organisation (WHO): Contact tracing in the context of
COVID-19
The WHO initially produced guidance on enhanced criteria to adjust public health and social
measures in the context of Covid- in May 2020. The relevant extract from the criteria
about the effectiveness of contact tracing within the context of public health surveillance at
that time was:
At least 80% of new cases have their close These indicate that the capacity to conduct
contacts traced and in quarantine within 72 contact tracing is sufficient for the number of
hours of case confirmation cases and contacts
Source: https://apps.who.int/iris/rest/bitstreams/1277773/retrieve
In response to questions about whether the Scottish Government had been incorrectly
Scotland might start at the wrong point in the process), an assessment was undertaken at the
start of 2020, and is available within Appendix 2 of the Weekly Covid-19 Statistical report
(publication date 27 January 2021).
replaced with further WHO
guidance issued in February 2021, reflecting the evolution of the state of the
pandemic. This revised guidance now focuses on targeted approaches to contact tracing
based on transmission patterns, engaging communities, and prioritising follow-up of high risk
cases when it is not possible to identify, monitor and quarantine all contacts.
59
Appendix 3: Hospital Admissions Notes
Hospital Admissions
RAPID (Rapid and Preliminary Inpatient Data)
COVID-
PCR test for COVID up to 14 days prior to admission to hospital, on the day of their
admission or during
date of discharge from hospital, they are not included in the analysis.
The number reported does not take into account the reason for hospitalisation. Therefore,
people that were admitted for a non COVID-19 related reason (and tested positive upon
admission) may be included.
RAPID is a daily submission of people who have been admitted and discharged to hospital.
These data include admissions to acute hospitals only and do not include psychiatric or
maternity/obstetrics specialties. Figures are subject to change as hospital records are
updated. It can take 6-8 weeks or longer before a record is finalised, particularly discharge
details.
In the data presented here, an admission is defined as a period of stay in a single hospital.
There may be multiple admissions for a single patient if they have moved between locations
during a continuous inpatient stay (CIS), or if they have been admitted to hospital on
separate occasions.
Hospital Inpatients (Scottish Government Data)
Number of patients in hospital with recently confirmed COVID-19
This measure (available from 11 September 2020 and first published 15 September 2020)
includes patients who first tested positive in hospital or in the 14 days before admission.
Patients stop being included after 28 days in hospital (or 28 days after first testing positive if
this is after admission). Further background on this new approach is provided in this Scottish
Government blog.
This is based on the number of patients in beds at 8am the day prior to reporting, with the
data extract taken at 8am on the day of reporting to allow 24 hours for test results to
become available. Where a patient has not yet received a positive test result they will not be
included in this figure. Patients who have been in hospital for more than 28 days and still
being treated for COVID-19 will stop being included in this figure after 28 days.
All patients in hospital, including in intensive care, and community, mental health and long
stay hospitals are included in this figure.
Appendix 4: Contact Tracing
Definitions
An index case is generated for each positive result with a test date on or after 28 May 2020.
This includes tests derived from Scottish and UK Government laboratories, as well as self-
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An individual is a unique person who has had a positive test. An individual can have multiple
positive tests which results in multiple cases within the test and protect system. In these
figures, each person is only counted once.
A contact may be contacted more than once if multiple positive cases list them as a contact.
Completed cases are cases which are marked as completed in the case management
system, which means that all contacts have been followed up and completed. It excludes
cases marked as failed, excluded, in progress or new. In the latest weeks there will be cases
which are still open either because contact tracing is still underway (particularly for the latest
week) or the NHS Board is still managing the case as part of an open outbreak.
Weekly data presented from Monday to Sunday in order to be consistent. Figures are
provisional and may change as the test and protect tool is updated by contact tracers.
Individuals unable to be contacted
This information is only available for index cases that have been recorded on the CMS. The
CMS went live on 22 June 2020 with NHS Boards migrating on a phased approach with all
Boards using CMS from 21 July 2020. Prior to a Board migrating to CMS, data was recorded
in a Simple Tracing Tool which did not give the level of granularity required to report on these
measures. These data are developmental and an extensive data quality assurance exercise
is underway and data may be revised in subsequent publications. Please note the
methodology has changed as of 1 November 2020, a refined method has now been applied
to identify unique indexes.
Contact tracers will contact index cases by telephone, and by default all close contacts will
receive an automated SMS. This approach ensures high quality calls can continue to be
prioritised for index cases. Even when SMS is defaulted to, in these scenarios, a number of
close contacts are still telephoned, following clinical risk assessment, particularly if they are
linked to complex cases. When close contacts of index cases are contacted via SMS text
message, the GOV.UK Notify Service is used which means it is known if the SMS has been
received by the mobile phone, not just that it has been sent. Where the SMS is not received,
a contact tracer will attempt to contact the individual through other means.
Appendix 5: Lateral Flow Device Testing
UK Gov other includes any LFD result which has come through the UK Government route
to 28 July 2021 are reported via this method. From 28 July 2021 onwards, universal offer
results are reported separately as Universal Offer.
The Attend An Event, High Cases In Local Area, Lives With Someone Who Is Shielding,
Travel Within UK and Universal Offer categories only include data from 28 July 2021
onwards. From this date these categories are now options when entering a non-work LFD
result via the UK Gov portal. Please note that it is up to the user to select the Attend An
Event, High Cases In Local Area, Lives With Someone Who Is Shielding or Travel Within UK
category, these are not part of any defined testing programme such us Community Testing or
University Testing.
University Testing Site tests are tests which took place at a university testing site, generally in
the 2020/21 academic year, though there are still a small number of tests each week in this
category. Tests in the university students and university staff categories are tests via the UK
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Gov portal for someone entering a test to attend their place of work/education, these tests
are from 28th July 2021 onwards and will be for the 2021/22 academic year.
For information regarding LFD testing during term time as part of the Schools Asymptomatic
Testing Programme, please visit the COVID-19 Education Surveillance Report.
Please note bulk uploading functionality is not yet available so data is likely to be an
undercount. Data will be update and revised in future publications.
Other is any result entered via the gov.uk website
selected. Please note anyone requesting a LFD test via the general population offer, will
currently report their results via this category.
Appendix 6: Data Sources and Limitations
Date of extraction and analysis
Due to delays in reporting, figures are subject to change as records are updated. A marker
(greyed-out block) has been applied where data is preliminary and caution should be taken in
their interpretation.
The definitions described below are being used for the purposes of evaluating the impact of
the COVID-19 vaccine on COVID-19 cases, COVID-19 related acute hospital admissions and
confirmed COVID-19 deaths. The numbers reported in this section use test data, accounting
for potential reinfections, and may differ from other sections and elsewhere which only count
the number of new COVID-19 cases.
Please note that this section only includes PCR confirmed COVID-19 cases, COVID-19
related acute hospital admissions and confirmed COVID-19 deaths. Lateral flow test
(LFT) confirmed cases are not included in this section and therefore will result in an
underestimation of recent case rate trends. Work is underway to include these data in
future publications.
COVID-19 PCR test results: All positive COVID-19 PCR test results and associated
demographics of an individual are extracted from the Test and Protect database (Corporate
Data Warehouse) which contains test results from ECOSS. Data included in this analysis is
reported up until the Friday of the previous week. Non-Scottish residents are excluded from
the dataset.
COVID-19 cases are identified as the following: An individual that has tested positive for
COVID-19 by PCR. If an individual tests positive more than once, the repeat positive PCR
test is only counted if the positive PCR test is more than 90 days apart. Records with missing
CHI numbers are excluded as these data cannot be linked to vaccination status.
COVID-19 cases included for the age-standardised rates only includes individuals 10 years
old and over. Although the majority of 10- and 11-year-olds are currently not eligible for
vaccination, the five-year age band standardised to the 2013 European Standard Population
used in this analysis ranges from 10-14 years and therefore cases and denominators for
these age groups are included.
Denominators for the 16 and over population are taken from the COVID-19 vaccination
database. The denominator for under 16 year olds is from the NRS mid-2020 population
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estimates. Population data are extracted from Community Health Index (CHI) dataset
representing all those currently registered with a GP practice in Scotland. These are different
denominators than those in the Public Health Scotland COVID-19 Daily Dashboard and may
over-estimate the population size as they will include, for example, some individuals who are
no longer residents in Scotland. This is a particular issue for the denominator for the
unvaccinated cohort, because for vaccinated individuals we know they were resident in
Scotland at the time of their vaccination whereas for the unvaccinated cohort there will be a
mixture of people who have chosen not to have the vaccine and those who are no longer
resident in Scotland. This means that the rates of COVID infection and harm for the
unvaccinated groups will be underestimated, whereas the rates for the vaccinated groups will
be more accurate.
Vaccination status for all individuals who test positive for COVID-19 by PCR is extracted
from the data used to produce the PHS vaccine uptake/daily dashboard. Vaccine records
include the number of doses and date of vaccination. Individuals are listed as unvaccinated if
there is no vaccination record linked to their unique CHI identifier at the time of analysis.
Vaccination status is taken at date of specimen for COVID-19 cases, acute hospital
admissions, or death and assigned to number of doses according to the case definitions
described below.
COVID-19 vaccination status is defined as per the following:
Unvaccinated: An individual that has had no doses of COVID-19 vaccine and has
tested positive for COVID-19 by PCR or has had one dose of COVID-19 vaccine and
has tested positive less than or equal to 21 days after their 1st dose of COVID-19
vaccine.
Dose 1: An individual that has had one dose of COVID-19 vaccine and has tested
positive for COVID-19 by PCR more than 21 days after their 1st dose of COVID-19
vaccine or less than or equal to 14 days after their second dose of COVID-19 vaccine.
Dose 2: An individual that has had at least two doses of COVID-19 vaccine and has
tested positive for COVID-19 by PCR more than 14 days after their 2nd dose of
COVID-19 vaccine.
Booster or 3 doses: An individual that has had a booster or 3rd dose of COVID-19
vaccine and has tested positive for COVID-19 by PCR more than 14 days after their
booster or 3rd dose of COVID-19 vaccine.
COVID-19 related acute hospital admissions have been identified as the following: An
individual that has tested positive for COVID-19 by PCR:
Up to 14 days prior to hospital admission
On the day of, or day following admission (if no discharge date is available)
In between hospital admission and discharge (if there is a valid discharge date
available).
Are 15 years old and over.
Where an individual has more than one PCR positive test, positive results are only included
for the first PCR positive test associated with a hospitalisation, or if the positive PCR test is
more than 90 days after the previous PCR positive test that was eligible for inclusion. Using
these criterion, all records of hospitalisation occurring within 90 days of a previous positive
test are excluded. Therefore, if a positive PCR test result for an individual meets these
criteria for multiple hospital stays, for example, an individual is admitted twice within a week,
only the earliest hospital admission is included in the analysis.
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If a patient tested positive after their date of discharge from hospital, they are not included in
the analysis unless they are readmitted to hospital and meet the criteria described above.
The number of reported acute hospitalisations does not take into account the reason for
hospitalisation, Therefore, people that were admitted for a non-COVID-19 related reason
(and tested positive upon admission) may be included and result in an overestimation of
COVID-19 related acute hospitalisations.
Hospital admission data is extracted from the Rapid and Preliminary Inpatient Data (RAPID)
dataset on Monday 17 January 2022. RAPID is a daily submission of people who have been
admitted and discharged to hospital. Figures are subject to change as hospital records are
updated. Data included in this analysis is reported up until the Friday of the previous week.
In the data presented here, an admission is defined as a period of stay in a single hospital. If
the patient has been transferred to another hospital during treatment, each transfer will
create a new admission record. Therefore, there may be multiple admissions for a single
patient if they have moved between locations during a continuous inpatient stay (CIS), or if
they have been admitted to hospital on separate occasions.
Confirmed COVID-19 deaths: Death data were extracted from the SMRA dataset on
Thursday 13 January 2022. Data included in these analyses are reported up until the last
date of death registration for the previous week.
A confirmed COVID-19 related death is defined as an individual who has tested positive by
PCR for SARS-CoV-2 at any time point and has COVID-19 listed as a underlying or
contributory cause of death on the death certificate. Vaccine status is determined at time of
most recent specimen date.
Age standardised hospitalisation and mortality rates are used to allow comparisons of
hospitalisation and mortality rates between populations that have different age distributions.
The 2013 European Standard Population is used to standardise rates. For more information
see the ONS methods. Denominators used to calculate age-standardised mortality rates are
the same as the cases and hospitalisations rate figures and tables described above.
Vaccine Wastage
The single source of vaccination wastage data for Scotland is through an NSS Service Now
wastage form, which is populated by health board clinicians which can impact timeliness and
accuracy.
It is important to note, that these statistics do not include wastage of vaccines in GPs
practices. Therefore, the Scotland level figures reported above may be an under estimate.
Appendix 7: Hospit-19
For the purposes of this investigation, people admitted to hospital were included if they had a
COVID-19 PCR confirmed diagnosis within 14 days prior to or in the 48 hours following their
hospital admission date. All hospital admissions, including emergency and selective visits,
COVID-19 were assigned according to the case definitions described in Box 1.
Definite because of COVID-19: Admitted (or transferred in within 48 hours of
admission) to a COVID-designated ward or ICU if applicable OR determined
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through case review as having a presenting complaint mentioning COVID-19 as a
cause for admission.
Probable because of COVID-19: Admitted (or transferred in within 48 hours of
admission) to COVID designated ward or ICU but presenting complaint does not
mention COVID-19 OR clinical symptomatology, radiological or low oximetry or
other investigation consistent with COVID diagnosis OR treatment indicative of
COVID-19, including requirement for oxygen therapy amonst those admitted with
respiratory complaint or dexamethasone, appropriate antivirals, monoclonal
antibodies, etc.
With Covid-19 All admissions to non-COVID-19 wards where the primary
presenting complaint is complete but does not mention COVID-19.
-19 are presented as a single category,
since similar case definitions were used. Cases that had an unknown admission complaint or
that had a confirmatory diagnosis more than 48 hours after admission (considered to be
nosocomial transmission) were excluded, as we sought to assess the contributions of
community-acquired COVID-19 infections to hospital admissions rather than infections
possibly or definitely acquired in hospital.
vaccination status and variant type.
As noted in the main results, caution should be taken when comparing the results of this
approach and the previous one reported in December by Public Health Scotland. In addition
published figure would have included nosocomial transmissions. Results here based on the
clinical audit methods include only community-acquired transmissions.
Other limitations that are important to consider when putting these findings into context or
considering the replicability of this approach going forward is that at this point, only three
Boards were able to conduct this investigation. The reason for this is because in many
Boards, substantial human resources and time are required to review case files. For the three
participating Boards in this investigation, there is a potential for misclassification of the
primary outcome as only a single clinician was available to review and assign outcomes to
cases.
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