Today, we have published a new report on our real-time tracking of the COVID-19 pandemic. This information is helping the government to track the COVID-19 pandemic in real time.

We have highlighted the latest findings and provided interpretation of what these findings mean. We have also explained our recent model and report changes.

---

Updated findings

1. The current estimate of the daily number of new infections occurring each day across England is 86,000 (60,300–124,000, 95% credible interval).
2. The daily infection rate is particularly high in the North West (NW) and North East (NE) with 22,800, 6,160 new daily infections, corresponding to 313, and 232 per 100,000 population, respectively. Note that a substantial proportion of these daily infections will be asymptomatic.
3. We predict that the number of deaths occurring daily is likely to be between 550 and 1040 on the 10th February 2021.
4. The probability of Rt exceeding 1 is 83% and 79% in the NW and South West (SW) respectively; 69% in NE; 55% in Yorkshire and Humber (YH); 30% in the East Midlands (EM); 26% in the West Midlands (WM) and lower than 10% in London, the South East (SE) and East of England (EE).
5. The growth rate for England is now estimated to be 0.01 (-0.02–0.03, 95% credible interval) per day. This means that, nationally, the number of infections is slightly increasing, but with a high degree of regional variation. Infections are still increasing in the SW, NE and NW, plateauing in YH, and decreasing in all other regions.
6. London, followed by the NW, the NE and WM, continues to have the highest attack rate, that is the proportion of the population who have ever been infected, with 37%, 33% and 27% respectively. The SW continues to have the lowest attack rate at 11%.
7. Note that the deaths data used are only very weakly informative on Rt over the last two weeks. Therefore, the estimate for current incidence, Rt and the forecast of daily numbers of deaths are likely to be subject to some revision.

---

Interpretation

The plots of Rt over time are showing a plateau in the estimated values, following a period of downwards trends from the introduction of the national Tier 4 restrictions and the beginning of the Christmas period. Many of the Rt values are below 1, notably in London, the EE and the SE, but remain higher than 1 in the SW, NW, NE and YH where the number of infections is increasing (SW, NW, NE) or plateauing (YH).

Incidence of deaths which had levelled off during the last week of November / first week of December, with some falls noted in the NE, NW, and YH, EM and WM started to climb significantly throughout December and early January in all regions. The deaths, which are now at a level similar to (e.g. London and WM) or higher than the first wave (SE and EE) are predicted to start falling in most regions, with the exception of regions where the number of new infections is still growing (SW, NW, NE).

In most regions, a downward trend in Rt started around the time of the launch of Tier 4 restrictions on Saturday 19th December appears to have been consolidated by the Christmas holiday period and the nationwide lockdown announced on the 5th January. It is difficult to separate the individual impacts of each, though in four regions (EE, London, SE and WM), the sharpest drop coincides with the timing of this latest lockdown, whereas in the Northern regions (NE, NW, YH) there is no appreciable decline in Rt after an initial drop when schools first closed over the Christmas period. In these regions Rt remains above 1.

However, due to the recency of the lockdown, its estimated impact is highly volatile and, with a high likelihood, could change over the coming week. This, combined with the conflicting signals from the two primary data streams (over a number of weeks the deaths continue to increase while prevalence declines), gives a reduced confidence in our outputs this week. Other indicators (e.g. hospital bed prevalence, case data etc) currently suggest a declining epidemic, so an estimate of positive epidemic growth may be a little unreliable. Conversely, it is this data conflict that leads to a very low estimate for Rt in EE, which should be treated with caution. Regardless of current trends, the prevalence of infection remains high and the demand on healthcare services is currently extreme, so continued restrictions are essential to lower these levels and to gain control over transmission over the coming period.

---

Additional comment from lead researcher – Professor Daniela De Angelis, MRC Investigator and Deputy Director

“This week, the impacts of the lockdown are beginning to be identified. A general downward trend in Rt was augmented by the lockdown leading to large drops in four regions. However, in the three most northerly regions the decline has not been sufficient to lower Rt below 1, and in the South West Rt it appears to be constant. We continue to anticipate a decline in deaths that has not yet materialised, but would be in concordance with declining prevalence (as estimated by the ONS), falling levels of hospitalisation and declining case numbers. It remains a possibility that there are 100,000 new infections per day. The continuation of the current restrictions are essential to lower these levels and to gain some control over transmission.”

---

Model and report changes

1. The model incorporates estimates of community prevalence, by region and age group, from the Office of National Statistics COVID-19 Infection Survey (see Data Sources for details). These are included weekly over the last 50 days and for the age groups >4 years to inform trends in incidence that are too recent to be captured by the data on deaths.
2. The geographical definition has been changed from the seven NHS regions (map) to the nine regions typically used in government (map). This new spatial definition more appropriately reflects the existing regional heterogeneity.
3. Using observations of improved survival in hospitalised COVID-19 patients, we have allowed the probability of dying following infection with SARS-CoV2 (the infection-fatality rate, IFR) to gradually change over the course of June 2020, with a decrease being estimated.
4. The modelling now accounts for a different susceptibility to infection in the under-15s, using information from literature (Viner et al, 2020) suggesting that children less likely to acquire infection when in contact with an infectious individual.

---

Link to full report

https://www.mrc-bsu.cam.ac.uk/nowcasting-and-forecasting-29th-january-2021/