State of the Epidemic in Scotland

27th February 2022

Summary -
The daily positivity estimate from the Covid-19 Infection Survey for Scotland has been increasing in recent weeks. By comparison, the weekly case rate in Scotland has continued to decrease slightly in the most recent week, but remains high compared to previous phases of the pandemic. Nationwide, wastewater Covid-19
RNA levels did not continue the upturn seen last week, but have remained at similar levels.

While overall weekly PCR or LFD case rates by specimen date across Scotland slightly decreased, the case rates for those aged 50 or older continued to increase in the most recent week. The biggest rise in case rates was seen among those aged 70 to 79, and aged 80 or older. Similarly, the estimated percentage of the population testing positive for Covid-19 according to the Office for National Statistics (ONS), Covid-19 Infection Survey has increased for those aged above 40 years in the week to 19 February 2022. The majority of local authorities saw an increase in the weekly
PCR or LFD case rate by specimen date in the most recent week, with only 11 local authorities seeing decreasing weekly case rates.
Daily hospital occupancy and the weekly number of Covid-19 related admissions to hospital have both increased in the most recent week. However, combined ICU occupancy and admissions to ICU remained at similar levels to the previous week.

Covid-19 deaths have decreased overall in the week leading up to 20 February, however, the number of Covid-19 deaths increased among those aged 85 or older.

Key Points
 The UK Health Security Agency's (UKHSA) consensus estimate for R in Scotland as at 8 February is between 0.9 and 1.1. The lower and upper limits of the R value have increased since the last published figure.

 As at 8 February, the UKHSA's consensus view was that the incidence of new daily infections in Scotland was between 252 and 498 per 100,000 people.

 The latest growth rate for Scotland as at 8 February was between -2% and 1%. The upper limit has remained unchanged since the previous week, but the lower growth limit has increased.

 As determined through the latest weekly ONS Covid-19 Infection Survey, in Scotland, the percentage of people testing positive for Covid-19 increased in the week 14 to 20 February 2022. In the same week, it is estimated that around 1 in 20 people (95% credible interval: 1 in 25 to 1 in 20) had Covid-19 at any given time.

 Nationwide, wastewater Covid-19 RNA levels did not continue the upturn seen last week. The week ending on 21 February saw levels of around 76 million gene copies per person per day (Mgc/p/d), slightly lower than 90 Mgc/p/d the previous week.

 By specimen date, the seven-day combined PCR and LFD case rate continued to decrease slightly in Scotland in the week leading up to 19 February. There were 786 weekly combined PCR and LFD cases per 100,000 population in the week to 19 February, which is a 1% decrease from 794 weekly cases per 100,000 on 12 February and a 9% decrease from three weeks previous (866 on 29 January). This remains a high case rate compared to previous phases of the epidemic in Scotland.

 Data from the PHS Daily Dashboard shows that as of 19 February, the highest combined PCR and LFD weekly case rates by specimen date per 100,000 were observed amongst those aged 20 to 39, followed by those aged 40 to 49, 19 and younger, and 50 to 59. The lowest weekly case rates were seen among those aged 60 to 69, 70 to 79, and 80 or older.

 The total combined PCR and LFD weekly case rates per 100,000 by specimen date among children and young adults (aged 19 or younger) in the week leading up to 19 February have decreased for all age groups compared to the previous week (ending 12 February). The exceptions are those aged under 1 and 16 to 17, where there has been a slight increase compared to the
previous week.

 In the week to and including 23 February, Covid-19 hospital occupancy showed an increase by 20% compared to the previous week ending 16 February, while combined ICU occupancy (short and long stay) has remained unchanged in the week to 23 February compared to the previous week ending 16 February.

 Admissions to hospital in the week to 19 February increased by 11% compared to the previous week ending 12 February, while ICU admissions have remained at similar levels in the week to 22 February compared to the previous week ending 15 February.

 While remaining at a high level, average hospital admissions related to Covid19 in children and young adults have decreased among all ages except for 12-17 and 20 -21 in the three weeks leading up to 16 February compared to the previous three-week period leading up to 9 February. These figures refer to both young patients in hospital because of Covid-19 and with Covid-19, and
are linked to PCR cases only.

 The overall number of Covid-19 deaths has continued to decrease in the week leading up to 20 February. Compared to the previous week ending 13 February, the number of deaths decreased by 6%, or 5 deaths, to a total of 75 deaths in the week leading up to 20 February.

 In the week leading up to 19 February 2022, Shetland Islands had the highest combined PCR and LFD weekly case rate by specimen date, reporting 2,121 cases per 100,000 population. Dumfries and Galloway had the lowest weekly combined LFD and PCR case rate in the same time period, reporting 514 cases per 100,000.

Hospital Admissions
Admissions to hospital have increased over the last week, with 686 admissions to hospital for people with confirmed Covid-19 in the week to 19 February compared to 619 in the week to 12 February. This is an 11% increase over the last week, and compares to 1,171 weekly hospital admissions during the most recent peak in the
week leading up to 10 January (Figure 9) 36. Similarly to daily hospital occupancy, this corresponds with an increase in the percentage of people estimated to test positive for Covid-19 in Scotland in the week ending 20 February 2022, as seen in
the ONS Covid-19 Infection Survey.

The seven-day average hospital occupancy in Scotland per one million people was 181 patients in the week leading up to 22 February 2022. The seven-day average hospital occupancy per one million population in the same period for other UK nations were as follows:
 England: 165 per one million
 Northern Ireland: 282 per one million
 Wales: 183 per one million

In Scotland, there was a daily average of 18 hospital admissions per one million people in the week leading up to and including 19 February 2022. Seven-day average hospital admissions per one million population in the same period for other UK nations were as follows:
 England: 18 per one million
 Northern Ireland: 18 per one million
 Wales: 7 per one million.

Deaths
After a period of decreasing numbers of Covid-19 deaths throughout the last two months of 2021, the week to 23 January 2022 saw a peak of 146 Covid deaths. This came after three weeks of increasing numbers of deaths, largely consisting of fatalities among those aged 45 or above, as Covid-19 deaths among younger age
groups have remained at similar low levels throughout the pandemic.

The overall number of Covid-19 deaths has decreased by 6%, or 5 deaths, to a total of 75 deaths in the most recent week leading up to 20 February, compared to 80 in the week prior leading up to 13 February. This figure is 89% lower than the peak in 2020, when the week ending 27 April saw a total of 663 deaths where Covid-19 was
mentioned on the death certificate..

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