State of the Epidemic in Scotland - 7 January 2022 Background - The ...
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State of the Epidemic in Scotland – 7 January 2022 Background This report summarises the current situation of the Covid-19 epidemic in Scotland. It brings together the different sources of evidence and data about the epidemic in Scotland at this point in time, why we are at that place, and what is likely to happen next. This summarises the data up to and including 6 January 2022 on Covid-19 in Scotland. This updates the previous publication published on 23 December1. The information in this document helps the Scottish Government, the health service and the wider public sector respond to the epidemic and put in place what is needed to keep us safe and treat people who have the virus. This edition of the State of the Epidemic summarises current data on Covid-19 at a national and local level, and how Scotland currently compares to the rest of the UK. It looks at the vaccination program in Scotland and its impact. Information is provided about variants of concern and what impact these may have. Bringing this information together in one place gives the opportunity to better understand the current state of the epidemic in Scotland. Public Health Scotland (PHS) are aware of larger volumes of tests being processed by laboratories. This and the holiday weekend appears to have impacted turnaround times resulting in delays between specimens being taken and results being received and reported. Public Health Scotland expect variability in reporting of Covid-19 testing data over the festive period due to availability of testing and people presenting for testing. Caution is advised when interpreting this data. Cases and testing data continue to be reported in line with the existing definitions and sources. SG and PHS analytical teams are reviewing the recent testing policy changes announced on 5 January 2022 and any changes will be incorporated in future reports2. 1 Scottish Government: Coronavirus (COVID-19): state of the epidemic - gov.scot (www.gov.scot) 2 Self-Isolation and testing changes - gov.scot (www.gov.scot)
Key Points The latest R value for Scotland, as of 21 December 2021 (using data to 4 January 2022), was between 1.2 and 1.5, with a growth rate of between 4% and 9%. The lower and upper limits have increased since the last publication for both R value and growth rate. Latest modelled estimates suggest that, as at 21 December, the incidence of new daily infections in Scotland was between 237 and 507 new infections per 100,000. These figures are based on data to 4 January 2022. Nationwide, wastewater Covid-19 RNA levels have shown a large increase during the Christmas period, increasing by approximately 71% since the week ending 21 December. The week ending on 4 January saw levels in excess of 220 million gene copies per person per day (Mgc/p/d), up from around 130 Mgc/p/d in the week ending on 21 December. As determined through the latest weekly ONS infection survey, the percentage of people testing positive for Covid-19 in the private residential population in Scotland has continued to increase in the most recent week (25 to 31 December 2021), equating to around 1 in 20 people. An average of 15,435 cases were reported per day in the 7 days to 6 January 2022. This is a 37% increase from the daily average of 11,284 recorded on 30 December 2021. In the last week, 7 day case rates in Scotland have consistently and rapidly increased. There were 2,062 weekly cases per 100,000 population in the week to 3 January 2022, which is a 62% increase from 1,274 weekly cases per 100,000 on 27 December 2021. This is higher than the most recent peak (825 weekly cases per 100,000 on 6 September 2021) and the peak in July (425 weekly cases per 100,000 recorded on 3 July 2021). As of 3 January 2022, the highest case rates (by specimen date) were observed amongst those aged 20-39, followed by 40-59, under
20, 60-79 and 80+. In the week to 3 January 2022, case rates have
increased in all age groups.
91.1% of all PCR tests from Pillar 2 Lighthouse Labs had the S-gene
target failure, as reported on 5 January 2022. S-gene target failure is
used as a proxy for Omicron cases.
A total of 21,832 confirmed cases of Omicron variant (B.1.1.529), as
determined through whole genome sequencing, have been reported
as of 5 January 2022.
Following a sharp increase in Lateral Flow Device (LFD) tests
throughout December 2021, there was an 8.9% decrease in LFD
tests that were reported in Scotland from 26 December 2021 to 2
January 2022. By 6 January 2022 PCR tests per 1,000 people
increased to 79.
In the week to 22 December Covid-19 hospital occupancy and Covid-
19 ICU occupancy (short and long stay) increased by 56% and 16%
overall from this time last week.
Average hospital admissions (3-week rolling average) related to
Covid-19 in children and young adults have increased overall in the
week leading up to 29 December 2021 compared to the previous
three-week period. Average hospital admissions have almost doubled
in those aged 0-1 and 20-21 in the same time period.
There were 44 deaths registered where Covid-19 was mentioned on
the death certificate in the week to 2 January 2022. This is a
decrease of 9 (-17%) in the number of deaths from the previous
week.
Inverclyde currently has the highest weekly case rate in Scotland
reporting 2,726 weekly cases per 100,000 in the week to 3 January
2022. Shetland has the lowest case rate in Scotland, reporting 708
weekly cases per 100,000 population.
Infections, hospitalisations and hospital occupancy have been
increasing and are expected to continue to rise as Omicron continues
to spread.
Method
This report brings together a wide range of publically available figures
from a range of data sources. These include publications by Scottish
Government, Public Heath Scotland, National Records of Scotland and
Office for National Statistics along with scientific publications and SAGE
and UKHSA summaries where appropriate to summarise the state of the
epidemic in Scotland in a given week. We also provide information on
public attitudes to the virus from weekly YouGov polling surveys.Summary
Estimated Infection Levels
The latest R value for Scotland as of 21 December was between 1.2 and
1.5 (Figure 1), with a growth rate of between 4% and 9%. R is an
indicator that lags by two to three weeks and therefore should not be
expected to fully reflect the increased prevalence of Omicron in the
recent weeks. These figures are based on data to 4 January 20223. The
lower and upper limits have increased since the past publication for both
R value and growth rate.
Figure 1: R in Scotland over time
2.0
1.5
1.5
1.2
1.0
0.5
0.0
22/05/2020
12/06/2020
01/07/2020
22/07/2020
12/08/2020
02/09/2020
23/09/2020
14/10/2020
04/11/2020
25/11/2020
16/12/2020
13/01/2021
03/02/2021
24/02/2021
17/03/2021
07/04/2021
28/04/2021
19/05/2021
09/06/2021
30/06/2021
21/07/2021
11/08/2021
01/09/2021
22/09/2021
13/10/2021
03/11/2021
24/11/2021
15/12/2021
Latest modelled estimates suggest that, as at 21 December, based on
data to 4 January, the incidence of new daily infections in Scotland was
between 237 and 507 new infections per 100,0004. This equates to
between 13,000 and 27,700 people becoming infected each day in
Scotland.
3 Scottish Government: Coronavirus (COVID-19): modelling the epidemic - gov.scot (www.gov.scot)
4 Ibid.Covid-19 Cases in Scotland
An average of 15,435 cases were reported per day in the 7 days to 6
January 2022. This is a 37% increase from the daily average of 11,284
recorded on 30 December 20215. A total of 21,832 cases of confirmed
Omicron variant (B.1.1.529) which had been reported as of 5 January
20226, including 8,183 in the latest 24 hours.
In the last week, 7 day case rates (by specimen date) have consistently
and rapidly increased in Scotland. There were 2,062 weekly cases per
100,000 population in the week to 3 January 2022, which is a 62%
increase from 1,274 weekly cases per 100,000 on 27 December 20217.
This is higher than the most recent peak of 825 weekly cases per
100,000 on 6 September and the previous peak of 425 weekly cases
recorded on 3 July (Figure 2).
In the week to 31 December 2021, there were 3,333 cases (PCR testing
only) per 100,000 among individuals with one or two doses of a Covid-
19 vaccine, compared to 1,243 cases per 100,000 for those that had a
booster or 3rd dose of a Covid-19 vaccine8.
Figure 2: Seven day case rate for Scotland by specimen date. Refers to
PCR testing only. Data up to 3 January 2021.
2500
7 day cases per 100,000
2000
1500
1000
500
0
Specimen date
5 Scottish Government: https://www.gov.scot/publications/coronavirus-covid-19-daily-data-for-scotland/
(week on week comparison may be affected by the festive period and the data flow issue.)
6
Coronavirus (COVID-19): additional data and information - gov.scot (www.gov.scot)
7 Public Health Scotland Covid-19 dashboard: https://public.tableau.com/profile/phs.covid.19#!/vizhome/COVID-
19DailyDashboard_15960160643010/Overview
8 Public Health Scotland COVID-19 statistical reportAs of 3 January 2022, the highest case rates (by specimen date) were
observed amongst those aged 20-39, followed by 40-59, under 20, 60-
79 and 80+. In the week to 3 January 2022, case rates increased in all
age groups (Figure 3). Case rates among those aged over 60 more than
doubled in the week to 3 January.
Figure 3: Seven day case rate in Scotland by age group by specimen
date9. Refers to PCR testing only. Data up to 3 January 2022
4000
3500
7 Day Cases Per 100,000
3000
2500
2000
1500
1000
500
0
Specimen Date
0-19 20-39 40-59 60-79 80+
Case rates also increased for all age groups under 22 in the week to 3
January 2022. The largest increase in case rates in these age groups
occurred among those aged 0-1, with the case rate more than doubling
in a week. Those aged 16-17, 18-19 and 20-21 had a higher 7 day case
rate than the Scotland average in the week to 3 January 202210.
Wastewater Estimates
Nationwide, wastewater Covid-19 RNA levels have shown a large
increase during the Christmas period, increasing by approximately 71%
since the week ending 21 December.
The week ending on 4 January saw levels in excess of 220 million gene
copies per person per day (Mgc/p/d), up from around 130 Mgc/p/d in the
9 Source: Public Health Scotland
10 Public Health Scotland: PHS COVID-19 Education report (shinyapps.io)week ending on 21 December, and 67 Mgc/p/d in the previous reported
week ending 14 December, an increase of 71%. The trend confirms the
recent steep rise in cases caused by the rapid spread of Omicron
variant, although these results arise from a reduced sampling scheme
over the festive period (Figure 4).
Figure 4: National running average trends in wastewater Covid-19 and
daily new case rates (7-day moving average) to 4 January 2022
Covid Infection Survey
The percentage of people testing positive for Covid-19 in the private
residential population continued to increase in the most recent week. The
ONS Covid-19 Infection Survey estimates that in the week 25 to 31
December 2021, the estimated percentage of the population living in
private residential households testing positive for Covid-19 in Scotland
was 4.52% (95% credible interval: 3.98% to 5.09%), equating to around 1
in 20 people. This is higher than the latest peak of 2.29% recorded in the
week to 11 September 2021, and higher than the previous peak of 1.24%
recorded in the week to 17 July 2021. In the week 25 to 31 December
2021, estimates for the other nations of the UK are as follows and can be
seen in Figure 5:
In England, the trend in the percentage of people testing positive in
private residential households has continued to increase in the
most recent week: 6.00% (95% credible interval: 5.80% to 6.19%),
equating to around 1 in 15 people. In Wales, the trend in the percentage of people testing positive in
private residential households has continued to increase in the
most recent week: 5.20% (95% credible interval: 4.57% to 5.91%),
equating to around 1 in 20 people.
In Northern Ireland, the trend in the percentage of people testing
positive in private residential households has continued to increase
in the most recent week: 3.97% (95% credible interval: 3.10% to
4.91%), equating to around 1 in 25 people11.
In Scotland, the percentage of people testing positive for Covid-19
increased for primary school aged children in recent weeks, and
increased in all other ages in the most recent week12.
Figure 5: Modelled daily estimates of the percentage of the private
residential population testing positive for Covid-19 in each of the four
nations of the UK, between 20 November and 31 December 2021,
including 95% credible intervals
Testing Rates and Positivity
PCR tests per 1,000 population (seven day total) remained relatively
stable throughout November with a slight decrease towards the end of
the month. By 6 January 2022 PCR tests per 1,000 people increased to
79. Test positivity rate in the last seven days (proportion of positive
11 Coronavirus (COVID-19): infection survey - gov.scot (www.gov.scot)
12 ibidtests) has increased, and as of 6 January 2022 it was at 29% (Figure
6)13.
Figure 6: Seven day testing rate per 1,000 population and seven day
test positivity rate in Scotland (week ending 6 January 2022)14. Refers to
PCR testing only.
90 35%
80
30%
7 day test rate per 1,000 people
70
25%
60
Test positivity
50 20%
40 15%
30
10%
20
5%
10
- 0%
07/04/2020
07/02/2021
07/05/2020
07/06/2020
07/07/2020
07/08/2020
07/09/2020
07/10/2020
07/11/2020
07/12/2020
07/01/2021
07/03/2021
07/04/2021
07/05/2021
07/06/2021
07/07/2021
07/08/2021
07/09/2021
07/10/2021
07/11/2021
07/12/2021
Date notified
Tests in last 7 days per 1,000 population Test positivity rate in last 7 days
Following a sharp increase in Lateral Flow Device (LFD) tests
throughout December 2021, there was an 8.9% decrease in LFD tests
that were reported in Scotland from 26 December 2021 to 2 January
2022 (Figure 7)15.
13
https://www.gov.scot/publications/coronavirus-covid-19-daily-data-for-scotland/
14 Figures for test positivity rate in the last 7 days are available from 24 August 2020. Gaps in the line chart
represent missing data for the periods 28 July 2021 to 2 August 2021 and 16 September 2021
15 Public Health Scotland COVID-19 statistical reportFigure 7: Trend of LFD tests reported in Scotland from 29 November
2020 to 2 Jan 2022
1,000,000
900,000
Number of LFD Tests
800,000
700,000
600,000
500,000
400,000
300,000
200,000
100,000
0
Week ending
Scottish Contact Survey now asks whether people use Lateral Flow
Device tests and if so how often. Approximately 85% of individuals have
taken at least one lateral flow test within the last 7 days for the survey
pertaining to the 23-29 December, with 47% of individuals taking at least
three16.
The youngest and oldest age groups (18-29 and 70+) have reported the
lowest proportions of individuals who have taken one or more lateral flow
tests, 64% and 56% respectively. In contrast, those aged between 30-69
report the highest proportion of individuals taking at least one lateral flow
test within the last 7 days, with at least 73% taken at least one17.
Omicron variant
Omicron, designated as a variant of concern by the WHO on 26
November 2021, is the dominant strain of the virus within Scotland with
widespread community transmission. As determined by the ONS Covid-
19 Infection Survey, in Scotland, the estimated percentage of the
population living in private residential households testing positive for
Omicron variant compatible cases of Covid-19 has continued to increase
rapidly in the most recent week (25 to 31 December 2021). The
16 Scottish Government: Coronavirus (COVID-19): modelling the epidemic - gov.scot (www.gov.scot)
17 ibidpercentage of people testing positive for Delta variant compatible cases
has continued to decrease in the most recent week18 19.
S-gene target failure (combined with positive detection of the other two
target genes (ORF1AB and N)) has been identified as a reasonable
proxy for Omicron variant (B.1.1.529) in the UK. As of 5 January 2022,
S-gene target failure (SGTF) cases were at 91.1% of all PCR tests from
Pillar 2 Lighthouse Labs, and have risen exponentially (Figure 8)20. For
more information on the emergence of the Omicron variant, see earlier
publications.
Figure 8: Proportion of new daily cases tested in Pillar 2 Lighthouse
Labs for S gene status by result (reported date), 23 November 2021 to 5
January 2022, Scotland21
100
91.1
90
80
S gene target failure (Percent)
70
60
50
40
30
20
10
0
The latest Omicron risk assessment carried out by the UK Health
Security Agency (UKHSA), established with high confidence from
analysis of UK data that Omicron is showing increased household
18 There is considerable uncertainty surrounding these estimates by variant due to the small numbers of positives
detected in Scotland.
19 Coronavirus (COVID-19): infection survey - gov.scot (www.gov.scot)
20 Coronavirus (COVID-19): additional data and information - gov.scot (www.gov.scot)
21 Public Health Scotland COVID-19 statistical reporttransmission risk, increased secondary attack rates and substantially increased growth rates compared to Delta, the previously dominant variant. There is also high confidence that Omicron displays a reduction in immune protection against infection. Omicron infections have a reduced risk of hospitalisation (low confidence)22. Scientific evidence indicates that Omicron has some ability to evade natural immunity from prior infection. Multiple laboratory trials report the potential for reduced vaccine efficacy with Omicron compared to previous variants. In addition analysis of real world vaccine effectiveness data in the UK23 24 and South Africa highlights reduced protection against infection and an increase in the risk of reinfection with Omicron. However, vaccine effectiveness against hospitalisation is high, currently estimated at 88% (78 to 93%) for Omicron after 3 doses of vaccine25. There is evidence that there is reduced overall risk of hospitalisation for Omicron compared to Delta26 27, with the most recent estimate of the risk of presentation to emergency care or hospital admission with Omicron was approximately half of that for Delta28. Hospital and ICU Occupancy and Admissions NHS boards reported 1,267 patients in hospital on 6 January 2022 with recently confirmed Covid-19, compared to 1,223 on 5 January and 811 a week ago (30 December 2021). This is an increase of 456 patients (+56%) from last week, and compares with 2,053 patients in hospital at the peak in January 2021 (Figure 9). ICU occupancy (including long stay) has increased to 57 on 6 January, an increase of 16% since last week but lower than the peak of 172 recorded in January 202129. The latest data from PHS shows that admissions to hospitals have increased in the last week, with 904 admissions to hospital for people with confirmed Covid-19 in the week to 2 January 2022 compared to 584 in the week to 26 December 202130. Average hospital admissions (3- week rolling average) related to Covid-19 in children and young adults 22 22 December 2021 Risk assessment for SARS-CoV-2 variant: Omicron VOC-21NOV-01 (B.1.1.529) (publishing.service.gov.uk) 23 SARS-CoV-2 variants of concern and variants under investigation (publishing.service.gov.uk) 24 Ibid. 25 Ibid. 26 Severity of Omicron variant of concern and vaccine effectiveness against symptomatic disease | The University of Edinburgh 27 2021-12-22-COVID19-Report-50.pdf (imperial.ac.uk) 28 SARS-CoV-2 variants of concern and variants under investigation (publishing.service.gov.uk) 29 Coronavirus (COVID-19): trends in daily data - gov.scot (www.gov.scot) 30 Public Health Scotland dashboard: COVID-19 Daily Dashboard - PHS COVID-19 | Tableau Public.
have increased overall in the week leading up to 29 December 2021
compared to the previous three-week period. Average hospital
admissions have almost doubled in those aged 0-1 and 20-21 in the
same time period31 32.
Figure 9: Patients in hospital (including those in ICU; short and long
stay) and ICU33 with recently confirmed Covid-19
2,000
1,500
1,000
500
0
12-Mar
26-Mar
01-Jan
15-Jan
29-Jan
07-May
21-May
04-Jun
18-Jun
02-Jul
16-Jul
30-Jul
12-Feb
26-Feb
13-Aug
11-Sep
25-Sep
06-Nov
20-Nov
04-Dec
18-Dec
09-Apr
23-Apr
27-Aug
10-Sep
24-Sep
05-Nov
19-Nov
03-Dec
17-Dec
31-Dec
09-Oct
23-Oct
08-Oct
22-Oct
Hospital ICU (short and long stay)
As the population is increasingly vaccinated, more of the patients in
hospital will be fully or partially vaccinated. Therefore, it is important that
we can differentiate between patients in hospital because of Covid-19
rather than with Covid-19. Public Health Scotland estimates that as at
August 2021, 68% of Covid-19 related acute hospital admissions had a
primary diagnosis of Covid-19. In March 2021 this figure stood at 75%,
and then decreased to a low of 66% in April 2021. This increased to
75% in July, but saw a decrease in August34.
A clinical audit of case notes shows that as of 2 January 2022 in NHS
Greater Glasgow and Clyde and as of 4 January 2022 in NHS
31 These figures refer both to young patients in hospital because of Covid-19 and with Covid-19.
32 COVID-19 Education Surveillance dashboard - Enhanced surveillance of COVID-19 in education settings -
COVID-19 data and intelligence - COVID-19 - Our areas of work - Public Health Scotland
33 ICU or combined ICU/HDU (with length of stay 28 days or less and with length of stay more than 28 days).
Please note that only patients with length of stay 28 days or less in ICU were recorded until 20 January 2021.
From 20 January 2021 ICU short and long stay includes both ICU or combined ICU/HDU with length of stay 28
days or less and with length of stay more than 28 days.
34 Public Health Scotland COVID-19 statistical reportGrampian, 60% of acute hospital admissions were ‘because of’ Covid-19
as opposed to coincidental ‘with’ Covid-19. This is lower than the
previously reported value of 68% from discharge summaries from NHS
boards from between March and August 2021, however these are not
directly comparable. Further analysis, based on the clinical audit,
showed that 42% of all hospital admissions ‘because of’ Covid were in
those aged over 6535.
Deaths
There were 44 deaths registered where Covid-19 was mentioned on the
death certificate in the week to 2 January 2022. This is a decrease of 9
(-17%) in the number of deaths from the previous week, and 93% lower
than the peak in April 2020 (663 deaths)36. In the same week, deaths
involving coronavirus increased slightly among those aged 15-44, 45-64
and 75-84, and decreased or remained stable in all other age groups
compared to the week ending 26 December 2021 (Figure 10). National
Records of Scotland publish a weekly detailed analysis on deaths
involving Covid-19 in Scotland in their weekly report37.
Figure 10: Deaths by age group (weekly total by week beginning, NRS)
60
350 50
40
30
300
20
10
250 0
200
150
100
50
0
09/03/20
09/04/20
09/05/20
09/06/20
09/07/20
09/08/20
09/09/20
09/10/20
09/11/20
09/12/20
09/01/21
09/02/21
09/03/21
09/04/21
09/05/21
09/06/21
09/07/21
09/08/21
09/09/21
09/10/21
09/11/21
09/12/21
Week Beginning
Under 1 year 01-14 15-44 45-64 65-74 75-84 85+
35 Public Health Scotland COVID-19 statistical report
36
NRS Scotland: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-
events/general-publications/weekly-and-monthly-data-on-births-and-deaths/deaths-involving-coronavirus-covid-
19-in-scotland
37 ibidVaccinations
The first vaccines were administered on Tuesday 8 December 2020 and
by 6 January 2022 almost 4.4 million people (91.5% of those aged 12+)
had received their first dose and over 4 million people (84.3% of those
aged 12+) had received their second dose38. There remains a low level
of deaths amongst vaccinated individuals.
A booster dose or a third dose of the vaccine is now available in
Scotland, in line with JCVI advice including all adults aged over 18 for
whom it has been at least 12 weeks since their second dose. Over 3
million people (63.6% of those over 12 years of age) have received their
dose 3 or booster vaccine by 6 January 202239.
Booster vaccine uptake is at least 91% amongst males and females
aged 60 or over, and around 85% for males and females aged 55-59.
However, there is a difference between male and female vaccine uptake
in those aged between 18 and 49 with females showing a higher uptake
compared to males (Figure 11).
Figure 11: Estimated percentage of people vaccinated with booster/dose
3 by age and sex by 6 January 2022
100%
100% 95% 97% 96% 97%
93% 95% 95% 92%
91%
90% 85% 86%
78%79%
80%
68%
70%
62%
60%
50%
50%
42%
38%
40%
29%
30%
20%
10% 7% 7%
1% 1%
0%
12 to 15 16 to 17 18 to 29 30 to 39 40 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80+
Male Female
38 Public Health Scotland Covid-19 dashboard: https://public.tableau.com/profile/phs.covid.19#!/vizhome/COVID-
19DailyDashboard_15960160643010/Overview
39 ibidAntibodies Estimates The ONS Covid-19 Infection Survey estimated that in the week beginning 29 November 2021, 95.0% (95% CI: 94.0% to 95.9%) of the adult population living in private residential households in Scotland would have tested positive for antibodies against SARS-CoV-2, as a result of having the infection in the past or being vaccinated. This compares to: 95.0% in England (95% CI: 94.2% to 95.7%), 93.6% in Wales (95% CI: 92.3% to 94.8%), 95.0% in Northern Ireland (95% CI: 94.0% to 95.9%)40. The percentage of adults aged 16 to 24 years testing positive for antibodies was 95.8% (95% credible interval: 93.9% to 97.1%). The percentage of adults aged 25 and over testing positive for antibodies ranged from 93.2% to 98.4%. The highest percentage of people testing positive for antibodies was in those aged 75 to 79 at 98.4% (95% credible interval: 97.6% to 98.9%), followed by those aged 65 to 6941. The effectiveness of vaccines On 29 October 2021, the Vaccine Effectiveness Expert Panel (VEEP) published their updated consensus view on the effectiveness of different vaccines on infections, symptomatic disease, and severe disease against Delta variant as well as some initial evidence on vaccine waning effects42. The consensus view of vaccine effectiveness against symptomatic disease in fully vaccinated people is between 45-95%, depending on the vaccine and when it was administered however, protection against severe disease including hospitalisation and death remains high (over 80% after two doses of vaccine) over time. The latest UK Health Security Agency (UKHSA) data show an increase in vaccine effectiveness against symptomatic disease with Delta variant after the booster dose43. The UKHSA reported that Omicron is displaying a reduction in immune protection against infection, with first estimates of vaccine effectiveness for two doses of Pfizer-BioNTech and AstraZeneca vaccine significantly reduced. The third, booster dose of Pfizer-BioNTech vaccine restores 40Coronavirus (COVID-19): ONS Infection Survey – antibody data for Scotland – 23 December 2021 - gov.scot (www.gov.scot) 41 ibid 42 Research and analysis overview: VEEP: Vaccine effectiveness table, 24 September 2021 - GOV.UK (www.gov.uk) 43 COVID-19 vaccine surveillance report - week 50 (publishing.service.gov.uk)
protection against symptomatic disease to 70-75% in the early period after a booster dose. The data are insufficient to quantify the effect of booster on protection against severe disease44. PHS estimated in an analysis published on 25 November that 27,656 deaths in people 60 years and older have been directly averted as a result of Scotland’s Covid-19 vaccination programme. This equates to an estimated 86% of deaths averted by vaccination in this age group45. Situation by local authority within Scotland Case rates have increased in Scotland over the past week, with all local authorities seeing an increasing case rate over the week. Inverclyde currently has the highest weekly case rate in Scotland reporting 2,726 weekly cases per 100,000 in the week to 3 January 2022. Shetland has the lowest case rate in Scotland, reporting 708 weekly cases per 100,000 population in the same week (Figure 12 and Table 1)46. 44 COVID-19 vaccine surveillance report - week 50 (publishing.service.gov.uk) 45 https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.47.2101021 46Public Health Scotland Covid dashboard: https://public.tableau.com/profile/phs.covid.19#!/vizhome/COVID- 19DailyDashboard_15960160643010/Overview
Table 1: Total new weekly cases (by specimen date) per 100,000
population to 3 January 2022, in order of prevalence
Local authority Total new cases in Change since
the week, per previous
100,000 population week
Inverclyde 2,726 +1,119
South Lanarkshire 2,687 +1,061
North Lanarkshire 2,680 +0,1034
Renfrewshire 2,630 +865
Moray 2,477 +1,526
East Renfrewshire 2,419 +747
West Dunbartonshire 2,348 +770
East Ayrshire 2,322 +941
East Dunbartonshire 2,258 +581
Glasgow City 2,194 +617
North Ayrshire 2,142 +1,034
West Lothian 2,112 +739
South Ayrshire 2,061 +857
Falkirk 2,019 +749
Clackmannanshire 2,012 +542
Midlothian 1,914 +640
Dumfries and Galloway 1,894 +1,111
Fife 1,855 +860
City of Edinburgh 1,835 +418
Stirling 1,830 +371
Dundee City 1,816 +777
Perth and Kinross 1,766 +800
Highland 1,751 +1,019
Aberdeen City 1,748 +810
East Lothian 1,744 +644
Scottish Borders 1,699 +497
Angus 1,662 +839
Aberdeenshire 1,540 +738
Argyll and Bute 1,332 +520
Orkney Islands 1,071 +67
Na h-Eileanan Siar 913 +279
Shetland Islands 708 +236
Scotland 2,062 +788Figure 12: Map of weekly new positive cases per 100,000 people in Scotland, data up to 3 January 2021 Modelled rates of positive tests per 100K using data to 4 January indicate that, for the week commencing 16 January 2022, 29 of the 32 local authorities are expected to exceed 50 cases per 100K with at least 75% probability. The exceptions are Na h-Eileanan Siar, Orkney Islands and Shetland. These 29 areas are also expected to exceed 500 cases per 100K with at least 75% probability. 28 local authorities are expected to exceed 1000 cases per 100K with at least 75% probability. These are Aberdeen City, Aberdeenshire, Angus, City of Edinburgh, Clackmannanshire, Dumfries and Galloway, Dundee City, East Ayrshire, East Dunbartonshire, East Lothian, East Renfrewshire, Falkirk, Fife, Glasgow City, Highland, Inverclyde, Midlothian, Moray, North Ayrshire, North Lanarkshire, Perth and Kinross,
Renfrewshire, Scottish Borders, South Ayrshire, South Lanarkshire, Stirling, West Dunbartonshire and West Lothian. 14 local authorities are expected to exceed 3000 cases per 100K with at least 75% probability. These are Aberdeen City, Dumfries and Galloway, Dundee City, East Ayrshire, East Dunbartonshire, Falkirk, Glasgow City, Highland, Inverclyde, North Lanarkshire, Perth and Kinross, Renfrewshire, Scottish Borders and South Lanarkshire. 3 local authorities are expected to exceed 4000 cases per 100K with at least 75% probability. These are Aberdeen City, North Lanarkshire and South Lanarkshire. Please note that this modelling continues to be based on Covid-19 cases and deaths using data to 4 January from several academic groups to give an indication of whether a local authority is likely to experience high levels of Covid-19 in the future. This has not been compiled via UKHSA into a consensus this week and is based on one modelling group. Due to the Christmas period, there is increased uncertainty due to differences in case reporting. Typically across the regions, case numbers have been lower over Christmas, and have increased sharply since. These trends have been detected to varying degrees by the model. How Scotland compares with the rest of the UK Average daily cases in Scotland (2,824 per 1 million population) in the week to 6 January 2022 were above England but below Wales and Northern Ireland: England (2,615 per 1 million) Wales (3,481 per 1 million) Northern Ireland (3,893 per 1 million)47. Average daily deaths in Scotland (1 per 1 million population) in the week to 6 January were below all other UK nations (2 per 1 million each)48. There were 17,988 confirmed Covid-19 patients in hospital in the UK on 5 January 2022, with 15,659 of them reported in England, 1,223 in Scotland, 702 in Wales and 404 in Northern Ireland49. This translates to 24 patients per 100,000 population for England, 18 patients per 100,000 47 UK Government: https://coronavirus.data.gov.uk/ 48 ibid 49 UK Government: https://coronavirus.data.gov.uk/details/healthcare
in Scotland, 19 per 100,000 for Wales and 22 per 100,000 for Northern Ireland (based on 7 day averages for all 4 nations). Please note that data about Covid-19 patients in hospitals are collected differently by each nation and therefore might not be directly comparable. Over the four-week period ending 6 December 2021, an estimated 1,266,000 people (95% confidence interval: 1,228,000 to 1,304,000) in the private residential population in the UK (1.96%; 95% CI: 1.90% to 2.02%) reported experiencing long Covid (symptoms persisting more than four weeks after the first suspected coronavirus (Covid-19) episode that are not explained by something else). In Scotland, over the same period, an estimated 100,000 people (1.90% of the respective population) in the private residential population reported experiencing long Covid of any duration. This compares to 1.98% in England, 1.91% in Wales and 1.57% in Northern Ireland50. Looking ahead Scottish Contact Survey Changes in patterns of mixing and adherence to restrictions will impact on future case numbers. The Scottish Contact Survey measures times and settings that people mix where they could potentially spread Covid- 19. Average contacts from the most recent Panel A cohort of the Scottish Contact Survey (week ending 29 December) indicate an average of 5.2 contacts. Mean contacts have decreased within the work and other setting (contacts outside home, school and work) reducing by 26% and 23% respectively. Contacts within the home have increased by 22% over the same period. All age groups, with the exception of those aged 18-29, have decreased their contacts. The 18-29 age group have reported an increase of contacts by 21%. This is largely driven by a rise in contacts within the home and work. 50 Office for National Statistics: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/pre valenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/2december2021
Self-reported compliance with the current regulations and guidance has decreased since January but remains at a high level. On 4-5 January, 69% of people reported ‘complete’ or ‘almost complete’ compliance51. Modelling the Epidemic The latest Modelling the Epidemic report shows estimated number of infections, including projections over the four weeks to end of January for combined Delta and Omicron infections. Infections, hospitalisations and hospital occupancy have been increasing and are expected to continue to rise as Omicron continues to spread. Next steps The Scottish Government continues to work closely with Public Health Scotland and modelling groups to monitor what is happening across Scotland. Each week this report will provide an overview of the current Covid-19 situation in Scotland. This will include real time data on case rates, hospitalisations and deaths and how Scotland’s figures compare to those from the rest of the UK. Modelling can tell us where the epidemic is likely to be heading. Local data and data by age group can highlight where problems arise, which can help in addressing some of these issues. In the coming weeks the roll out of the vaccine will continue to be monitored along with the impact of this on case rates and deaths among different age cohorts. Investigations are ongoing by NERVTAG, SPI-M, SAGE, UKHSA, Public Health England and Public Health Scotland regarding the impact of new variants and of vaccination; this will be reflected here as work is undertaken. 51 Results are taken from questions run on behalf of Scottish Government on the YouGov online omnibus survey. The sample is demographically and geographically representative of adults 18+ across Scotland, with c. 1000 responses each week. Fieldwork took place on 4-5 January with a total sample size of 1012 adults. ‘Complete’ or ‘almost complete’ compliance refers to respondents who rated themselves 6 or 7 on a scale of 1-7 for the question: Thinking about ALL of the guidance on what to do and what not to do during the Coronavirus pandemic (including distancing, protection measures and all restrictions).On a scale of 1-7, where 1 is 'Not at all' and 7 is 'Completely', to what extent do you feel you are following the regulations and guidance?
This publication will be available in accessible HTML on the gov.scot website © Crown copyright 2022 You may re-use this information (excluding logos and images) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open- government-licence/ or e-mail: psi@nationalarchives.gsi.gov.uk. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. The views expressed in this report are those of the researchers and do not necessarily represent those of the Scottish Government or Scottish Ministers. This document is also available from our website at www.gov.scot. ISBN: 978-1-80201-903-2 The Scottish Government St Andrew’s House Edinburgh EH1 3DG Produced for the Scottish Government by APS Group Scotland PPDAS1004218 (01/22) Published by the Scottish Government, January 2022 ISBN 978-1-80201-903-2 Web Publication PPDAS1004218 (01/22)
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