Local Outbreak Engagement Board Covid-19 Overview Data from 01/06/2020 – 04/12/2020

Birmingham Public Health Division 07/12/2020 Pillar 1 and 2 testing summary on 6th December

. Total cases up to the 4th December 42,054 cases • Increase since 27th November 2,096 cases (5.2% increase) . 7 Day Pillar 2 testing rate at 4th December 2,208/100K • Rate of testing on 27th November 2,140/100K • Ranked 10th highest in the region . % of positive tests in Pillar 2 at 4th December 7.9% • Lower than the rate on 27th November 11.0% . 7 Day Rolling Rate to 4th December (pillar 1 & 2) 183.6/100K • Rate on 27th November 240.1/100K • Ranked 6th in the region

* Dates differ due to different data sources Cases by ward (total, last month & last week)

All Cases Last Month Last Week Note: Cases for the week 28th of November to 4th December are likely to be an under-estimate due to time-lags in reporting

PAGE 3 Top Ten Case Rates by Ward Prior week Most recent Change between last two Ward Total week (2020-11- (2020-11-11 to weeks 2020-11-17) 18 to 2020-11-24) Absolute Case Rate Case Rate Case Rate Change difference Heartlands 739 5489.9 79 586.9 47 349.2 -237.7 Decrease Bromford & Hodge Hill 1067 4871.0 75 342.4 74 337.8 -4.6 = 452 3715.6 46 378.1 41 337.0 -41.1 = North 966 3929.9 81 329.5 81 329.5 0.0 = Lozells 562 5741.7 56 572.1 32 326.9 -245.2 Decrease Handsworth 522 4172.3 45 359.7 40 319.7 -40.0 = Ward End 630 4595.9 56 408.5 43 313.7 -94.8 = Alum Rock 1325 4902.5 138 510.6 84 310.8 -199.8 Decrease Sutton Trinity 290 3126.7 28 301.9 28 301.9 0.0 = 980 4703.2 76 364.7 57 273.6 -91.1 = 26 wards have shown a significant decrease in case rates between the most recent week and the prior week. None of the wards have shown a significant increase. Case numbers by ward – last 7 days

The following wards had high numbers of cases in the last 7 days (between 28th November and 4th December): • 83 cases in North Edgbaston • 77 in Alum Rock • 78 in & Balsall Heath East • 64 in Bromford & Hodge Hill (9 linked to a single setting outbreak) • 63 in • 61 in Small Heath • 60 in Glebe Farm & Tile Cross • 58 in Soho & Jewellery Quarter (8 linked to a single setting outbreak) • 55 in Aston • 51 cases in

Note: Cases for the week 28th of November to 4th December are likely to be an under-estimate due to time-lags in reporting

PAGE 5 Testing by LSOA (Pillar 2 only, 7 days up to Dec. 4th) Test sites by Status and Type as at 7th December Test Locations Drive-through facilities From the 2nd November, it is planned that only 1 Mobile Testing Unit (MTU) will be deployed in the city centre with a 2nd unit in a suburban location. The MTU resource at the former Tower Ballroom Reservoir Rd (North Edgbaston) site has been moved to the Aston Uni site (Holt St) due to traffic management issues. Activity at the Aston Uni site will be closely monitored until a resolution can be found at the Reservoir Rd site.

Walk-through facilities • Villa St Lozells • South Parade • University of B/ham South Gate Car Park • Summerfield Community Sports Centre • Woodgate Valley Country Park • Health & Wellbeing Centre • Alfred Rd Car Park Sparkbrook • Aston University Car Park 6, Coleshill St • Lifford House, 45 Fordhouse Lane, Stirchley • 7 Capital , Orphanage Rd Community Engagement 30th November to 6th December 2020 Percentage of Covid 19 cases by age group compared to age profile of Birmingham population (2018)

1st June to Current Key points to highlight • These different data sources are different to the previous slides and comes from the individual case line listings and 2018 mid year estimates.

• There is an over-representation in the 18-64yr age group compared to the overall population of the city.

• This may reflect the increasing Data Source: PHE West Midlands Incident Co-ordinate Centre number of adults returning to (01/06/2020 – 04/12/2020) work/university and increasing and 2018 Population Estimates socialisation. COVID-19 Birmingham Cases by Week and Age Group COVID-19 Birmingham Cases by Week & Age Group Week ending 13th September to Week ending 6th December (incomplete week) 5000 National lockdown National lockdown Key points to highlight ends 4500 begins 171 • This data also comes from 4000 145 462 192 the individual case line 439 3500 395 91 listings. 87 391 1293 3000 313 1141 • Positive cases have fallen 100 1092 224 2500 53 92 80+

Cases 153 856 1019 amongst all age groups, but 271 60 -79 41 661 2000 154 505 40 - 59 the largest proportion of 708 91 32 405 193 20 - 39 163 1646 1500 1585 1383 0 - 19 cases is still in the 20 – 39 27 551 122 433 1075 1328 1233 1331 384 806 age group. 1000 7820 959 247 686 673 500 599 • This appears to be a result 439 800 787 755 722 623 668 425 582 510 533 420 222 286 of the recent lockdown and 0 increased restrictions that

have remained in force. Week Ending

Data Source: PHE West Midlands Incident Co-ordination Centre (NB: different data sources)

Note: Cases for the week 28th of November to 6th December are likely to be an under-estimate due to time-lags in reporting COVID-19 Birmingham Cases by COVID-19 Birmingham Cases aged 21 and under by Week & Age Group Week and Age Group in those aged Week ending 13th September to 6th December (incomplete week) 1,200 under 21yrs National lockdown National lockdown begins ends 1,000 Key points to highlight 293 194 800 466 544 • This data also comes from 279 the individual case line 436 291 161 19-21 600 205

Cases 16-18 listings. 198 117 193 11-15 203 160 289 100 95 5-10 • Positive cases numbers 400 128 Under 5 have fallen in most age 326 283 183 255 85 84 185 95 220 200 51 66 164 bands, most markedly in the 200 160 36 110 188 87 119 103 157 19-21yrs and 16-18yrs. 63 103 104 144 87 94 74 97 69 70 70 46 47 55 60 60 70 69 76 91 61 0 36 39 39 40 43

Week Ending

Source: PHE COVID-19 Positive Test Data (weekly line listing) Note: Cases for the week 28th of November to 6th December are likely to be an under-estimate due to time-lags in reporting Growth in cases by age

COVID-19 Birmingham Cases Rate per 100,000 Population by Week & Age Group Week ending 13th September to Week ending 6th December (incomplete week) Chart shows growth in case rates by 600 age group. Case rates have fallen National lockdown National lockdown begins ends sharply in all age groups since the 500 week ending 22nd of November.

400 Case rates remain highest in the 40- 0 - 9 10 - 19 49yrs and 30-39yrs age groups.The 300 20 - 29 over 80+ case rate remains of 30 - 39 40 - 49 concern although has fallen. 200 50 - 59 Cases per 100k population 60 - 69 70 - 79 80+ Week ending 6th December is an 100 incomplete week therefore the rates shown at the end of the graph are 0 artificially low.

Week Ending

Note: Cases for the week 28th of November to 6th December are likely to be an under-estimate due to time-lags in reporting Cases by age in the last week

Cases by Age Week Ending 6th December 2020 (incomplete week) 50 This chart shows the cases by age to the week ending 6th 45

December. Please note that due to 40 delays in reporting data this represents an incomplete week. 35

30

The highest number of cases are 25 Cases seen in those in the 20-40 age bands. 20

15 N.B. cases in the 0 year age group are being investigated to see if this is 10

due to reporting error. 5

0 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86 88 90 92 94 97 100 Age

Note: Cases for the week 28th of November to 6th December are likely to be an under-estimate due to time-lags in reporting Case rate in 60+ population

COVID-19 Rate in Birmingham Aged 60+ by Week 350.0 This chart shows how the case rate First national National lockdown lockdown begins begins within the 60+ years population has 300.0 changed since the start of the

outbreak. 250.0

The rate has risen since August, and 200.0 has recently surpassed levels reached 150.0 during the peak in early April.

th Rate per 100,000 Population However, the week ending 29 100.0

November shows a significant fall. National lockdown ends 50.0 It should be noted that the last week is an incomplete week so the final 0.0 week downturn is therefore artificially 15/03/2020 22/03/2020 29/03/2020 05/04/2020 12/04/2020 19/04/2020 26/04/2020 03/05/2020 10/05/2020 17/05/2020 24/05/2020 31/05/2020 07/06/2020 14/06/2020 21/06/2020 28/06/2020 05/07/2020 12/07/2020 19/07/2020 26/07/2020 02/08/2020 09/08/2020 16/08/2020 23/08/2020 30/08/2020 06/09/2020 13/09/2020 20/09/2020 27/09/2020 04/10/2020 11/10/2020 18/10/2020 25/10/2020 01/11/2020 08/11/2020 15/11/2020 22/11/2020 29/11/2020 06/12/2020 low. Week Ending

Note: Cases for the week 28th of November to 6th December are likely to be an under-estimate due to time-lags in reporting Young Adult Cases . Cases in the 18-21 age group have fallen from 489 cases/100K (09-15/10) and the rate is now below the average across all age ranges. . Student transmission is primarily household based, no evidence to date of linkages in classroom settings, i.e. students from different courses or not attended classrooms in same time period, but clear evidence of house sharing and social mixing. Cases Age Group 28/11 – 04/12/2020 Population Rate per 100,000

Student 18-21 136 79,964 170.1

All Ages exc 18-21 1,994 1,061,852 187.8

Grand Total 2,130 1,141,816 186.5 Case rate by ethnicity COVID-19 Birmingham Cases Rate per 100,000 Population by Week & Ethnic Group. Week ending 13th September to Week ending 6th December (incomplete week)

This chart shows the change in case 600 rates by ethnicity from the week Asian Black ending 13th September to the week 500 Mixed / Other ending 6th December (incomplete White week). 400

In the recent weeks we have seen a 300 fall in the rates of cases in all ethnic groups.

Cases per 100k Population 200

th National lockdown 100 Week ending 6 December is an begins National lockdown incomplete week therefore the rates ends

shown at the end of the graph are 0 13/09/2020 27/09/2020 11/10/2020 25/10/2020 08/11/2020 22/11/2020 06/12/2020 artificially low. Week Ending

Note: Cases for the week 28th of November to 6th December are likely to be an under-estimate due to time-lags in reporting Case rate by ethnicity COVID-19 Birmingham Cases by Week & Ethnicity Week ending 13th September to 6th December (incomplete week) 5000 National lockdown National lockdown This chart shows the change in case 4500 begins ends rates by ethnicity from the week 4000 587 ending 13th September to the week 487 464 ending 6th December (incomplete 3500 414 3000 week). 460 1729 1514 1424 2500 406 Unknown 323 Cases 437 1191 White 1235 In the recent weeks we have seen a 2000 332 Mixed / Other 184 201 1081 248 899 207 fall in the cases numbers in all 211 234 Black 227 991 172 228 1500 753 139 189 Asian 155 663 ethnic groups. 405 162 169 157 299 168 1000 113 110 121 180 124 104 86 99 123 119 202 97 1583 1621 163 1376 1485 8862 1204 th 500 971 1016 Week ending 6 December is an 781 895 843 840 771 550 incomplete week therefore the rates 0 shown at the end of the graph are artificially low. Week Ending

Source: PHE COVID-19 Positive Test Data (weekly line listing)

Note: Cases for the week 28th of November to 6th December are likely to be an under-estimate due to time-lags in reporting

PAGE 17 COVID-19 Cases 1st June to 4th December by Ethnicity vs Birmingham Population by Ethnicity (2018 mid year estimates) * excludes cases with unknown ethnicity 70%

60% 58%

50% 44% 42% 40%

30% Percentage 27%

20%

8% 9% 10% 6% 6%

0% Asian Black Mixed / Other White Ethnicity

Cases Population MYE

Source: PHE COVID-19 Positive Test Data (weekly line listing) Note: Cases for the week 28th of November to 6th December are likely to be an under-estimate due to time-lags in reporting

PAGE 18 Situation Awareness

. Ongoing number of situations associated with schools but limited evidence of transmission in the classroom. . Increasing number of challenging workplaces emerging through contact tracing. Investigations highlight lack of social distancing and car sharing as particular issues. . Small number outbreaks/clusters in NHS settings linked to failure to follow covid-safety procedures especially when not in patient facing activities. . Increasing numbers of outbreaks in Care Homes (<10 cases) but of concern and several larger outbreaks. Investigation highlights failures in social distancing and PPE primarily. . Some issues in student accommodation, shift in pattern now to private rental accommodation, relative numbers are still small compared to total student population and few have actually attended classes.

PAGE 19 Type of Situation 28th November 2020 to Public Health England define 6th December situations as: Outbreak Cluster Exposure • Cluster: A number of cases with possible but unconfirmed epidemiological link • Outbreak: A number of cases with highly probable or confirmed epidemiological link • Exposure: Where a person or a number of 42 129 people have been exposed 31 • Issue: Where there is a local situation that requires monitoring • Threat: A wider situation which required long term monitoring and planning 11 14 27 (35%) (82%) (26%) Contact Tracing

. There has been substantial work developed to improve contact tracing approach by the national contact tracing service to take account of family units and the contact tracing process for children in families. . Up to the 8th December the national Contact tracing service: • Completed 75.4% of cases referred to the system, this compares to 81.3% across the west midlands and 83.4% nationally • An average of 2.8 contacts were identified by each case who completed the national tracing process this is slightly higher than the average for the West Midlands (2.7) and England (2.6) . Locally we are restarting enhanced contact tracing shortly now the national data issues have been resolved.

PAGE 21 Contacts by exposure/activity setting and current contact tracing outcome in Birmingham (May 28 2020 to December 5th 2020) and most recent two weeks (22nd November to 5th December) Data has been collected by NHS Track & Trace (NTAT)

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