What can different statistics tell us about coronavirus in Wales so far?
We seem to be bombarded with different measures, but what do they mean and how does Wales compare with other parts of the UK?
Here, we try to answer some of the questions and explain what the different measures are and also give some of the most recent figures.
How many deaths have there been?
In Wales, there were 24 deaths involving Covid-19 registered in the week ending 7 August, accounting for 4.3% of all registered deaths – 14 more than in the previous week.
The total number of Covid deaths in Wales up to 7 August was 2,544 – for deaths to be included in these figures, they must have been registered by 15 August.
The figure is 2,537 for those registered up to 31 July.
Cardiff has had the largest number of deaths with 386, followed by Rhondda Cynon Taff (RCT) with 302 up to 31 July, but the rate has dramatically slowed down.
There were no new coronavirus deaths registered in 15 council areas, but for those registered by 7 August there were 24 deaths: nine in Wrexham – the highest of any local authority area in England and Wales for the second week running, four in Denbighshire, three in Flintshire and Cardiff, two in Rhondda Cynon Taff and one each in Caerphilly, Powys and Vale of Glamorgan.
What about ‘excess deaths’?
Deaths during the pandemic in Wales
All causes and those involving Covid-19 by week
So-called excess deaths, which compare all registered deaths to previous years, are below the five-year average now in Wales.
In Wales, the number of all registered deaths rose to 563 deaths from all causes, which is eight fewer than the five-year average.
So far this year, there have been 23,075 deaths in Wales, which is 1,994 (9.5%) more than the five-year average; 11% mentioned coronavirus on the death certificate.
Is there a Welsh hot spot?
Early on in the pandemic, the hot spot was in the Aneurin Bevan health board area of south east Wales; there was one death in the region in the latest week.
There were 16 deaths registered in the last week – nine of these were Wrexham residents in hospital.
The latest cumulative figures show RCT has had 125.7 deaths per 100,000 people – which ranks 28th across all local authorities in England and Wales.
This is followed by Denbighshire (112.2), ranked 64th, and Merthyr (108).
Ceredigion still has the second lowest rate behind the Isles of Scilly, with a death rate of 9.6 per 100,000. Pembrokeshire is also in the bottom 20.
There are also very few positive cases in Ceredigion and a combination of factors have been suggested by experts for its comparative success, including remoteness and the early, local response.
Some questions have been raised locally about a comparatively high overall death rate early in the year although the chief medical officer has said it is “very unlikely” to have been due to coronavirus.
When looking at the highest death rates across England and Wales, London boroughs dominate, with three out of the 10 highest, including Hertsmere, Harrow and Brent at the top.
Middlesbrough, north east Derbyshire and Midlands towns such as Walsall and Bromsgrove also feature.
Which area has the most deaths?
Across England and Wales, North West England had the largest number of deaths involving Covid-19 (33 deaths) but Wales had the highest proportion of deaths involving the virus (4.3%).
For the week ending 7 August, 152 deaths mentioned coronavirus across England and Wales, the lowest number in the last 20 weeks and a 21.2% drop on the previous week. The virus accounted for 1.7% of all deaths.
Where are coronavirus deaths?
Totals in Wales by place of occurrence
What about deaths in care homes?
There have now been a total of 701 Covid-19 deaths in care homes up to 7 August, making up 27.6% of all coronavirus deaths in Wales.
All deaths in care homes in Wales
Notified to Care Inspectorate Wales
Meanwhile, Care Inspectorate Wales (CIW) compiles its own figures, which showed it was notified of 3,899 deaths in care homes from 1 March until 14 August.
This is 63% higher than deaths reported for the same time period last year, and 40% higher than for the same period in 2018.
Covid-19 was confirmed or suspected in 742 deaths of care home residents. This makes up 19% of all deaths notified to CIW, which is updating its figures now every two weeks.
There were six care home deaths where Covid-19 was mentioned on the death certificate in the latest ONS weekly total in Wales.
The ONS says across England and Wales combined, deaths involving Covid-19 in care homes as a proportion of all deaths in care homes fell again from 2.6% to 1.9% in the week ending 7 August.
Deaths by age group in Wales
Registered up to 31 July
What about age, gender and different ethnic groups?
The number of deaths involving coronavirus rises sharply for those over 75.
Although more men are dying from Covid-19 than women, more women over 85 are being registered with coronavirus involved than men.
Black men and women are nearly twice as likely to die with coronavirus as white people in England and Wales, according to the ONS.
Between 2 March and 15 May, there were 44 deaths in Wales involving Covid-19 of black, Asian and minority ethnic (BAME) people.
This suggests that deaths involving the virus accounted for a higher proportion of all deaths in BAME groups (35%) in that period compared with those in the white group (23%).
Analysis of critically ill coronavirus patients from the Intensive Care National Audit and Research Centre found there was a “noticeably higher” proportion from BAME backgrounds.
The British Medical Association in Wales said it was “shockingly clear” the number of BAME healthcare professionals being adversely affected by the virus was “significantly disproportionate”.
Health Minister Vaughan Gething said: “We don’t yet fully understand why – there will be a number of reasons and complexity behind this.
“We also know that people from BAME backgrounds have higher rates of some underlying health conditions, such as type 2 diabetes and hypertension, which may put them at greater risk.”
An expert panel was set up by the Welsh Government, led by judge Ray Singh, who also chairs Race Council Cymru.
A sub-group has now reported on how systemic racism may have contributed to increased risks. It said “the lack of or poor quality of ethnicity data has resulted in poor health decisions, and BAME communities face a higher risk of catching and dying from the disease”.
The group will also look at the “ongoing risk assessment in relation to front-line healthcare workers” and an online risk-assessment tool has been developed.
Coronavirus and deprivation in Wales
Deaths per 100,000 based on levels of deprivation, March-June
What else can we tell?
The ONS has published figures which suggest nearly twice as many Covid-19 deaths have occurred in Wales’ poorer areas.
There were 119.1 deaths per 100,000 population in the four months to the end of June in the most deprived areas.
This compares to 63.5 deaths in least deprived parts, the ONS has said.
For men, it was 149.1 deaths per 100,000 in the most deprived areas compared to 81.8 in the least deprived.
Analysis of July’s mortality rate found that deaths due to coronavirus – with Covid-19 as the underlying cause of death – did not even make the top 10 for causes of deaths in Wales. Heart disease was the biggest cause of death for the month.
GP consultation rate
Per 100,000 population by day for coronavirus
Health officials say we should also look at how many people are consulting their GP – as another indicator of how the virus is progressing.
This surveillance data – which involves around 400 GP practices, shows how the rate has come down from the clear peak in April.
Public Health Wales’ data dashboard also shows consultations for flu and respiratory conditions. It is currently around three consultations per 100,000 people for suspected Covid-19, compared to around 0.1 per 100,000 for flu symptoms.
Critical care in Wales
Numbers in invasive ventilated and critical care beds
How many people are in hospital with coronavirus?
NHS Wales also gives us figures weekly about how many patients are being treated.
The number of patients in critical care or on ventilation with coronavirus is among the lowest levels since the pandemic began.
Latest figures from NHS Wales Informatics show there are more than 20 times as many patients in critical care with other conditions.
These are the headlines:
- A total of five people were being treated on invasive ventilated beds, including in critical care, for confirmed or suspected coronavirus, according to the NHS Wales figures on 19 August – this is two fewer than the week before
- Cwm Taf Morgannwg – which at its peak had 27 patients in critical care – had no patient in critical care and only one patient recorded in more than two weeks
- There were 331 coronavirus-related patients in hospital beds – about the same as last week
- The seven-day average in total daily admissions to hospitals of confirmed and suspected Covid-19 cases is currently 48, also about the same as last week
- The average age of someone being treated in critical care has been around 55 and most coronavirus patients in intensive care are men
- Three-quarters of people in critical care are mechanically ventilated within the first 24 hours, and 11 days has been the typical length of time for patients needing respiratory support
Coronavirus infections in hospital
Numbers of probable and definite hospital onset infections by week
What about infections in hospital?
Figures from Public Health Wales have revealed hundreds of patients caught coronavirus while in hospital.
This followed analysis into “probable” and “definite” infections of patients, an issue particularly early on in the pandemic.
Latest figures show a spike in patients infected with coronavirus in hospital in north Wales has eased off.
The week ending 16 August showed just one probable or definite infection in the Betsi Cadwaladr health board area.
The other two in Wales were in the Aneurin Bevan and Cwm Taf health board areas.
What are the differences between these different measures?
The ONS and public health bodies are measuring things in a different way – and information is available at different times so do not expect to see the same thing.
- The ONS gives figures weekly based on all deaths registered involving Covid-19, according to what a doctor puts on the death certificate, whether in or out of hospital
- The virus may not be the main cause of death, just a factor. There does not need to have been a positive test – it could be it was just suspected by the doctor
- There is a time lag as people have up to two weeks to register deaths, but more than 80% are usually registered in Wales within a week
- Public Health Wales’ daily updates on its online dashboard show numbers of deaths and positive tests for coronavirus.
- Most of the deaths PHW reports are in hospitals – it receives information on a daily basis from health boards. But Powys has no general hospital and patients from here are treated over the border. The 94 deaths of Powys residents so far are not reflected in the PHW figures
- It will only include deaths which were given a positive test for Covid-19 in a laboratory – not any suspected cases. This can also include deaths reported by health boards, which could be from several days ago
The data is revised and PHW refines and verifies it and then each individual fatality is assigned to the date at which it occurred.
PHW has also revised the figures on two notable occasions: Once after it emerged Betsi Cadwaladr health board had been using a different computer system and had under-reported numbers.
Hywel Dda health board also had a “consistent under-count” of its figures, which were then adjusted.
PHW also acknowledges the “true number of Covid-19 deaths will be higher”.
When looking at cases of people testing positive it is quite complicated as the results coming back at different times mean the dashboard showing tests for particular days are revised and updated as they come back in.
Coronavirus case rates in Wales
Change per 100,000 population over last seven days
Why are there more cases in some areas?
When we look at the case rate provided by PHW – reflecting population size – Wrexham is the highest cumulatively for positive tests, overtaking Merthyr Tydfil.
It saw a spike in July, which was attributed to cases linked to workers at a local meat factory. But there were also infections at the local hospital.
Two mobile testing units were put in place in Wrexham in a bid to track and trace more individuals who could have been spreading the disease in the community, with cases at the local hospital also an issue.
More than 1,400 people came forward for tests – including those with mild or no symptoms who just wanted reassurance. But there was little evidence of community transmission, with cases lower than expected.
The rate has eased off and the outbreak involving workers at the meat factory has been declared as over.
Cardiff has now become the latest place to see a rise – a case rate of 13.9 per 100,000 – in the last week.
This included cases among call centre workers.
But the increase has been far less than some places in the north of England and in Birmingham, which has been added to a national watch list in England.
In England, the “hotspot” areas where there have been interventions have seen infections running at between 70 and 90 cases per 100,000 people per week.
Public health officials in Wales warned as the lockdown was eased, we might expect to see localised spikes in cases but that they were keeping “a constant eye on it”.
It was also important, from their point of view, that the number of positive tests among those tested was consistently below 1%.
Coronavirus cases across Wales
Positive cases and total of registered deaths
The overall infection rate across Wales on average rose by just four cases per 100,000 in the week to 23 August – 126 new cases in all.
Two areas – Blaenau Gwent and Ceredigion – had no cases at all in the last week.
A spokesman said: “The statistics Public Health Wales provides are part of a rapid reporting system. Unfortunately, it is impossible to say with any degree of certainty why the positivity rate may be higher in some areas than others, especially by comparing areas of Wales with other parts of the UK.
“There are a wide variety of factors that may influence this variation. For example, variation in true burden of disease, population composition, testing policy, access to testing and uptake of testing rates could account for differences in the positivity.
“Conclusions should not be immediately drawn from these variations.”
Who is being tested in Wales?
More than 491,000 people had been tested by 17 August.
PHW has now included the results of thousands of more tests of Welsh residents undertaken by non-NHS laboratories, with data being revised on 14 July.
Access to reliable data from the laboratories in England had been an issue but figures were now coming through which meant that they could now give up to date information.
“We have daily data flows, we present all those figures together so we don’t have one half of a story,” he said.
We can also see from more detailed PHW figures how many different key workers and others who have been tested so far.
Figures up to 16 August show 25.1% of results of key workers came back within 24 hours and around 54% of on-demand community testing came back within a day.
Within the last week, only 20% of key worker results came back within a day and 68.6% of community tests – a worsening performance.
Speed is regarded as important in managing the virus and the Welsh Government said measures were in place to improve turnaround times.
A spokesperson said: “Across Wales, when you look at those tested, in person, at mass testing centres, the vast majority had their results back in one day.
By 16 August, more than 31,700 healthcare workers had been tested. There were also 41,800 tests on care home residents, 3.6% of tests proving positive – with 17 residents testing positive in the last week.
How many people are infected?
The ONS said analysis of more than 6,000 swab results means it can estimate that in the week to 13 August, 1,400 people in Wales had coronavirus.
This is around 0.04% or one in 2,400 people.
What about tracing contacts?
As for the “test, trace, protect” system for contacting people with coronavirus and tracing contacts, since 21 June, 90% of the 900 positive cases were reached and able to provide details of their recent contacts. In the most recent week, 90% of the 87 positive cases were reached.
Of the 2,913 close contacts that were eligible for follow-up, 90% were successfully contacted and advised, according to NHS Wales.
Coronavirus deaths in Wales
Daily deaths from different data sources
Can we compare the two sets of figures?
The graphic above shows how it looks when you compare figures from all the different data sources – and how there is a difference of 962 deaths.
The figure for total deaths being given by PHW has been consistently around 60% of what has turned out to be the total figure when including all registered deaths.
The UK government also includes PHW figures in its daily bulletin, which covers all deaths that occurred in hospitals in England and, like in Wales, only those patients who tested positive for coronavirus.
It also includes all known deaths given to it by PHW and the agencies in Scotland and Northern Ireland. Figures are currently not being published while the UK government data dashboard is being revised.
Since 29 April, Public Health England has been giving the UK government numbers of confirmed Covid-19 deaths wherever they took place, not just in hospitals.
So which should we look at?
The ONS says the daily figures issued by the UK government and other health bodies are valuable because they are available very quickly and give us “snapshot” of what is happening day by day.
But it suggests its own figures – although they take longer to produce because it takes longer to register deaths – offer the most accurate and complete picture.
PHW would agree with that too and it also now includes ONS figures and its own analysis of them on its online dashboard.
Coronavirus deaths in Wales
NHS Wales’ chief statistician argues to look at the trend and the curve of the outbreak, it is best to focus on deaths on the day they have occurred rather than the daily PHW figures as they first appear, as these can be volatile.
So the chart above shows the daily deaths, as they have been adjusted, as well as a seven-day rolling average.
By 23 August, it was below 0.3 deaths a day.
Meanwhile, analysts at Johns Hopkins University in America have been looking at the global picture in detail, giving regular updates, and currently rank the United Kingdom third highest in terms of mortality rate for major countries in cases per population.
How many people recover?
Doctors at Wales’ largest hospital, the University Hospital of Wales in Cardiff in May said 30% of patients admitted to its intensive care unit with Covid-19 had died and said the road to recovery was long.
Another hospital in the valleys had a survival rate of 55% for those critically ill with suspected or confirmed covid.
NHS Wales said in July that more than 9,000 people with Covid-19 symptoms had been discharged from hospitals.
Chief executive Dr Andrew Goodall said the figure should be celebrated and showed “people can recover from this terrible virus”.