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Covid-19: Infections in England fell by 60% in past two months

BMJ 2021; 373 doi: (Published 08 April 2021) Cite this as: BMJ 2021;373:n929

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  1. Jacqui Wise
  1. London

The rate of new coronavirus infections in England fell by about 60% from February to March but has now levelled off, with an estimated 1 in 500 people currently infected.

The findings from the 10th round of the Real Time Assessment of Community Transmission (React 1) programme show a flattening in the infection rate with an estimated R number of 1 (95% confidence interval 0.81 to 1.21).1

The researchers from Imperial College London also found that the relation between the prevalence of infection and hospital admission or death had diverged from late January onwards. Infections are now leading to fewer admissions and deaths, which likely reflects the impact of the vaccination programme.

The study analyses the results of at-home swab tests taken by 140 844 people from 11 to 30 March. Of these, 227 were positive, giving a weighted infection prevalence of 0.20%. In the previous round of the study, carried out from 4 to 23 February, the national prevalence was 0.49%. Prevalence of infection in England is now at a level last seen in early September 2020 and nearing the level at the end of the first lockdown in England in May 2020.

The study found that infections fell by half every 26 days since the last round of the study, although the rate of decline slowed throughout that period and has now plateaued.

Different regions

Paul Elliott, director of the React programme at Imperial’s School of Public Health, said that the results were “hugely encouraging . . . we’re headed in the right direction.”

He added, “However, in our most recent data there has been a flattening off in the infection rate with an R number now around 1. This shows that we need to continue to approach the situation with caution and keep sticking to the rules.”

When compared with February’s data, prevalence has fallen substantially in different regions of the country: from 0.36% to 0.07% in the South East, from 0.60% to 0.16% in London, from 0.47% to 0.15% in the East of England, from 0.59% to 0.19% in the East Midlands, and from 0.69% to 0.31% in the North West.

Primary school aged children had the highest number of infections at 0.41%, while over 65s had the lowest at 0.09%. These trends are probably due to schools reopening on 8 March and the covid-19 vaccination programme that has focused initially on older people and the most vulnerable.

The study also found that people living in the least deprived neighbourhoods had a lower prevalence of swab positivity at 0.13%, compared with 0.33% in the most deprived neighbourhoods.

Steven Riley, professor of infectious disease dynamics at Imperial, said that the results were supportive of a gradual easing of restrictions. “But with the country continuing to open up in the coming weeks, we would expect prevalence of infections to rise,” he said. “Future rounds will allow us to monitor the situation closely.”

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