According to a survey conducted in the United Kingdom (UK) in April 2022, 4.13 percent of all people aged between 35 and 49 years reported to be suffering from long COVID symptoms, the highest share across all age groups. Furthermore, around 3.7 percent of the population aged 50 to 69 years were estimated to suffer from long COVID. Overall, around 863 thousand people in the UK reported their ability to undertake daily activities and routines was affected a little by long COVID symptoms.

Present state of COVID-19 As of May 2022, over 22 million COVID-19 cases had been reported in the UK. The largest surge of cases was noted over the winter period 2021/22. The incidence of cases in the county since the pandemic began stood at around 32,624 per 100,000 population. Cyprus had the highest incidence of COVID-19 cases among its population in Europe at 75,798 per 100,000 people, followed by a rate of 51,573 in Iceland. Over 175 thousand COVID-19 deaths have been reported in the UK. The deadliest day on record was January 20, 2021, when 1,820 deaths were recorded. In the UK, a COVID-19 death is defined as a person who died within 28 days of a positive test.

Preventing long COVID through vaccination According to the WHO, being fully vaccinated alongside a significant proportion of the population also vaccinated is the best way to avoid the spread of COVID-19 or serious symptoms associated with the virus. It is therefore regarded that receiving a vaccine course as well as subsequent booster vaccines limits the chance of developing long COVID symptoms. As of April 27, 2022, around 53.2 million first doses, 49.7 million second doses, and 39.2 booster doses had been administered in the UK.

Due to changes in the collection and availability of data on COVID-19, this dataset is no longer updated. Latest information about COVID-19 is available via the UKHSA data dashboard. The UK government publish daily data, updated weekly, on COVID-19 cases, vaccinations, hospital admissions and deaths. This note provides a summary of the key data for London from this release. Data are published through the UK Coronavirus Dashboard, last updated on 23 March 2023. This update contains: Data on the number of cases identified daily through Pillar 1 and Pillar 2 testing at the national, regional and local authority level Data on the number of people who have been vaccinated against COVID-19 Data on the number of COVID-19 patients in Hospital Data on the number of people who have died within 28 days of a COVID-19 diagnosis Data for London and London boroughs and data disaggregated by age group Data on weekly deaths related to COVID-19, published by the Office for National Statistics and NHS, is also available. Key Points On 23 March 2023 the daily number of people tested positive for COVID-19 in London was reported as 2,775 On 23 March 2023 it was newly reported that 94 people in London died within 28 days of a positive COVID-19 test The total number of COVID-19 cases identified in London to date is 3,146,752 comprising 15.2 percent of the England total of 20,714,868 cases In the most recent week of complete data (12 March 2023 - 18 March 2023) 2,951 new cases were identified in London, a rate of 33 cases per 100,000 population. This compares with 2,883 cases and a rate of 32 for the previous week In England as a whole, 29,426 new cases were identified in the most recent week of data, a rate of 52 cases per 100,000 population. This compares with 26,368 cases and a rate of 47 for the previous week Up to and including 22 March 2023 6,452,895 people in London had received the first dose of a COVID-19 vaccine and 6,068,578 had received two doses Up to and including 22 March 2023 4,435,586 people in London had received either a third vaccine dose or a booster dose On 22 March 2023 there were 1,370 COVID-19 patients in London hospitals. This compares with 1,426 patients on 15 March 2023. On 22 March 2023 there were 70 COVID-19 patients in mechanical ventilation beds in London hospitals. This compares with 72 patients on 15 March 2023. Update: From 1st July updates are weekly From Friday 1 July 2022, this page will be updated weekly rather than daily. This change results from a change to the UK government COVID-19 Dashboard which will move to weekly reporting. Weekly updates will be published every Thursday. Daily data up to the most recent available will continue to be added in each weekly update. Data summary 리소스 CSV phe_vaccines_age_london_boroughs.csv CSV 다운로드 phe_vaccines_age_london_boroughs.csv CSV phe_healthcare_admissions_age.csv CSV 다운로드

Due to changes in the collection and availability of data on COVID-19 this page will no longer be updated. The webpage will no longer be available as of 11 May 2023. On-going, reliable sources of data for COVID-19 are available via the COVID-19 dashboard, Office for National Statistics, and the UKHSA This page provides a weekly summary of data on deaths related to COVID-19 published by NHS England and the Office for National Statistics. More frequent reporting on COVID-19 deaths is now available here, alongside data on cases, hospitalisations, and vaccinations. This update contains data on deaths related to COVID-19 from: NHS England COVID-19 Daily Deaths - last updated on 28 June 2022 with data up to and including 27 June 2022. ONS weekly deaths by Local Authority - last updated on 16 August 2022 with data up to and including 05 August 2022. Summary notes about each these sources are provided at the end of this document. Note on interpreting deaths data: statistics from the available sources differ in definition, timing and completeness. It is important to understand these differences when interpreting the data or comparing between sources. Weekly Key Points An additional 24 deaths in London hospitals of patients who had tested positive for COVID-19 and an additional 5 where COVID-19 was mentioned on the death certificate were announced in the week ending 27 June 2022. This compares with 40 and 3 for the previous week. A total of 306 deaths in hospitals of patients who had tested positive for COVID-19 and 27 where COVID-19 was mentioned on the death certificate were announced for England as whole. This compares with 301 and 26 for the previous week. The total number of COVID-19 deaths reported in London hospitals of patients who had tested positive for COVID-19 is now 19,102. The total number of deaths in London hospitals where COVID-19 was mentioned on the death certificate is now 1,590. This compares to figures of 119,237 and 8,197 for English hospitals as a whole. Due to the delay between death occurrence and reporting, the estimated number of deaths to this point will be revised upwards over coming days These figures do not include deaths that occurred outside of hospitals. Data from ONS has indicated that the majority (79%) of COVID-19 deaths in London have taken place in hospitals. Recently announced deaths in Hospitals 21 June 22 June 23 June 24 June 25 June 26 June 27 June London No positive test 0 0 1 4 0 0 0 London Positive test 3 7 2 10 0 0 2 Rest of England No positive test 2 6 4 4 0 0 6 Rest of England Positive test 47 49 41 58 6 0 81 16 May 23 May 30 May 06 June 13 June 20 June 27 June London No positive test 14 3 4 0 4 3 5 London Positive test 45 34 55 20 62 40 24 Rest of England No positive test 41 58 33 23 47 23 22 Rest of England Positive test 456 375 266 218 254 261 282 Deaths by date of occurrence 21 June 22 June 23 June 24 June 25 June 26 June 27 June London 20,683 20,686 20,690 20,691 20,692 20,692 20,692 Rest of England 106,604 106,635 106,679 106,697 106,713 106,733 106,742 Interpreting the data The data published by NHS England are incomplete due to: delays in the occurrence and subsequent reporting of deaths deaths occurring outside of hospitals not being included The total deaths reported up to a given point are therefore less than the actual number that have occurred by the same point. Delays in reporting NHS provide the following guidance regarding the delay between occurrence and reporting of deaths: Confirmation of COVID-19 diagnosis, death notification and reporting in central figures can take up to several days and the hospitals providing the data are under significant operational pressure. This means that the totals reported at 5pm on each day may not include all deaths that occurred on that day or on recent prior days. The data published by NHS England for reporting periods from April 1st onward includes both date of occurrence and date of reporting and so it is possible to illustrate the distribution of these reporting delays. This data shows that approximately 10% of COVID-19 deaths occurring in London hospitals are included in the reporting period ending on the same day, and that approximately two-thirds of deaths were reported by two days after the date of occurrence. Deaths outside of hospitals The data published by NHS England does not include deaths that occur outside of hospitals, i.e. those in homes, hospices, and care homes. ONS have published data for deaths by place of occurrence. This shows that, up to 05 August, 79% of deaths in London recorded as involving COVID-19 occurred in hospitals (this compares with 44% for all causes of death). This would suggest that the NHS England data may underestimate overall deaths from COVID-19 by around 20%. Number of deaths Proportion of deaths Week ending Hospital Care home Home Other Hospital Care home Home Other 06 Mar 2020 1 1 0 0 50% 50% 0% 0% 13 Mar 2020 13 0 4 0 76% 0% 24% 0% 20 Mar 2020 148 9 11 0 88% 5% 7% 0% 27 Mar 2020 610 45 53 14 84% 6% 7% 2% 03 Apr 2020 1,215 132 143 27 80% 9% 9% 2% 10 Apr 2020 1,495 282 162 32 76% 14% 8% 2% 17 Apr 2020 1,076 295 101 29 72% 20% 7% 2% 24 Apr 2020 669 210 72 35 68% 21% 7% 4% 01 May 2020 348 125 43 15 66% 24% 8% 3% 08 May 2020 261 93 29 16 65% 23% 7% 4% 15 May 2020 152 51 22 5 66% 22% 10% 2% 22 May 2020 93 51 10 3 59% 32% 6% 2% 29 May 2020 62 25 7 6 62% 25% 7% 6% 05 Jun 2020 53 23 4 1 65% 28% 5% 1% 12 Jun 2020 27 11 9 3 54% 22% 18% 6% 19 Jun 2020 22 7 6 2 59% 19% 16% 5% 26 Jun 2020 14 14 5 1 41% 41% 15% 3% 03 Jul 2020 10 5 2 5 45% 23% 9% 23% 10 Jul 2020 15 3 0 1 79% 16% 0% 5% 17 Jul 2020 8 7 2 0 47% 41% 12% 0% 24 Jul 2020 15 1 0 2 83% 6% 0% 11% 31 Jul 2020 6 2 1 0 67% 22% 11% 0% 07 Aug 2020 6 2 0 1 67% 22% 0% 11% 14 Aug 2020 7 4 2 1 50% 29% 14% 7% 21 Aug 2020 4 0 0 0 100% 0% 0% 0% 28 Aug 2020 1 2 0 0 33% 67% 0% 0% 04 Sep 2020 3 0 1 0 75% 0% 25% 0% 11 Sep 2020 7 2 0 1 70% 20% 0% 10% 18 Sep 2020 9 2 1 0 75% 17% 8% 0% 25 Sep 2020 23 3 3 0 79% 10% 10% 0% 02 Oct 2020 27 3 2 0 84% 9% 6% 0% 09 Oct 2020 36 3 3 0 86% 7% 7% 0% 16 Oct 2020 41 0 2 0 95% 0% 5% 0% 23 Oct 2020 47 4 4 0 85% 7% 7% 0% 30 Oct 2020 91 3 5 1 91% 3% 5% 1% 06 Nov 2020 93 7 5 2 87% 7% 5% 2% 13 Nov 2020 109 11 10 2 83% 8% 8% 2% 20 Nov 2020 162 5 8 4 91% 3% 4% 2% 27 Nov 2020 175 8 14 5 87% 4% 7% 2% 04 Dec 2020 190 10 13 10 85% 4% 6% 4% 11 Dec 2020 199 9 13 6 88% 4% 6% 3% 18 Dec 2020 267 15 25 4 86% 5% 8% 1% 25 Dec 2020 403 30 43 7 83% 6% 9% 1% 01 Jan 2021 677 35 109 28 80% 4% 13% 3% 08 Jan 2021 959 73 167 36 78% 6% 14% 3% 15 Jan 2021 1,125 84 165 39 80% 6% 12% 3% 22 Jan 2021 1,163 96 142 43 81% 7% 10% 3% 29 Jan 2021 863 82 101 28 80% 8% 9% 3% 05 Feb 2021 605 70 59 38 78% 9% 8% 5% 12 Feb 2021 439 29 49 14 83% 5% 9% 3% 19 Feb 2021 338 29 33 12 82% 7% 8% 3% 26 Feb 2021 214 19 19 11 81% 7% 7% 4% 05 Mar 2021 141 11 19 5 80% 6% 11% 3% 12 Mar 2021 99 9 7 1 85% 8% 6% 1% 19 Mar 2021 65 10 1 1 84% 13% 1% 1% 26 Mar 2021 41 9 4 2 73% 16% 7% 4% 02 Apr 2021 35 5 4 0 80% 11% 9% 0% 09 Apr 2021 29 2 3 0 85% 6% 9% 0% 16 Apr 2021 24 6 2 0 75% 19% 6% 0% 23 Apr 2021 14 1 0 0 93% 7% 0% 0% 30 Apr 2021 13 1 1 0 87% 7% 7% 0% 07 May 2021 14 3 0 0 82% 18% 0% 0% 14 May 2021 6 2 0 0 75% 25% 0% 0% 21 May 2021 8 1 1 0 80% 10% 10% 0% 28 May 2021 11 1 2 1 73% 7% 13% 7% 04 Jun 2021 9 0 0 0 100% 0% 0% 0% 11 Jun 2021 11 3 0 0 79% 21% 0% 0% 18 Jun 2021 11 4 2 1 61% 22% 11% 6% 25 Jun 2021 10 0 0 1 91% 0% 0% 9% 02 Jul 2021 14 1 2 0 82% 6% 12% 0% 09 Jul 2021 12 1 4 1 67% 6% 22% 6% 16 Jul 2021 18 3 2 0 78% 13% 9% 0% 23 Jul 2021 48 0 7 1 86% 0% 12% 2% 30 Jul 2021 49 2 4 4 83% 3% 7% 7% 06 Aug 2021 66 1 9 1 86% 1% 12% 1% 13 Aug 2021 60 1 12 1 81% 1% 16% 1% 20 Aug 2021 84 1 5 1 92% 1% 5% 1% 27 Aug 2021 78 3 10 3 83% 3% 11% 3% 03 Sep 2021 85 3 7 1 89% 3% 7% 1% 10 Sep 2021 83 2 10 2 86% 2% 10% 2% 17 Sep 2021 65 2 9 1 84% 3% 12% 1% 24 Sep 2021 76 5 5 0 88% 6% 6% 0% 01 Oct 2021 88 2 15 1 83% 2% 14% 1% 08 Oct 2021 65 2 7 1 87% 3% 9% 1% 15 Oct 2021 62 1 9 4 82% 1% 12% 5% 22 Oct 2021 64 2 11 2 81% 3% 14% 3% 29 Oct 2021 66 3 11 1 81% 4% 14% 1% 05 Nov 2021 67 3 10 5 79% 4% 12% 6% 12 Nov 2021 84 2 12 1 85% 2% 12% 1% 19 Nov 2021 63 2 2 0 94% 3% 3% 0% 26 Nov 2021 68 2 8 0 87% 3% 10% 0% 03 Dec 2021 72 2 10 1 85% 2% 12% 1% 10 Dec 2021 81 3 12 4 81% 3% 12% 4% 17 Dec 2021 91 1 12 3 85% 1% 11% 3% 24 Dec 2021 101 8 15 3 80% 6% 12% 2% 31 Dec 2021 129 11 19 6 78% 7% 12% 4% 07 Jan 2022 178 18 19 4 81% 8% 9% 2% 14 Jan 2022 194 23 16 14 79% 9% 6% 6% 21 Jan 2022 165 25 11 4 80% 12% 5% 2% 28 Jan 2022 119 20 13 5 76% 13% 8% 3% 04 Feb 2022 97 13 8 2 81% 11% 7% 2% 11 Feb 2022 51 10 6 6 70% 14% 8% 8% 18 Feb 2022 62 6 9 3 78% 8% 11% 4% 25 Feb 2022 55 2 2 1 92% 3% 3% 2% 04 Mar 2022 47 2 2 2 89% 4% 4% 4% 11 Mar 2022 48 3 4 0 87% 5% 7% 0% 18 Mar 2022 60 7 8 4 76% 9% 10% 5% 25 Mar 2022 51 11 5 2 74% 16% 7% 3% 01 Apr 2022 60 8 5 2 80% 11% 7% 3% 08 Apr 2022 78 4 7 3 85% 4% 8% 3% 15 Apr 2022 74 6 6 3 83% 7% 7% 3% 22 Apr 2022 58 10 7 6 72% 12% 9% 7% 29 Apr 2022 39 8 3 4 72% 15% 6% 7% 06 May 2022 44 3 4 0 86% 6% 8% 0% 13 May 2022 29 2 4 2 78% 5% 11% 5% 20 May 2022 16 4 0 2 73% 18% 0% 9% 27 May 2022 34 3 3 1 83% 7% 7% 2% 03 Jun 2022 18 1 1 0 90% 5% 5% 0% 10 Jun 2022 18 1 3 0 82% 5% 14% 0% 17 Jun 2022 22 1 2 0 88% 4% 8% 0% 24 Jun 2022 33 2 3 1 85% 5% 8% 3% 01 Jul 2022 33 2 2 0 89% 5% 5% 0% 08 Jul 2022 51 4 4 4 81% 6% 6% 6% 15 Jul 2022 60 5 4 2 85% 7% 6% 3% 22 Jul 2022 71 9 10 3 76% 10% 11% 3% 29 Jul 2022 48 7 9 0 75% 11% 14% 0% 05 Aug 2022 35 1 3 4 81% 2% 7% 9% Total 18,924 2,390 2,152 634 79% 10% 9% 3% Comparison with all cause mortality Comparison of data sources Note on data sources NHS England provides numbers of patients who have died in hospitals in England and had tested positive for COVID-19, and from 25 April, the number of patients where COVID-19 is mentioned on the death certificate and no positive COVID-19 test result was received. Figures are updated each day at 2pm with deaths reported up to 5pm the previous day. There is a delay between the occurrence of a death to it being captured in the

Provisional data on excess mortality (excluding COVID-19) during heat-periods in the 65 years and over age group estimates in England, including the estimated number of deaths where the death occurred within 28 days of a positive COVID-19 result and the mean central England temperature.

As of June 6, 2022, the novel coronavirus SARS-CoV-2 that originated in Wuhan, the capital of Hubei province in China, had infected over 2.1 million people and killed 14,612 in the country. Hong Kong is currently the region with the highest active cases in China.

From Wuhan to the rest of China

In late December 2019, health authorities in Wuhan detected several pneumonia cases of unknown cause. Most of these patients had links to the Huanan Seafood Market. With Chinese New Year approaching, millions of Chinese migrant workers travelled back to their hometowns for the celebration. Before the start of the travel ban on January 23, around five million people had left Wuhan. By the end of January, the number of infections had surged to over ten thousand. The death toll from the virus exceeded that of the SARS outbreak a few days later. On February 12, thousands more cases were confirmed in Wuhan after an improvement to the diagnosis method, resulting in another sudden surge of confirmed cases. On March 31, 2020, the National Health Commission (NHC) in China announced that it would begin reporting the infection number of symptom-free individuals who tested positive for coronavirus. On April 17, 2020, health authorities in Wuhan revised its death toll, adding 50 percent more fatalities. After quarantine measures were implemented, the country reported no new local coronavirus COVID-19 transmissions for the first time on March 18, 2020.

The overloaded healthcare system

In Wuhan, 28 hospitals were designated to treat coronavirus patients, but the outbreak continued to test China’s disease control system and most of the hospitals were soon fully occupied. To combat the virus, the government announced plans to build a new hospital swiftly. On February 3, 2020, Huoshenshan Hospital was opened to provide an additional 1,300 beds. Due to an extreme shortage of health-care professionals in Wuhan, thousands of medical staff from all over China came voluntarily to the epicenter to offer their support. After no new deaths reported for first time, China lifted ten-week lockdown on Wuhan on April 8, 2020. Daily life was returning slowly back to normal in the country.

COVID-19 Trends MethodologyOur goal is to analyze and present daily updates in the form of recent trends within countries, states, or counties during the COVID-19 global pandemic. The data we are analyzing is taken directly from the Johns Hopkins University Coronavirus COVID-19 Global Cases Dashboard, though we expect to be one day behind the dashboard’s live feeds to allow for quality assurance of the data.Revisions added on 4/23/2020 are highlighted.Revisions added on 4/30/2020 are highlighted.Discussion of our assertion of an abundance of caution in assigning trends in rural counties added 5/7/2020. Correction on 6/1/2020Methodology update on 6/2/2020: This sets the length of the tail of new cases to 6 to a maximum of 14 days, rather than 21 days as determined by the last 1/3 of cases. This was done to align trends and criteria for them with U.S. CDC guidance. The impact is areas transition into Controlled trend sooner for not bearing the burden of new case 15-21 days earlier.Reasons for undertaking this work:The popular online maps and dashboards show counts of confirmed cases, deaths, and recoveries by country or administrative sub-region. Comparing the counts of one country to another can only provide a basis for comparison during the initial stages of the outbreak when counts were low and the number of local outbreaks in each country was low. By late March 2020, countries with small populations were being left out of the mainstream news because it was not easy to recognize they had high per capita rates of cases (Switzerland, Luxembourg, Iceland, etc.). Additionally, comparing countries that have had confirmed COVID-19 cases for high numbers of days to countries where the outbreak occurred recently is also a poor basis for comparison.The graphs of confirmed cases and daily increases in cases were fit into a standard size rectangle, though the Y-axis for one country had a maximum value of 50, and for another country 100,000, which potentially misled people interpreting the slope of the curve. Such misleading circumstances affected comparing large population countries to small population counties or countries with low numbers of cases to China which had a large count of cases in the early part of the outbreak. These challenges for interpreting and comparing these graphs represent work each reader must do based on their experience and ability. Thus, we felt it would be a service to attempt to automate the thought process experts would use when visually analyzing these graphs, particularly the most recent tail of the graph, and provide readers with an a resulting synthesis to characterize the state of the pandemic in that country, state, or county.The lack of reliable data for confirmed recoveries and therefore active cases. Merely subtracting deaths from total cases to arrive at this figure progressively loses accuracy after two weeks. The reason is 81% of cases recover after experiencing mild symptoms in 10 to 14 days. Severe cases are 14% and last 15-30 days (based on average days with symptoms of 11 when admitted to hospital plus 12 days median stay, and plus of one week to include a full range of severely affected people who recover). Critical cases are 5% and last 31-56 days. Sources:U.S. CDC. April 3, 2020 Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). Accessed online. Initial older guidance was also obtained online. Additionally, many people who recover may not be tested, and many who are, may not be tracked due to privacy laws. Thus, the formula used to compute an estimate of active cases is: Active Cases = 100% of new cases in past 14 days + 19% from past 15-30 days + 5% from past 31-56 days - total deaths.We’ve never been inside a pandemic with the ability to learn of new cases as they are confirmed anywhere in the world. After reviewing epidemiological and pandemic scientific literature, three needs arose. We need to specify which portions of the pandemic lifecycle this map cover. The World Health Organization (WHO) specifies six phases. The source data for this map begins just after the beginning of Phase 5: human to human spread and encompasses Phase 6: pandemic phase. Phase six is only characterized in terms of pre- and post-peak. However, these two phases are after-the-fact analyses and cannot ascertained during the event. Instead, we describe (below) a series of five trends for Phase 6 of the COVID-19 pandemic.Choosing terms to describe the five trends was informed by the scientific literature, particularly the use of epidemic, which signifies uncontrolled spread. The five trends are: Emergent, Spreading, Epidemic, Controlled, and End Stage. Not every locale will experience all five, but all will experience at least three: emergent, controlled, and end stage.This layer presents the current trends for the COVID-19 pandemic by country (or appropriate level). There are five trends:Emergent: Early stages of outbreak. Spreading: Early stages and depending on an administrative area’s capacity, this may represent a manageable rate of spread. Epidemic: Uncontrolled spread. Controlled: Very low levels of new casesEnd Stage: No New cases These trends can be applied at several levels of administration: Local: Ex., City, District or County – a.k.a. Admin level 2State: Ex., State or Province – a.k.a. Admin level 1National: Country – a.k.a. Admin level 0Recommend that at least 100,000 persons be represented by a unit; granted this may not be possible, and then the case rate per 100,000 will become more important.Key Concepts and Basis for Methodology: 10 Total Cases minimum threshold: Empirically, there must be enough cases to constitute an outbreak. Ideally, this would be 5.0 per 100,000, but not every area has a population of 100,000 or more. Ten, or fewer, cases are also relatively less difficult to track and trace to sources. 21 Days of Cases minimum threshold: Empirically based on COVID-19 and would need to be adjusted for any other event. 21 days is also the minimum threshold for analyzing the “tail” of the new cases curve, providing seven cases as the basis for a likely trend (note that 21 days in the tail is preferred). This is the minimum needed to encompass the onset and duration of a normal case (5-7 days plus 10-14 days). Specifically, a median of 5.1 days incubation time, and 11.2 days for 97.5% of cases to incubate. This is also driven by pressure to understand trends and could easily be adjusted to 28 days. Source used as basis:Stephen A. Lauer, MS, PhD *; Kyra H. Grantz, BA *; Qifang Bi, MHS; Forrest K. Jones, MPH; Qulu Zheng, MHS; Hannah R. Meredith, PhD; Andrew S. Azman, PhD; Nicholas G. Reich, PhD; Justin Lessler, PhD. 2020. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Annals of Internal Medicine DOI: 10.7326/M20-0504.New Cases per Day (NCD) = Measures the daily spread of COVID-19. This is the basis for all rates. Back-casting revisions: In the Johns Hopkins’ data, the structure is to provide the cumulative number of cases per day, which presumes an ever-increasing sequence of numbers, e.g., 0,0,1,1,2,5,7,7,7, etc. However, revisions do occur and would look like, 0,0,1,1,2,5,7,7,6. To accommodate this, we revised the lists to eliminate decreases, which make this list look like, 0,0,1,1,2,5,6,6,6.Reporting Interval: In the early weeks, Johns Hopkins' data provided reporting every day regardless of change. In late April, this changed allowing for days to be skipped if no new data was available. The day was still included, but the value of total cases was set to Null. The processing therefore was updated to include tracking of the spacing between intervals with valid values.100 News Cases in a day as a spike threshold: Empirically, this is based on COVID-19’s rate of spread, or r0 of ~2.5, which indicates each case will infect between two and three other people. There is a point at which each administrative area’s capacity will not have the resources to trace and account for all contacts of each patient. Thus, this is an indicator of uncontrolled or epidemic trend. Spiking activity in combination with the rate of new cases is the basis for determining whether an area has a spreading or epidemic trend (see below). Source used as basis:World Health Organization (WHO). 16-24 Feb 2020. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Obtained online.Mean of Recent Tail of NCD = Empirical, and a COVID-19-specific basis for establishing a recent trend. The recent mean of NCD is taken from the most recent fourteen days. A minimum of 21 days of cases is required for analysis but cannot be considered reliable. Thus, a preference of 42 days of cases ensures much higher reliability. This analysis is not explanatory and thus, merely represents a likely trend. The tail is analyzed for the following:Most recent 2 days: In terms of likelihood, this does not mean much, but can indicate a reason for hope and a basis to share positive change that is not yet a trend. There are two worthwhile indicators:Last 2 days count of new cases is less than any in either the past five or 14 days. Past 2 days has only one or fewer new cases – this is an extremely positive outcome if the rate of testing has continued at the same rate as the previous 5 days or 14 days. Most recent 5 days: In terms of likelihood, this is more meaningful, as it does represent at short-term trend. There are five worthwhile indicators:Past five days is greater than past 2 days and past 14 days indicates the potential of the past 2 days being an aberration. Past five days is greater than past 14 days and less than past 2 days indicates slight positive trend, but likely still within peak trend time frame.Past five days is less than the past 14 days. This means a downward trend. This would be an

BackgroundNirmatrelvir with ritonavir (Paxlovid) is indicated for patients with Coronavirus Disease 2019 (COVID-19) who are at risk for progression to severe disease due to the presence of one or more risk factors. Millions of treatment courses have been prescribed in the United States alone. Paxlovid was highly effective at preventing hospitalization and death in clinical trials. Several studies have found a protective association in real-world data, but they variously used less recent study periods, correlational methods, and small, local cohorts. Their estimates also varied widely. The real-world effectiveness of Paxlovid remains uncertain, and it is unknown whether its effect is homogeneous across demographic strata. This study leverages electronic health record data in the National COVID Cohort Collaborative’s (N3C) repository to investigate disparities in Paxlovid treatment and to emulate a target trial assessing its effectiveness in reducing severe COVID-19 outcomes.Methods and findingsThis target trial emulation used a cohort of 703,647 patients with COVID-19 seen at 34 clinical sites across the United States between April 1, 2022 and August 28, 2023. Treatment was defined as receipt of a Paxlovid prescription within 5 days of the patient’s COVID-19 index date (positive test or diagnosis). To emulate randomization, we used the clone-censor-weight technique with inverse probability of censoring weights to balance a set of covariates including sex, age, race and ethnicity, comorbidities, community well-being index (CWBI), prior healthcare utilization, month of COVID-19 index, and site of care provision. The primary outcome was hospitalization; death was a secondary outcome. We estimated that Paxlovid reduced the risk of hospitalization by 39% (95% confidence interval (CI) [36%, 41%]; p < 0.001), with an absolute risk reduction of 0.9 percentage points (95% CI [0.9, 1.0]; p < 0.001), and reduced the risk of death by 61% (95% CI [55%, 67%]; p < 0.001), with an absolute risk reduction of 0.2 percentage points (95% CI [0.1, 0.2]; p < 0.001). We also conducted stratified analyses by vaccination status and age group. Absolute risk reduction for hospitalization was similar among patients that were vaccinated and unvaccinate, but was much greater among patients aged 65+ years than among younger patients. We observed disparities in Paxlovid treatment, with lower rates among black and Hispanic or Latino patients, and within socially vulnerable communities. This study’s main limitation is that it estimates causal effects using observational data and could be biased by unmeasured confounding.ConclusionsIn this study of Paxlovid’s real-world effectiveness, we observed that Paxlovid is effective at preventing hospitalization and death, including among vaccinated patients, and particularly among older patients. This remains true in the era of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron subvariants. However, disparities in Paxlovid treatment rates imply that the benefit of Paxlovid’s effectiveness is not equitably distributed.