select search filters
briefings
roundups & rapid reactions
before the headlines
Fiona fox's blog
The Office for National Statistics (ONS) have released the latest estimates of the prevalence people with self-reported “long COVID” using data from the UK COVID-19 Infection Survey.
Dr Michael Absoud, Senior Lecturer, Dept of Women & Children’s Health, King’s College London, said:
“The latest ONS experimental statistics release on the prevalence of ongoing symptoms following coronavirus, provides a helpful indicator alongside the REACT-2 data and the King’s College London Covid Symptom Study. More detail of ONS methodology is yet to be published, with the last update from the 26th March 2021. In particular, persistent individual symptoms for children are not yet published due to small numbers on follow up. The ONS control group also needs comprehensive description (currently defined as never symptomatic, never tested, never self-isolated, never a contact of anyone testing positive). After the first month of enrolment, participants are followed up with questionnaires on a monthly basis, with questions relating to a 7 day period.
“A previous ONS sensitivity analysis of impact of defining illness end to a single asymptomatic visit (as opposed to two) also lowered prevalence for illness >12 weeks (from 13.7% to 0.9%). The symptom durations for the population prevalence estimate is based on retrospective reporting of the initial (confirmed or suspected) infection.
“Other factors contribute to differences in studies such as design of questionnaires, sampling methods and timing, population demographics and representativeness.
“The ONS survey provides valuable insights, and we look forward to full publication of refined methodology.”
Refs:
https://www.gov.uk/government/publications/ons-short-report-on-long-covid-22-july-2021
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00198-X/fulltext
Prof Esther Crawley, Professor of Child Health, University of Bristol, said:
“These stats look at ongoing symptoms in all ages but I’ll focus on the data in children.
“This data is important for the NHS and clinicians providing paediatric long-COVID clinics because it shows the estimated number of children with self-reported long-COVID and the number of those disabled by their symptoms. The data is provided for those aged 2-11, those aged 12-16 and those aged 17-24.
“Although long-COVID in children and young people is less common than in adults, the estimated numbers of those disabled by self-reported long-COVID is worrying. For example, an estimated 0.47% of young people aged 12-16 have self reported long-COVID and 0.3% of young people aged 12-16 (so about half of those self reporting long-COVID) have their activity limited “a little” or “a lot”. This is across the whole population of adolescents aged 12-16 and therefore represents a very large number in the UK. As the number of children and young people who get COVID increases, this number developing long-COVID is also likely to increase.
“The limitations in the data are acknowledged by the ONS. The most important limitation is that this is self-reported long-COVID. However, this contributes to the emerging picture that long-COVID is less common in children and adolescents compared to adults, but is still a very important health issue. The NHS will need significant resource to provide appropriate support and treatment.”
Prof Kevin McConway, Emeritus Professor of Applied Statistics, The Open University, said:
“The latest ONS monthly bulletin on what they describe as “ongoing symptoms following Covid-19 infection” covers the four-week period ending 4 July. The data come from a representative sample of the community population of the UK, and so this isn’t based on people putting themselves forward to describe their experience. ONS are careful not to call the condition or conditions “long Covid”, except in what are generally called ‘scare quotes’ to emphasise that they aren’t using a clearly defined term. That’s sensible because there isn’t a good clear definition of what’s meant by long Covid – what’s covered by this ONS bulletin could include people whose original Covid symptoms happen to continue for quite a long time, as well as people who have different though related symptoms that still exist months after they originally had Covid, and might even have come or gone at intervals.
“People have criticised previous ONS releases on this topic on various grounds. The data are self-reported – the people who report ongoing symptoms haven’t necessarily had them checked out or confirmed by health professionals. That’s true, but given the lack of support that some patients say they have got from health professionals, and the lack of health services or clinics that they can get involved with in many places, it’s difficult to see how we could get anything like a good, complete estimate from other sources than self-report. It’s been said that some of these people might be mistaking symptoms of other conditions as ongoing symptoms following Covid. That’s possible as well, though all the people who report symptoms for this study did also report that they had Covid previously, and though there’s no way to tell how common it might be that the symptoms aren’t a consequence of Covid. But I’d argue that, to a considerable extent, those criticisms are red herrings anyway. These results show quite major levels of illness, discomfort, and to some extent disability, that were mostly not there before the pandemic. Even if in some cases they were not directly caused by the effects of the virus on bodily systems, the symptoms still need to be dealt with, and that isn’t yet happening on anything like a comprehensive enough scale, as far as I can tell.
“The numbers do continue to be alarmingly high. The estimated number of people in the country with symptoms lasting over four weeks, in the latest bulletin (so for four weeks to 4 July), is 945,000. While that’s less than in the previous two bulletins (962,000 for four weeks to 6 June, 1,021,000 for four weeks to 2 May), it’s still a very high number, amounting to around 1 in 70 of the whole population (excluding those living in communal population such as care homes, and those aged under 2 years, who aren’t included in the ONS survey). Some of those 1 in 70 people may not have particularly severe symptoms, but two-thirds of them say that the symptoms reduce their ability to carry out day-to-day activities, and a fifth of the total say that their ability to carry out day-to-day activities is reduced a lot. That is, about 1 in every 350 people has ongoing symptoms, that lasted at least four weeks so far, that are restricting their day-to-day activities a lot. At least the fall in numbers compared to the previous bulletins does show that people can recover, but the rate of decrease is pretty slow.
“For symptoms going on at least a year, the number of people affected has been roughly stable over today’s ONS bulletin and the previous two, at 380,000 in the latest one (4 weeks to 4 July), 385,000 (to 6 June) and 376,000 (to 2 May). So we’ve got (for the latest figure) 1 in every 170 people in the population who are experiencing symptoms that have gone on for at least a year. At least a year! That’s a long time to be ill. Again, about a fifth of those report that their symptoms reduce a lot their ability to carry their daily activities. That’s 74,000 people who count as disabled on the standard definition – their activities are restricted a lot by their health condition, and the condition has been going on for a long time. That amounts to a large extra load on health services and on services for disabled people. Yes, we do need to understand more about how a Covid-19 infection can lead to these long-term symptoms, and even whether they do not stem directly from Covid-19 in some cases. But, before we can get to the bottom of those questions, we do already urgently need services to help the people who are suffering from these long-term conditions and symptoms, however they arose, and that needs planning and considerable resources.”
All our previous output on this subject can be seen at this weblink:
www.sciencemediacentre.org/tag/covid-19
Declared interests
Prof Kevin McConway: “I am a Trustee of the SMC and a member of its Advisory Committee. I am also a member of the Public Data Advisory Group, which provides expert advice to the Cabinet Office on aspects of public understanding of data during the pandemic. My quote above is in my capacity as an independent professional statistician.”
None others received.