11^th October 2022:
The official confirmed UK COVID-19 daily case rate has shown an increase once more. On the 19^th August 2022, 3,312 cases were reported compared to 6,441 reported on the 1^st October 2022. The latest ONS survey (7^th October 2022) estimates in the week ending 24^th September 2022, 1,105,400 people in England alone had COVID-19 infection, equivalent to 2.03% of the entire population. The most prevalent variant continues to be BA.5 (87.8%). The overall proportion of other variants as tested by the relevant assay in England between the 11^th-17^th September 2022 was BA.2 (0.6%), BA.4 (2.1%), BA.2.75 (4.5%), BA.4.6 (4.5%) and 0.5% were classified as other.  The risk of hospitalisation from disease appears to be the same for BA.4 and BA.5 compared to BA.2 (the previous dominant variant).   Overall, the Omicron (BA.4 and BA.5) variants appear to be equal in disease severity than the previous dominant BA.2. Omicron preferentially infects the upper airways, increasing transmissibility, and struggles to infect lung tissue, which may be responsible for reducing severity. COVID hospitalisations have slightly increased, with 7,486 patients on 17^thAugust 2022 testing positive for COVID-19 compared to 9,631 on 5^th October 2022. Mechanical ventilation admission rates, reflecting the highest severity end of the disease, remain plateaued with 195 patients with COVID-19 in hospital on 5^th October 2022. Deaths are around 420 patients per week recorded with COVID-19 on their death certificate. Recent changes in case rates will be reflected in deaths after approximately 3-4 weeks. Our results at RPL continue to show a lower positivity rate compared to the ONS survey data. With our methodology of screening all staff, this remains an accurate tracker for the true community prevalence of the virus. In week 132 since the pandemic began we have had a 0.35% peak positivity rate.

We continue to use the Abbott CMIA test being used to measure levels of antibodies against the virus nucleocapsid and the Roche Elecsys®Anti-SARS-CoV-2 S assay which detects antibodies against the virus spike protein, as we want to be able to detect both natural and vaccine generated immunity. Our recent publication shows that individuals who have been infected with SARS-CoV-2 previously develop higher antibody levels following vaccination, with either the Pfizer/BioNTech or Oxford/AstraZeneca vaccine, in comparison to naive individuals who have not been infected with SARS-CoV-2 prior to vaccination1. Watch the animation summarising these findings. For more information about this clinical trial, registered atClinicalTrials.gov visit: (NCT04404062). This concurs with studies of healthcare workers at St Bartholomew’s Hospital and Imperial College Healthcare NHS Trust, where individuals previously infected with SARS-CoV-2 developed peak antibody levels 140-fold higher than individuals with no previous infection following vaccination with the Pfizer/BioNTechvaccine2,3
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 Our recent publication ‘Why the SARS-CoV-2 antibody test results may be misleading: insights from a longitudinal analysis of COVID-19’ shows our results align with the study led by Imperial College reporting antibodies levels decline significantly over four months post infection7,8,9,10. Currently we are trying to understand more about the kinetics of antibody responses post vaccination and the relative protection to future infection and hope to publish this data soon.