A high number of people remain infected with the coronavirus in England and the rate of new infections was not dropping 10 days into lockdown.

According to these recent findings from the ongoing REACT study, around 1 in 63 people currently have the virus, or 1.58% of the population. This is the highest figure the study has reported since it began testing in May 2020 and an increase of more than 50% compared with previous findings from early December.

Based on swab tests on almost 143,000 people in the community between 6th and 15th January, the study has also picked up early signs that infections may have begun to rise at the national level, with R estimated at 1.04.

"To prevent our already stretched health system from becoming overwhelmed infections must be brought down." Prof Paul Elliott School of Public Health

London’s prevalence was found to be almost twice that of the national average with 1 in 36 testing positive, the highest in the country, and all adult age groups have seen a rise in infections with people aged 18-24 most likely to be infected.

Using mobility data from the Facebook app, which tracks movements by GPS, the researchers have picked up changes in people’s activity which may help to explain infection trends, with a significant dip at the end of December during the Christmas period followed by a rise at the start of January when people returned to work.

Professor Paul Elliott, director of the programme at Imperial, said: “Our data are showing worrying suggestions of a recent uptick in infections which we will continue to monitor closely. To prevent our already stretched health system from becoming overwhelmed infections must be brought down; if prevalence continues at the high rate we are seeing then hospitals will continue to be put under immense pressure, and more and more lives will be lost.

“We all have a part to play in preventing this situation from worsening and must do our best to stay at home wherever possible.”

These findings from the REal-time Assessment of Community Transmission (REACT 1) programme, carried out in partnership with Ipsos MORI, are available in a pre-print interim report and will be submitted for peer-review. The full report including tests on an anticipated 160,000 people in total is expected next week.

Trends in coronavirus infections

The REACT 1 study is tracking current coronavirus infections in the community by testing more than 150,000 randomly-selected people each month over a two-week period. Volunteers take throat and nose swabs at home, which are then analysed in a laboratory by a technique called RT-PCR. These findings are helping guide public health measures so that the Government can better respond to the pandemic as the situation evolves.

"We have no good evidence that infections are falling in England." Prof Steven Riley study author, Imperial College London

Out of 142,909 swabs taken so far for this latest study round, 1,962 tested positive, giving an overall prevalence of 1.58% or 158 infected people per 10,000 of the population. The previous testing round ran between 25th November and 3rd December, when 91 per 10,000 had the virus, and so there may have already been a peak in infections during this gap which was not picked up by this study.

Patterns of infection are uneven across the country and most regions have seen an increase since the last round. Prevalence more than doubled in the South East (0.75% to 1.68%), East of England (0.59% to 1.74%), West Midlands (0.71 to 1.76%) and London (1.21% to 2.80%), which has the highest number of infections. The only region that saw a drop in infections was Yorkshire and the Humber.

Professor Steven Riley, study author and Professor of Infectious Disease Dynamics at Imperial, said: “Across this round of the study we’ve seen that the number of infected people has remained high and we have no good evidence that infections are falling in England. We are working to better understand why we are seeing these trends when the country is in lockdown, including studying the new variant, so that policy-makers can respond urgently to help bring infections down and save lives.”

Identifying higher risk groups

Infections have increased in all adult age groups since the end of the previous round and are now highest in people aged 18-24 at 2.51%. Prevalence also more than doubled in those aged 65 and above to 0.94%.

"Over a million people in England have COVID-19 at any one time of our study." Kelly Beaver Ipsos MORI

There was also variation in prevalence for people of different ages across the country. In London for instance, 1 in 25 or 4% of 18-24-year-olds tested positive. London also had the highest proportion of older people over the age of 55 testing positive. London, the South East and East of England also all saw infection increases in older people, but Yorkshire and the Humber, the North East and East Midlands did not.

People living in poorer neighbourhoods, ethnic minorities and those living in large households were also found to have a higher risk of infection, as were key workers.

Health and Social Care Secretary Matt Hancock said: “These findings show why we must not let down our guard over the weeks to come.

“Infections across England are at very high levels and this will keep having a knock-on effect on the already significant pressures faced by our NHS and hospitals.

“It is absolutely paramount that everyone plays their part to bring down infections. This means staying at home and only going out where absolutely necessary, reducing contact with others and maintaining social distancing.”

Kelly Beaver, Managing Director - Public Affairs at Ipsos MORI, said: “As we reach a milestone of over a million people in England having COVID-19 at any one time of our study, the real-time tracking of COVID-19 across England is more important than ever. Our study’s ability to find individuals who have the virus, but do not display symptoms, is due to the millions of members of the public that have taken part, who I would like to thank for volunteering, helping to provide the Government with an invaluable tool as we fight this pandemic.”

Download the pre-print report here.