UKCovid alert level description

One of the main objectives of the UK Health and Security Agency (UKHSA) To provide advice to the UK Chief Medical Officer (CMO) Next, advise the Minister at the COVID-19 alert level in the United Kingdom.

The alert levels are:

• Level 1: COVID-19 is not known to exist in the UK
• Level 2: COVID-19 is present in the UK, but the number of cases and infection rate are low
• Level 3: The COVID-19 epidemic is generally prevalent
• Level 4: The COVID-19 epidemic is generally prevalent. Infection rates are high, and direct COVID-19 pressure on medical services is widespread, substantial or rising.
• Level 5: As Level 4, there is a significant risk that healthcare services will be overwhelmed directly by COVID-19.

In this document UKHSA Because we are considering the recommendations of CMO..The initial methodology was developed after consultation with public health experts nationwide, reviewed and notified by the Emergency Science Advisory Group (SAGE), and was published in the United Kingdom. CMO..

The methodology evolves as follows UKHSA Learn from current operations and as the information stream evolves. Therefore, it will be subject to future reviews. UKHSATechnical board, chaired by 4UK on a rotation basis CMO..

approach

UKHSAThe approach focuses on the criteria for moving between levels, rather than the criteria that define individual levels. In addition, thematic risk assessments that assess risks that occur in areas that cannot be grasped by indicators alone are also considered. The indicators and risk assessments listed below are considered in the context of various measures. Determining the alert level is not an automated or purely statistical process. This approach aims to blend expert judgment and risk assessment with the more quantifiable indicators and thresholds outlined below. This will give you an overall assessment of the situation and alert level recommendations. CMO..

The UK COVID-19 alert level focuses on data directly related to the impact of COVID-19. The only exception is the move between level 4 and level 5. UKHSAWhen CMO Consider all source pressures as this signals that medical services can be overwhelmed.

Our operational objectives are to avoid unnecessary, unpredictable or frequent changes in alert levels, explain the national complexity of the epidemic, and our evolution regarding COVID-19 and its transmission. It is to reflect understanding.

timing

Alert levels may need to be escalated as quickly as possible to signal an urgent and escalating national public health crisis. Conversely, as the risk of COVID-19 decreases, it is important to ensure that alert level changes are stable and that a long-term declining trend for new infections is established. As a guide, UKHSA Make sure that most, if not all, indicators are met and that thematic risk assessment is not high risk when recommended. CMO Decreased alert level.

Following the deescalation recommendations, a minimum of 4 weeks is allowed before the subsequent deescalation recommendations. During the four weeks immediately following deescalation, epidemic trajectories and risk assessments will continue to be monitored, and escalation recommendations may be made during this period, if necessary.

UKCOVID-19 Alert Level Escalation and Deescalation Indicators

Various metrics and thresholds are used to support the analysis underlying the alert level recommendations. Recommendations for raising alert levels can, in extreme cases, be based on a single metric alone, but can be based on a combination of metric described for each threshold along with a risk assessment. Will be the highest.

The escalation and deescalation indicators and thresholds for each alert level are shown below.

Alert level 1

There is a single holding metric and Level 1 recommendations are only possible if that metric is met.

• Is there credible evidence and consensus between the UK? CMO When UKHSA Does that COVID-19 no longer exist in the UK?

The rationale

A UK-to-UK consensus is required to recommend escalation to alert level 1. CMO When UKHSA That COVID-19 no longer exists in the UK. Evidence will be reviewed using information provided by health protection and central monitoring teams in the United Kingdom and, where appropriate, other sources. If the above indicators are not met, the alert level recommendations will be escalated to level 2 or will remain at level 2.

Escalate from level 2 to level 3

indicator

that is:

• Is the UK weekly case rate more than 50 per 100,000 population?
• Is the national R definitely estimated to be 1 or more?
• Is the confirmed new infection doubling time less than 7 days?

The rationale

At this level, many statistical or mathematical measurements such as R are unlikely to be reliable. The short doubling time of new confirmed infections suggests that contact tracing and quarantine programs do not include sufficient outbreaks. Weekly case rates are also taken into account.At these lower alert levels, regional thematic risk assessments are of particular importance and may take into account evidence from public health monitoring systems and outbreaks.

Sources include laboratory test results, public health monitoring systems, and modeling from SPI-M / SAGE.

Escalation from level 3 to level 4

index:

• Does the UK’s weekly case rate exceed 250 per 100,000 population?
• Is the country’s R definitely estimated to be R> 1?
• Is the confirmed new infection doubling time less than 7 days?
• Are there more than 30,000 estimated new infections per day in the UK?
• Has COVID-19-related hospitalization increased by more than 25% in the same 7 days?
• Has the occupancy rate of COVID-19 related hospitals increased by more than 25% in the same 7 days?
• It is a highly dependent unit related to COVID-19 (HDU) Or intensive care unit (ICU) Has hospitalization increased by 25% or more in the same 7 days?
• Related to COVID-19 HDU also ICU Has your occupancy increased by more than 25% in the same 7 days?
• Is new daily COVID-19-related deaths increased by more than 25% in the same 7 days?
• Is the current direct COVID-19 absolute medical pressure high enough to support escalation to Level 4?

The rationale

Hospital activity and serious health are important indicators of medical pressure, but they can be delayed from the time of infection. Therefore, it includes transmission dynamics, doubling time, and estimated incidence. Given the uncertainty of estimated incidence, weekly case rates should also be considered.

Sources include laboratory test results, hospitalization and mortality data ( GOV.UK dashboard). Presumed new infectious diseases are notified by various sources, including survey data (for example, the National Bureau of Statistics (for example).we) And ZOE / KCL) and mathematical modeling provided by SPI-M / SAGE.

Alert level 5

There is a single retention indicator and level 5 is recommended only if that indicator is met.

• Have UKHSA, In consultation with senior management of the NHS CMOIs it estimated that the projected medical demand will exceed the projected capacity in the UK, region, or the entire delegated government within the next 21 days?

If the above indicators are not met, you can consider deescalating to level 4 or leaving it at level 4. This allows you to focus on NHS capacity and operational pressure, even at high levels of COVID-19 infection.

The rationale

If you recommend escalating to COVID-19 Alert Level 5, you should consult with your medical service director and emergency response planner based on expected capacity, including surge capacity and mutual aid. As a rule, escalation to Level 5 should give enough time to implement urgent national measures to protect medical services from overwhelming.

Escalation from level 4 to level 3

index:

• Is the weekly case rate in the UK less than 125 per 100,000 population?
• Is the country’s R definitely estimated to be less than 1?
• Is the estimated number of new infections per day less than 30,000?
• Are the infections identified with the new daily COVID-19 declining or stable at low levels for at least 4 weeks?
• Are COVID-19-related hospitalizations declining or stable at low levels for at least 4 weeks?
• Is the occupancy rate of COVID-19-related hospitals declining or stable at low levels for at least 4 weeks?
• Related to COVID-19 HDU also ICU Is enrollment declining or stable at low levels for at least 4 weeks?
• Related to COVID-19 HDU also ICU Is occupancy declining or stable at low levels for at least 4 weeks?
• Are new daily COVID-19-related deaths declining or stable at low levels for at least 4 weeks?
• Is the current direct COVID-19 absolute health care pressure low enough to support escalation to level 4?

The rationale

Estimated infectious kinetics with a duration of R <1 were said to have been effective with non-pharmaceutical interventions (or other control measures), coupled with severe illness and / or a clear reduction in the number of people dying. Will give you confidence.

Lower weeks to give confidence that infection is decreasing, given the uncertainty of the estimated incidence and the fact that some estimates tend to be delayed when the incidence is decreasing. Case rates should also be considered.

Sources include laboratory test results, hospitalization and mortality data ( GOV.UK dashboard), Survey data (eg we And ZOE / KCL), and mathematical modeling provided by SPI-M / SAGE.

Escalation from level 3 to 2

indicator

• Is the weekly case rate in the UK less than 25 per 100,000 population?
• Are the infections identified with the new daily COVID-19 declining or stable at low levels for at least 4 weeks?
• Are COVID-19-related hospitalizations declining or stable at low levels for at least 4 weeks?
• Is the occupancy rate of COVID-19-related hospitals declining or stable at low levels for at least 4 weeks?
• Are new daily COVID-19-related deaths declining or stable at low levels for at least 4 weeks?

The rationale

The four-week declining trend gives confidence that the number of new infections is decreasing, in addition to the decrease in new infections.

Estimates of new infections can be unstable at such low levels or have very wide confidence intervals, so only weekly case rates are considered.

Sources include laboratory test results, hospitalization and mortality data ( GOV.UK dashboard), Mathematical modeling provided by SPI-M / SAGE, and public health monitoring system.

Thematic risk assessment

In addition to the above indicators, two major subject risks, namely mutations and regional heterogeneity, need to be considered.

These two specific subject areas were selected because they tend to identify risks to national alert levels that may not have been captured by existing indicators. It is likely to lead to changes in national epidemiology in the short term.

It is important to note that in exceptional circumstances, changes to alert levels may be recommended based solely on thematic risk assessments, regardless of the epidemic trajectory. The reverse is also true. This allows you to make agile recommendations without having to wait for pre-determined metrics to be met.

Each subject risk is assessed as high, medium, low, or minimal risk in terms of its tendency to affect national alert level indicators in the short term.