Coronavirus (COVID-19) Infection Survey, UK: 29 April 2022

In the week ending 23 April 2022:

• The percentage of people testing positive for coronavirus (COVID-19) continued to decrease in England, Wales and Scotland, and the trend was uncertain in Northern Ireland.

• In England, we estimate that 2,408,300 people had COVID-19 (95% credible interval: 2,326,300 to 2,494,500), equating to 4.42% of the population or around 1 in 25 people.

• In Wales, we estimate that 172,300 people had COVID-19 (95% credible interval: 151,300 to 194,700), equating to 5.67% of the population or around 1 in 18 people.

• In Northern Ireland, we estimate that 74,700 people had COVID-19 (95% credible interval: 60,500 to 91,700), equating to 4.07% of the population or around 1 in 25 people.

• In Scotland, we estimate that 218,000 people had COVID-19 (95% credible interval: 193,800 to 243,600), equating to 4.14% of the population or around 1 in 25 people.

Within this bulletin, we summarise some of the latest results from the Coronavirus (COVID-19) Infection Survey. For more detailed information on our methods, see our Coronavirus (COVID-19) Infection Survey methodology article.

About this bulletin

In this bulletin, we refer to the number of current COVID-19 infections within the population living in private residential households. We exclude those in hospitals, care homes and/or other communal establishments. In communal establishments, rates of COVID-19 infection are likely to be different. More information about the COVID-19 pandemic from the Office for National Statistics (ONS) and other sources can be found in our Coronavirus (COVID-19) latest insights.

The positivity rate is the percentage of people who have tested positive for COVID-19 on a polymerase chain reaction (PCR) test at a point in time. We use current COVID-19 infections to mean testing positive for SARS-CoV-2, with or without having symptoms, on a swab taken from the nose and throat. This is different to the incidence rate, which is a measure of only the new PCR positive cases in a given time period. All analysis was produced with our research partners at the University of Oxford.

Our estimates are based on confirmed positive test results. The remaining swabs are either negative, which are included in our analysis, or are inconclusive, which are not included in our analysis. Some swabs are test failures, which are also not included in our analysis. The impact of excluding inconclusive results on our estimates of positive infections is likely to be very small and unlikely to affect the trend.

Early management information from the Coronavirus (COVID-19) Infection Survey is made available to government decision-makers to inform their response to COVID-19. Occasionally we may publish figures early if it is considered in the public interest. We will ensure that we pre-announce any ad hoc or early publications as soon as we can. These will include supporting information where possible to aid user understanding. This is consistent with guidance from the Office for Statistics Regulation (OSR).

How the data in this bulletin can be used

The data can be used for:

• estimating the number of positive cases among the population living in private households, including cases where people do not report having any symptoms

• identifying differences in numbers of positive cases between UK countries and different regions in England

• estimating the number of new cases and change over time in positive cases

The data cannot be used for:

• measuring the number of cases and infections in care homes, hospitals and/or other communal establishments

• providing information about recovery time of those infected

The results in this bulletin are:

• provisional and subject to revision

• based on infections occurring in private households

• subject to uncertainty; a credible or confidence interval gives an indication of the uncertainty of an estimate from data analysis

The percentage of people testing positive for coronavirus (COVID-19) continued to decrease in England, Wales and Scotland in the week ending 23 April 2022. In Northern Ireland, the percentage of people testing positive for COVID-19 decreased in the most recent two weeks, however the trend was uncertain in the most recent week. Our estimates contain Omicron BA.1 and BA.2 variants and all other variants.

All estimates are based on statistical modelling of the trend in rates of positive nose and throat swab results. All estimates are subject to uncertainty given that a sample is only part of the wider population. Additionally, the estimates for the very latest days may change as more test results are received. Therefore, our official estimates for a particular week are based on a reference day a few days before the end of the week and caution should be taken in over-interpreting small movements in the very latest trends.

Figure 1: The percentage of people testing positive for COVID-19 continued to decrease in England, Wales and Scotland, and the trend was uncertain in Northern Ireland in the most recent week

Estimated percentage of the population testing positive for COVID-19 on nose and throat swabs, UK, 2 May 2021 to 23 April 2022

Notes:

1. Official reported estimates are plotted at a reference point believed to be most representative of the given week.

2. Official estimates present the best estimate at that point in time. Modelled estimates are used to calculate the official reported estimate. The model smooths the series to understand the trend and is revised each week to incorporate new test results, providing the best indication of trend over time.

3. Official estimates are displayed over a rolling year up to the most recent week. The full time series of our official estimates from 27 April 2020 onwards are available in our Coronavirus (COVID-19) Infection Survey datasets.

Download the data

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About our estimates

Our headline estimates of the percentage of people testing positive in England, Wales, Northern Ireland and Scotland are the latest official estimates. We include different measures to support our estimation and this section outlines the approaches used.

Official estimates should be used to understand the positivity rate for a single point in time. This is based on the modelled estimate for the latest week and is our best and most stable estimate, used in all previous outputs. The modelled estimate is more suited to understanding the recent trend. This is because the model is regularly updated to include new test results and smooths the trend over time. These modelled estimates can be found in our Coronavirus (COVID-19) Infection Survey datasets. 

The estimates for non-overlapping 14-day periods, which underpin our modelled official estimates, and the unweighted sample counts are also included in the associated datasets. These estimates are produced using a different method of weighting to the model. For more information on our methods and quality surrounding the estimates please see our Coronavirus (COVID-19) Infection Survey methods article and our Quality and Methodology Information report.

All estimates presented in this bulletin are provisional results. As swabs are not necessarily analysed in date order by the laboratory, we have not yet received test results for all swabs taken on the dates included in this analysis. Estimates may therefore be revised as more test results are included.

In the week ending 23 April 2022, the percentage of people testing positive for coronavirus (COVID-19) decreased in all regions of England.

Figure 2: The percentage of people testing positive for COVID-19 decreased across all regions in England in the week ending 23 April 2022

Modelled daily percentage of the population testing positive for COVID-19 on nose and throat swabs by region, England, 13 March to 23 April 2022

Notes:

1. Credible intervals widen slightly at the end as there is a delay between the swab being taken and reporting of results. We report latest figures based on the reference day for that week because of this greater uncertainty in the most recent days.

2. The percentage of people testing positive by region was calculated using a similar modelling approach to the national daily estimates in Section 2: COVID-19 by UK countries.

3. The analysis is conducted over a six-week period, which means some positive cases move in and out of the sample. This causes variability between estimates over time, which is expected given the lower number of positive tests in each region, compared with England as a whole.

4. We describe trends by comparing the probability that the estimate for the reference day is higher or lower than the estimate for 7 and 14 days prior.

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Estimates for non-overlapping 14-day periods (which underpin our modelled estimates) by region are available in our Coronavirus (COVID-19) Infection Survey datasets.

Sub-regional analysis of the UK

The percentage of people testing positive for COVID-19 remains high across sub-regions of the UK. Figure 3 presents modelled estimates for sub-regions of all UK countries in the week ending 23 April 2022.

Figure 3: The percentage of people testing positive for COVID-19 by UK sub-regions

Modelled percentage of the population testing positive for COVID-19 on nose and throat swabs by sub-regional geography, UK, 17 to 23 April 2022

Notes:

1. Sub-regional estimates are based on a different model to our headline estimates. Our sub-regional estimates are calculated as an average over a seven-day period and should not be compared with our headline positivity estimates, which are for a single reference date. Therefore, the sub-regional figures may differ from the headline estimates because they are averaged over a longer time period. If a trend is changing quickly, the figures shown in Figure 3 may not reflect the change we are seeing in our headline estimates.

2. The colour scale has been adjusted from the 7 January 2022 publication onwards to accommodate for increased infection levels and is not comparable with sub-regional charts in previous bulletins.

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Age group analysis for England

Our age groups separate children and young people by school age.

In the week ending 23 April 2022, the percentage of people testing positive decreased in all age groups. Caution should be taken in over-interpreting any small movements in the latest trend.

Figure 4: The percentage of people testing positive for COVID-19 in England decreased in all age groups in the most recent week

Modelled daily percentage of the population testing positive for COVID-19 on nose and throat swabs by age group, England, 13 March to 23 April 2022

Notes:

1. Credible intervals widen slightly at the end as there can be a delay between the swab being taken and reporting of results. We report latest figures based on the reference day for that week because of this greater uncertainty in the most recent days.

Download the data

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Estimates for non-overlapping 14-day periods (which underpin our modelled estimates) by age are available in our Coronavirus (COVID-19) Infection Survey datasets.

We are unable to produce the same grouped analysis as presented in Figure 4 for the devolved administrations because of smaller sample sizes within each age group. However, estimates on positivity by single year of age for Wales, Northern Ireland and Scotland using a different model are in the following section and accompanying datasets.

Age analysis by single year of age over time by country

In this section, we present modelled daily estimates of the percentage testing positive for COVID-19 by single year of age over time from 13 March to 23 April 2022 for England, Wales, Northern Ireland and Scotland. They are produced using a different method to the grouped age analysis for England presented previously and are therefore not directly comparable.

The data presented in Figure 5 for England suggest that the percentage of people testing positive decreased in most ages but remain high in older adults.

For Northern Ireland, rates have decreased among most ages over recent weeks, however the trend was uncertain in older adults. For Wales, rates have decreased across all ages over recent weeks, however the trend was uncertain in the most recent week. For Scotland, rates have decreased among older adults, and the trend was uncertain in young adults and children.

Figure 5: The percentage of people testing positive for COVID-19 by single year of age over time for England, Wales, Northern Ireland and Scotland

Modelled daily percentage of the population testing positive for COVID-19 on nose and throat swabs by single year of age, UK, 13 March to 23 April 2022

Notes:

1. These estimates use a different method to modelled daily estimates of the percentage testing positive by age group for England in the previous section and are therefore not directly comparable.

Download the data

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Further analysis on age for Wales, Northern Ireland and Scotland is published by their respective statistical agencies. Analysis for Wales is published in English and Welsh.

The incidence rate is a measure of new polymerase chain reaction (PCR)-positive cases per day per 10,000 people in a given time period. In this section, we look at an earlier time period to our analysis of the percentage testing positive. We include estimates of the incidence rate in our Coronavirus (COVID-19) Infection Survey datasets and in Table 2.

In the week ending 9 April 2022, the number of new PCR-positive COVID-19 cases per day decreased in all UK countries. Credible intervals are wider for Wales, Northern Ireland and Scotland because of relatively smaller sample sizes, and care should be taken in interpreting results.

The reference date used for our official estimates of incidence of PCR-positive cases is 14 days before the positivity reference day, meaning that there is a two-week lag between the incidence estimate and the positivity estimate. This is necessary as estimates later than this date are more likely to change as we receive additional data. While we believe that the incidence estimates are useful, they can be volatile and subject to change as more data become available. For more information on how we calculate estimates of incidence please see Coronavirus (COVID-19) Infection Survey: methods and further information.

The World Health Organization (WHO) have defined names for variants of concern.

Currently, variants under surveillance in the UK are:

• Omicron: B.1.1.529 (variant of concern), which includes sublineages BA.1, BA.2, BA.3, BA.4 and BA.5
• Delta: B.1.617.2 and its genetic descendants

We publish weekly breakdowns of gene pattern and Cycle-threshold (Ct) values.

The "Cycle threshold", known as a Ct value, reflects the quantity of virus (also known as viral load) found in a swab test.  A lower Ct value indicates a higher viral load. The latest Ct values of coronavirus (COVID-19) positive tests are provided in the Coronavirus (COVID-19) Infection Survey: technical dataset.

Since March 2022 Omicron BA.2 compatible infections, including all sublineages, have been the most common in all UK countries. This was last measured as 96.5% of all sequenced COVID-19 infections (in the four weeks to 25 April 2022).

The Omicron variant BA.1 has changes in one of the three genes that the coronavirus survey swab test detects, which means the S-gene is no longer detected. When there is a high viral load (for example, when a person is most infectious), not detecting the S-gene in combination with detecting the other two genes (ORF1ab and N-genes) is a reliable indicator of this Omicron BA.1 variant. However, as the viral load decreases (for example, if someone is near the end of their recovery from the infection), not detecting the S-gene is a less reliable indicator of this Omicron variant.

The Omicron variant BA.2 does not have changes in the S-gene, and therefore all three genes, or the S-gene and either ORF1ab or N, will usually be detected in infections with this variant.

We last published our main variant analysis in our Coronavirus (COVID-19) Infection Survey, UK: 22 April 2022 release. This showed a very high proportion of infections compatible with the BA.2 variant, so we have not included a breakdown of infections by variant in this release. We will continue to monitor infections by variant and will reintroduce the charts and analysis by gene pattern when considered helpful. More information on how we measure variants from positive tests on the survey can be found in our Understanding COVID-19 Variants blog and in our methodology article.

Our Coronavirus (COVID-19) Infection Survey: technical dataset includes analysis of the genetic lineages of coronavirus seen in the samples we sequence. More information on how we measure variants from positive tests on the survey can be found in our Understanding COVID-19 variants blog. Our Coronavirus (COVID-19) Infection Survey methods article gives more detail about how we sequence the virus' genetic material.

The sequencing is produced by the Wellcome Trust Sanger Institute and analysis is produced by research partners at the University of Oxford. Of particular note are Dr Katrina Lythgoe, Dr Tanya Golubchik and Dr Helen Fryer. Genome sequencing is funded by the COVID-19 Genomics UK (COG-UK) consortium. COG-UK is supported by funding from the Medical Research Council (MRC) part of UK Research and Innovation (UKRI), the National Institute of Health Research (NIHR), and Genome Research Limited operating as the Wellcome Sanger Institute.

The estimates provided in Sections 2 to 6 are for the percentage of the private-residential population testing positive for coronavirus (COVID-19), otherwise known as the positivity rate. We do not report the prevalence rate. To calculate the prevalence rate, we would need an accurate understanding of the swab test's sensitivity (true-positive rate) and specificity (true-negative rate).

While we do not know the true sensitivity and specificity of the test, our data and related studies provide an indication of what these are likely to be. In particular, the data suggest that the false-positive rate is very low - under 0.005%. We do not know the sensitivity of the swab test. However, other studies suggest that sensitivity (the rate of true-positive test results) may be somewhere between 85% and 98%.

You can find more information on sensitivity and specificity in our Coronavirus (COVID-19) Infection Survey methods article and our blog that explains why we trust the data from the Coronavirus (COVID-19) Infection Survey. You can find more information on the data suggesting that our test's false-positive rate is very low in a paper written by academic partners at the University of Oxford.

The Coronavirus (COVID-19) Infection Survey analysis was produced by the Office for National Statistics (ONS) in collaboration with our research partners at the University of Oxford, the University of Manchester, UK Health Security Agency (UK HSA) and Wellcome Trust. Of particular note are:

• Sarah Walker - University of Oxford, Nuffield Department for Medicine: Professor of Medical Statistics and Epidemiology and Study Chief Investigator
• Koen Pouwels - University of Oxford, Health Economics Research Centre, Nuffield Department of Population Health: Senior Researcher in Biostatistics and Health Economics
• Thomas House - University of Manchester, Department of Mathematics: Reader in Mathematical Statistics
• Anna Seale - University of Warwick, Warwick Medical School: Professor of Public Health; UK Health Security Agency, Data, Analytics and Surveillance: Scientific Advisor

Age groups for children and young people

• "aged 2 years to school Year 6" includes children in primary school and below

• "school Year 7 to school Year 11" includes children in secondary school

• "school Year 12 to those aged 24 years" includes young adults who may be in further or higher education

Those aged from 11 to 12 years and those aged 16 to 17 years have been split between different age categories depending on whether their birthday is before or after 1 September.

Confidence interval

A confidence interval gives an indication of the degree of uncertainty of an estimate, showing the precision of a sample estimate. The 95% confidence intervals are calculated so that if we repeated the study many times, 95% of the time the true unknown value would lie between the lower and upper confidence limits. A wider interval indicates more uncertainty in the estimate. Overlapping confidence intervals indicate that there may not be a true difference between two estimates. For more information, see our methodology page on statistical uncertainty.

Credible interval

A credible interval gives an indication of the uncertainty of an estimate from data analysis. The 95% credible intervals are calculated so that there is a 95% probability of the true value lying in the interval.

Cycle threshold (Ct) values

The strength of a positive coronavirus (COVID-19) test is determined by how quickly the virus is detected, measured by a Ct value. The lower the Ct value, the higher the viral load and stronger the positive test. Positive results with a high Ct value can be seen in the early stages of infection when virus levels are rising, or late in the infection, when the risk of transmission is low.

False-positives and false-negatives

A false-positive result occurs when the tests suggest a person has COVID-19 when in fact they do not. By contrast, a false-negative result occurs when the tests suggest a person does not have COVID-19 when in fact they do. For more information on false-positives and false-negatives, see our methods article and our blog.

Incidence rate

The incidence rate is a measure of the estimated number of new polymerase chain reaction (PCR)-positive cases per day per 10,000 people at a given point in time. It is different to positivity, which is an estimate of all current PCR positive cases at a point in time, regardless of whether the infection is new or existing.

Reference dates

We aim to provide the estimates of positivity rate (the percentage of those who test positive) and incidence that are most timely and most representative of each week. We decide the most recent week we can report on based on the availability of test results for visits that have already happened, accounting for the fact that swabs have to be couriered to the labs, tested and results returned. On most occasions, the reference dates align perfectly, but sometimes this is not feasible. This week, the reference week for positivity is 17 to 23 April 2022 for England, Wales, Northern Ireland and Scotland.

Within the most recent week, we provide an official estimate for positivity rate based on a reference point from the modelled trends. For positivity rates, we can include all swab test results, even from the most recent visits. Therefore, although we are still expecting further swab test results from the labs, there were sufficient data for the official estimate for infection to be based on a reference point after the start of the reference week. To improve stability in our modelling while maintaining relative timeliness of our estimates, we are reporting our official estimates based on the midpoint of the reference week. This week, the reference day for positivity rates is Wednesday 20 April 2022 for England, Wales, Northern Ireland and Scotland.

The reference date used for our official estimates of incidence of polymerase chain reaction (PCR)-positive cases is 14 days prior to the positivity reference day. This is necessary as estimates later than this date are more likely to change as we receive additional data. This week, the reference week for incidence is 3 to 9 April 2022 and the reference day is Wednesday 6 April 2022 for all UK countries.

Response rates

Enrolment for this wave of recruitment for the Coronavirus (COVID-19) Infection Survey ceased on 31 January 2022. Response rates for England, Wales, Northern Ireland and Scotland can be regarded as final response rates to the survey. Response rates for each nation are found in the Coronavirus (COVID-19) Infection Survey: technical dataset. We provide response rates separately for the different sampling phases of the study. Additional information on response rates can be found in our Coronavirus (COVID-19) Infection Survey methods article.

Survey fieldwork

Survey fieldwork for the pilot study began in England on 26 April 2020. In Wales, fieldwork began on 29 June 2020, in Northern Ireland fieldwork began on 26 July 2020 and in Scotland fieldwork began on 21 September 2020.

Sub-regional geographies

We have presented modelled estimates for the most recent week of data at the sub-regional level. To balance granularity with statistical power, we have grouped together local authorities into Coronavirus (COVID-19) Infection Survey sub-regions. The geographies are a rules-based composition of local authorities. Local authorities with a population over 200,000 have been retained where possible.

The boundaries for these Coronavirus (COVID-19) Infection Survey sub-regions can be found on the Open Geography Portal.

Other Coronavirus Infection Survey (CIS) analysis and studies

This study is one of a number of studies that look to provide information around the coronavirus pandemic within the UK. For information on other studies see Section 5: Quality characteristics of the Coronavirus (COVID-19) Infection Survey (coherence and comparability), revised 16 July 2021.

These statistics have been produced quickly in response to developing world events. The Office for Statistics Regulation (OSR), on behalf of the UK Statistics Authority, has reviewed them on 14 May 2020 and 17 March 2021 against several important aspects of the Code of Practice for Statistics and regards them as consistent with the Code's pillars of trustworthiness, quality and value.

The estimates presented in this bulletin contain uncertainty. There are many sources of uncertainty, including uncertainty in the test, in the estimates and in the quality of data collected in the questionnaire. Information on the main sources of uncertainty are presented in our Coronavirus (COVID-19) Infection Survey Quality and Methodology Information report, our methodology article, and our blog that explains why we trust the data from the Coronavirus (COVID-19) Infection Survey.