Professor Debra Lapthorne, Regional Director of Public Health, and Mike Wade, Deputy Director of Health Protection at Public Health England South West write:
In our fight against Covid-19, we are at a crucial point which is similar to where we were in March. However, if we all act now, we can prevent history repeating itself.
ONS data show that around 336,500 people across England had the virus in the week 2-8 October. This is around 1 in every 160 people. Hospital admissions for Covid-19 in the region are rising again, as are intensive care admissions. While the epidemic re-started in younger adult age groups in the last few weeks, there is clear evidence of gradual spread into older age groups, including in the South West.
The good news is that we are much more certain now that children are usually not badly affected by this virus but sadly, inevitably, increases in deaths are expected to follow in coming weeks, with over 800 UK lives lost in the last week.
The R rate for the UK is between 1.3 – 1.6. Roughly this means that every case generates more than one new case, through onward transmission – so the epidemic grows larger. Every NHS region of England has an R well above 1.0, suggesting widespread increases in transmission continues across the country, not just in the North of England.
In the South West, there were over 493 cases per 100,000 of population (for the whole of the pandemic), up to 18th October. Scientists estimate the doubling time in the UK for new infections is between 8 and 16 days and is even faster in some areas.
SAGE is clear that we need to act now.
Winter in the NHS is always a difficult period, and that is why in the first wave our strategy was: “contain, delay, research and mitigate” to push the first wave into Spring. This time it is different as we are now heading into the colder, darker winter months. We are in the middle of a severe pandemic and the seasons are against us. Basically, we are running into a headwind.
The NHS is bracing itself and they will do what they always do, which is work tirelessly to help as many people as possible. But we need to be realistic – there is only so much they can do. We all have to help our hard-working NHS staff continue to care for everyone who needs it urgently, and provide as many non-urgent tests, checks and treatments as possible, by helping to stem the rising tide of infections.
People point out that we must not lose sight of the indirect harms of Covid-19. They are absolutely right. We need to keep elective surgeries and non-urgent services open for as long as we can; we need to keep cancer treatment and diagnostic services going; and we need to continue to provide mental health services. Crucially, we need people to come forward for that care when they need it – and we know during the first peak, fear of the virus put many people off from doing so.
The best way we can do this is to keep the number of Covid-19 cases down. If cases rise dramatically, the NHS will need to focus more on dealing with the life-threatening situations immediately in front of them. This can mean freeing up staff and space by postponing other non-urgent procedures and treatments. By keeping Covid-19 numbers low we help the NHS; and in turn the NHS will be there to help us, our families and loved ones.
The principles for how we keep transmission low have not changed. Above all else, if you have Covid-19 symptoms you must self-isolate in line with published guidance and get a test.
At all times, even when you are well, wash your hands regularly, wear a face covering in confined spaces and follow the 2 metre social distancing rules. By keeping our contacts low, we reduce the number of opportunities for the virus to spread. I know this can be very hard, but it is an unfortunate scientific fact that this virus thrives on humans making social contact with one another.
What we would give to have had the level of data, testing and medical insight we have now back in February and March this year. We now have much improved testing capabilities, we know in more detail where the disease is, and we have better treatments.
Earlier in the year we were fighting a semi-invisible disease, about which we had little knowledge, and it seeded in the community at great speed. We now know where it is and how to tackle it – let’s all grasp this opportunity and prevent history from repeating itself.