- Amid a steep rise in confirmed cases of COVID-19 in the UK, gatherings of over six people are now banned in England
- It comes as Caerphilly in Wales goes into local lockdown, to stem an outbreak
- Enhanced restrictions are also in place in the west of Scotland
- 'It is of great concern at this point,' says England's deputy chief medical officer
'This is a big change. It is now consistent over two days and it is of great concern at this point.' When speaking to the BBC about the incisive spike in UK COVID-19 cases witnessed in government data this week, Prof Jonathan Van Tam–England's deputy chief medical officer–did not dust the facts with sugar.
Though it would have taken a year's supply of Tate&Lyle to have made them sweeter. On Sunday 6th September, it was announced that 2,988 people were confirmed, via testing, to be carrying the virus. This is a heady uptick: the largest number of folk to be confirmed to be infected in a single day since May, and a rise of 1,175 on the day before. Monday the 7th continued at the same, thrashing rate; 2,948 were told that COVID-19 had taken root in their respiratory tracts.
As of last night, news came in that fresh rules will come into force as a result: gatherings of more than six people, outside or indoors, will be illegal in England, as of Monday 14th September. (This doesn't apply to schools, workplaces, or 'COVID-secure' weddings, funerals or organised team sports.) If you're caught breaking this restriction, the police can issue you a £100 fine. Meanwhile, extra restrictions are now in place in the west of Scotland to stem numbers in the region, and Caerphilly in Wales has gone into local lockdown amid a rapid increase in cases.
'Some of that increase may be because of catch-up from delayed tests over the past few days, due to the widely reported difficulties the UK testing service has faced [in] dealing with the number of tests being requested,' said Paul Hunter, a medical professor at the University of East Anglia. 'Nevertheless this represents a marked increase in the seven day rolling average of 1,812 cases per day compared to 1,244 a week ago and 1,040 a week before that. Sadly, it is beginning to look like we are moving into a period of exponential growth in the UK epidemic and, if so, we can expect further increases over coming weeks.'
This reality seems to represent a knotty contradiction. Namely, the concerted push to get those of us who have been working from home in England back into the office and spending cash on 1pm baguettes, versus a swift change in tactic to halt socialising.
Is it right that rates are rising sharply in young people?
Per Public Health England data, cases of the virus are escalating most dramatically among those aged between 10 and 29. On the face of it, this feels like better news: we know that younger people, unless they have an underlying medical condition, tend to cope better with COVID-19 than their counterparts in later life. The issue here, as stated by Prof Jonathan Van Tam in his BBC interview, is transmission.
'If you look further into the European Union, you can see where cases rise in the younger parts of the population, they do filter through and start to give elevated rates of disease and hospital admissions to the older age groups. That then becomes a serious public health problem,' he said.
So, what will happen next?
'I completely agree with what Prof Jonathan Van Tam has said–things aren’t looking too good,' Linda Bauld, a Professor of Public Health at the University of Edinburgh, told WH on Tuesday 8th September, the day before the new rule on gatherings over six was announced. 'Whereas we had local spikes in some parts of the country, like Leicester, two or three weeks ago, now they seem to be all over the UK, including Caerphilly in Wales. There's a growing trend in terms of numbers rising, although in some places, like the south west, cases have remained low.'
And what might be our short term fate? 'If we are two to three weeks behind what's happening in France and Spain, then I would be confident that, unless we take action quickly, we will see numbers increase. These will then feed through to more hospitalisations. I don't think we’ll see the same high death rates [as over the summer] as we're protecting care homes, which is where over 40% of deaths were, but we will see some rise in hospitalisation and death.'
Bauld states that another worry is clear: the testing system appears to be breaking down. 'This is really bad news, and shouldn't be a surprise to England, as we experienced this a couple of weeks ago when schools in Scotland went back. There were issues with kids being unable to get tests or being sent all over the place to inappropriate testing centres.'
The situation here, she says, looks to be with the labs at which processing and analysis happens. These seem to be overwhelmed by the volume of tests and new labs, sorely needed, are not opening fast enough.
This has a domino effect. If testing drive-in centres don't get results back, quickly, they won't book in further tests. The test and trace system, which tells people who have symptoms to get tested, is then impacted. (On this issue, Health Secretary Matt Hancock has said that there has been 'a problem with a couple of contracts', which would take a matter of weeks to be 'sorted in the short term'. Labour leader Sir Keir Starmer said the testing programme is 'on the verge of collapse'.) Effective, rapid testing, so that the contacts of confirmed cases can be contacted and told to isolate, is integral to nixing the spread of the virus.
And what might the implications be?
'If I had a crystal ball, I think I would say that the first step will be a change in guidance in how many people we can meet indoors. That's an adjustment that the government can do that doesn't really impact economic activity. [This has, as of this morning, been brought into force.] 'If we do continue to see problematic localised spikes, using [what has happened] in the west of Scotland as an example, the next step would be to shut the pubs [after changing the rules to state that you cannot host people from other households in your home in that part of the country, the devolved Scottish government is now monitoring the hospitality sector, to see if restrictions should be imposed in restaurants and bars.]
And what about Christmas? The specifics, right now, are tricky to predict. Prof Bauld does say, though: 'It's going to be a difficult winter. Travel is interesting–the aviation industry is clearly on knees and lobbying hard for airport testing. If they can get that right, as Germany has, in a few months, you might see more international travel permitted, while you can’t socialise in your own homes.'
What should I do, now?
Of course, solving the testing issue is not in your remit. But there are things you can do to protect yourself and those whose lives yours might touch. Prof Bauld recommends that, as well as limiting your interactions with people from other households, indoors: 'People who have jobs where they can work from home should tell their employers that dong so is their preference. And, of course, continue to follow guidance on wearing a face covering and physical distancing from others. If you get symptoms, engage with the [NHS] system.'
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