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Covid-19 could now be endemic in some parts of the country combining severe deprivation, substandard housing and large BAME communities, according to a highly confidential analysis from Public Health England.
The document, filtered to Observer, and marked as ‘official sensitive’, suggests that the national lockdown in these parts of northern England had little effect in reducing the level of infections, and that in such communities it is now firmly established.
The analysis, prepared for local government leaders and health experts, relates specifically to the Northwest, where several local closures have recently been implemented following spikes in numbers. But it suggests that the lessons could be applied nationally. Based on a detailed analysis of case numbers in different local areas, the study builds links between higher concentrations of Covid-19 and problems of deprivation, poor housing and overcrowding, and ethnicity.
Produced in recent weeks and with data through August, it says: “The overall analysis suggests that Bolton, Manchester, Oldham and Rochdale never really left the epidemic phase, and that nine of the 10 districts [of Greater Manchester] they are currently experiencing an epidemic phase. “
The five most affected areas are currently in the Northwest. Bolton had 98.1 cases per 100,000 residents last week, with 63.2 in Bradford, 56.8 in Blackburn and Darwen, 53.6 in Oldham and 46.7 in Salford. Milton Keynes, by comparison, had 5.9 per 100,000, 5.2 in Kent and 3.2 in Southampton.
Comparing other English regions, the study says: “Each region has experienced its own epidemic journey with the north peaking later and the NW [north-west], Y&H [Yorkshire and Humber] and EM [East Midlands] not returning to a Covid state close to zero even during the lockdown, unlike other regions that have been able to return to a state almost prior to Covid. “
He also questions, under a heading marked “discussion,” why anyone should expect new local closures to work now in these areas: “If we accept the premise that in some areas the infection is now endemic, how does this change our strategy? ? If these areas were unable to reach a near zero Covid state during the full lockdown, how realistic can we expect the current restriction escalations to work? “
The comments point to friction between Public Health England and the government over the strategy to address local outbreaks, as it threatens a possible second wave of Covid-19.
Last night, Gabriel Scally, a visiting professor of public health at the University of Bristol and a member of Sage’s independent committee, described the findings of the leaked report as “extremely alarming” after they were displayed by the Observer.
“The only way forward is to build a system that provides much better and more locally tailored responses,” Scally said. “There is no integrated search, test, trace, isolate and support system at this time. Data on housing is extremely important. Overcrowded homes are part of the public health record. Housing conditions are very important and have always been, whether due to cholera, tuberculosis or Covid-19.
“Doing something about the living conditions of someone who has an active infection is extremely important and it is not something that can be handled by a call center run by a commercial company hundreds of miles away.”
Scally said helping people isolate themselves by providing financial support was also crucial: “Taking two weeks off if you have a zero-hour contract is not an option for people.”
Matthew Ashton, Liverpool city council director of public health, said upon viewing the study: “This report shows a strong link between our most deprived areas, our BAME communities and poor housing communities, and that can lead to the virus becoming endemic. I completely agree with that. But I think it is also more complicated because there are different types of outbreaks and different ways that the virus could become endemic, such as opening the night economy and having young people contract the virus asymptomatically and then transmit it. “
Last night, amid continuing confusion over the rules on quarantine upon returning to the UK, the Labor Party called for a “quick review” to restore public confidence. In a letter to the Home Secretary, the Labor Party urges the government to consider introducing a “robust testing regime at airports” that could help to safely minimize the need for a 14-day quarantine.
There have been more than 340,000 confirmed cases of coronavirus so far in the UK, and more than 40,000 people have died, according to government figures.
Local blockades are now being implemented or relaxed across the country in response to the sudden increases. In the most recent ones, Norfolk, Rossendale and Northampton were added as “areas of greatest support,” meaning that the government will work with local authorities to provide additional resources, such as testing or contact tracing, to help reduce the number of infections.
Improvements at Newark and Sherwood in Nottinghamshire, Slough in Berkshire and Wakefield. West Yorkshire means they have been removed from the watch list. Restrictions that were already in place in parts of Greater Manchester, Lancashire and West Yorkshire have been eased.
In Scotland, restrictions on visiting other homes in Glasgow, West Dunbartonshire and East Renfrewshire were reintroduced this week.
