Lancashire public health boss: 'Be patient - 2021 will be bumpy', says Dr. Sakthi as lockdown-lifting looms
Lancashire’s director of public health has issued a clarion call to the county to “stay awake” to the ongoing risks posed by the pandemic, as the nation prepares to embark on the government’s roadmap out of lockdown.
Dr. Sakthi Karunanithi warned residents that 2021 is likely to be a “bumpy” year - and even raised the spectre of a midsummer surge in cases as restrictions are removed.
He also repeated a request he first made late last year for Lancashire to be prioritised for a more rapid rollout of the vaccine programme, because of persistently higher case rates than in many other parts of the country.
With the staged lifting of lockdown set to begin next week when schools fully reopen, Dr. Karunanithi says the county finds itself in a similar position to the one it faced upon exit from the first shutdown last summer - only this time with an added complication.
“The rates in Lancashire and the North West are at least double those in the South West and London.
“So we need to positively discriminate [in favour of] areas with high levels of infection being vaccinated sooner. There is an economic case and a moral case for that - but also a biosecurity case in terms of preventing variants emerging.
“Variants occur when levels of infection are higher. In areas with enduring transmission, we need to go further to bring those levels down - and that means vaccinating faster, supporting families to isolate with good economic incentives and helping local businesses to support their employees and keep themselves Covid safe.
“It will benefit local areas, but it will also benefit the whole country to avoid a resurgence of the virus,” said Dr. Karunanithi, who was speaking before news emerged that half a dozen cases of a Brazilian Covid variant had been discovered in the UK.
The Lancashire County Council area had a case rate of 132 per 100,000 people in the week to 24th February - above the England average of 103 over the same period.
However, in Preston, that figure was far higher, standing at 204 - and the city has had the highest rate in Lancashire for much of the last month, a position occupied largely by districts in the east of the county throughout the autumn and winter months.
Dr. Karunanithi attributes the far slower decline in infections in Preston, when compared to other parts of the county, to the fact that the city is Lancashire’s “economic and transport hub”.
“You then have to overlay that with the type of economy we have [across Lancashire], which is largely small and medium-sized enterprises and [involves] people needing to come out of their house and not being able to work from home.”
While Lancashire’s vaccine rollout has been going well - with over half a million people now having had their first job and a take-up rate of 91 percent in the over 65s - Dr. Karunanithi warned that vaccines are not a silver bullet against an enemy like Covid.
“Its natural R number [which indicates how many others one person can infect] will require at least 80 percent of the population [to be immune] in order to [achieve] herd immunity.
“We are vaccinating the over 16s [16 and 17-year-olds with underlying healtj conditions, then all over 18s] - there will not be 100 percent take-up and even if there was, the immune response is not going to be 100 percent [amongst the vaccinated], so the idea of herd immunity is less attractive with this kind of virus.”
That is one of the reasons why Dr. Karunanithi is advocating a “very cautious lifting of lockdown” - along with the risk of a return to "damaging" localised restrictions, should case rates remain stubbornly high in areas like Lancashire.
He also fears that there may be another spike in cases around June or July.
“My worry is that once the lockdown lifts and, if our behaviours completely rebound to what they were before the pandemic, then we do face a risk of rising levels of infection again.
“But this time round it will probably hit harder on the working age population rather than older people, because of the [effect of] vaccinations.
“Thankfully, we should see a lot less deaths, unless the variants let it rip. But there is also the impact of Long Covid to consider as well.”
Dr. Karunanithi says any summer surge should not hit the NHS in the way that previous waves have done by threatening to overwhelm capacity - but warns that it would nevertheless jeopardise the health service's capacity to catch up on non-Covid related work, because of the resultant absence levels amongst its own staff.
Pressed on whether he believes the normality that we knew until this time last year can ever be recaptured, he offers cautious - but long-term - hope to the people of Lancashire. But it comes wrapped in a plea.
“We will [return to normal], but in 2021 we need to be fully awake - this year is still going to be a bumpy road.
"We will be living with testing and tracing, mask-wearing and avoiding large gatherings as much as possible for some time to come - definitely during 2021.
“So let’s stay awake and be patient.”