Breaking News: Hit the brakes, reverse the irreversible, enhance your response!

Devon and Cornwall set for ‘enhanced response measures’ as Covid rates soar

(But do carry on with the pub crawl Simon)

Alex Green www.devonlive.com

Enhanced response measures are set to be put in place across the South West due to high rates of Covid-19.

As the August Bank Holiday – one of the South West’s busiest times – gets underway, due to high prevalence of the virus in the area, Devon and Cornwall are to receive ‘an enhanced response package’ – subject to sign-off by Number 10.

While no extra restrictions will be put in place, from Friday, measures will be rolled out which will help with support measures for education settings and increased national communications support, clearly outlining the continued risks of Covid-19 and the need to take personal action, such as the wearing of face masks and social distancing.

The response will last for five weeks – but a review will be conducted at week four to determine whether the automatic roll off at week five is appropriate, or if there is a case for re-escalation of further measures.

A letter written by Nadine Dorries and sent to the regions MPs states that following discussions with officials in the relevant South West local authorities they will be identifying the appropriate interventions and will start deploying the enhanced response area measures.

And it states that while the Prime Minister has said we want the whole country to move out of and remain out of these restrictions together, they are trusting people to be responsible and to act with caution and common sense, as they have done throughout this pandemic, and to make decisions about how best to protect themselves and their loved ones, informed by the risks – with a warning that if it doesn’t happen, measures could be ‘re-escalated’.

For the week ending August 22, Cornwall has the highest infection rate in England, with West Devon 3rd, Teignbridge 4th, Torbay 5th, Mid Devon 6th, Torridge 7th, East Devon 9th, Exeter 10th, South Hams 11th, North Devon 12th and Plymouth 13th. Only Sedgemoor (2nd) and Mansfield (8th) are not in Devon and Cornwall.

Luke Pollard, MP for Plymouth Sutton and Devonport, said: “What this basically means is our rates are the highest in the country, and as a result they are kicking in new measures, which is basically a response to those high rates of infection.

“It also allows more communications, community testing, and a bigger push on some the advice such as wearing face masks in schools for instance.”

He added: “This affects all of the South West, but especially the peninsula, because the peninsula has the highest rates. So that’s Devon and Cornwall, Plymouth, South Hams and all the districts.

“It’s partly a reflection on the fact that we’re a tourist destination, partly a reflection on the fact that we didn’t have high levels of Covid during the main outbreak, because we had lower levels, and so there’s less natural immunity built up by people having Covid.

“We do have a good take up of people having the vaccine, so three quarters of the population are fully vaccinate, and despite there being challenges about vaccinating young people, there’s still lots of capacity for young people to come forward and have their vaccine.

“This happens at the point of Bank Holiday weekend, so one of our most important tourist seasons, and I think many tourist businesses will be concerned about this announcement. From my point of view, I want to see everyone follow the guidance and look after themselves.

“Our rate is too high at the moment, and what we mustn’t do is allow the virus to continue to spread at this level, because that puts pressure on our NHS and we’ve already seen at Derriford how we’re effectively on Black Alert.

“It might not feel like the peaks of the pandemic previously, but that doesn’t mean our NHS professionals aren’t being worked into the ground at this moment, and I think it’s a good reminder to say to people ‘please keep yourself safe, please keep others safe, please make sure you’re testing yourself twice a week, make sure you’re getting the vaccine’.”

Kevin Foster, MP for Torbay, added: “Over recent weeks cases have increased in our bay and region, although thanks to the high levels of vaccination across our region the impact is being mitigated. These latest measures are a proportionate response to the situation, including their reminders of what we can all do to help protect our neighbours.”

Full letter from Nadine Dorries

A letter written by Nadine Dorries, and seen by Reach’s titles in Devon and Cornwall, reads: “I am writing to you to inform you of plans, to be announced today, to add all the following South West local authorities to a list of areas receiving an enhanced response package due to high prevalence of COVID -19 in the area: Torbay Council, Plymouth City Council, Devon County Council, East Devon District Council, Exeter City Council, Mid Devon District Council, North Devon District Council, South Hams District Council, Teignbridge District Council, Torridge District Council, West Devon Borough Council, Cornwall Council, Council of the Isles of Scilly.

“In response to Delta now being the dominant strain and the move to Step 4 of the Roadmap, we have reviewed our approach to enhanced response areas, with simplified short-term support to areas where case rates and wider indicators suggest we will see the greatest pressure on the NHS.

“These modifications to enhanced response packages took effect from the 19 July. Guidance regarding extra support deployed in areas receiving an enhanced response to Covid-19 can be found on gov.uk.

As of 18 August, case rates for all ages in the South West were 441 per 100,000 which is above the national case rate of 324 per 100,000. Case rates are increasing across the whole of the South West region with case rates in the 11-16 and 17-21 years age ranges seeing the greatest increases.

“As of 18 August, case rates in the South West for those aged 17-21 was the highest across the country at 1,878 per 100,000 and almost double the national figure of 878 per 100,000. With regards to vaccination, 76% of the total population has been fully vaccinated, receiving two doses.

“As a region, the South West has the highest case rates nationally, with only a handful of areas below the national average. The proposed UTLAs of Devon, Cornwall, Plymouth, Torbay and Isles of Scilly have some of the highest case rates rises above the national average.

“The 7-day case rate per 100,000 population increases for West Devon is 157%, for South Hams it is 122% and for Isles of Scilly it is 400%.

“The enhanced response area package will help with support measures for education settings and increased national communications support, clearly outlining the continued risks of Covid-19 and the need to take personal action, such as the wearing of face masks and social distancing.

“Additionally, prioritised access to Wastewater testing, sequencing, national contact tracing capacity and national support with messaging will also be supported. I recognise the excellent work that Local Authorities have been doing, for a sustained period of time to manage the pandemic in their area. The enhanced response package is a short-term measure.

“Areas designated as enhanced response will automatically roll off after five weeks of receiving the enhanced support, a review will be conducted at week four to determine whether the automatic roll off at week five is appropriate, or if there is a case for re-escalation.

“Following discussions with officials in the relevant South West local authorities we will be identifying the appropriate interventions and will start deploying the enhanced response area measures from Friday 27 August 2021.

“As the Prime Minister has said we want the whole country to move out of and remain out of these restrictions together. We are trusting people to be responsible and to act with caution and common sense, as they have done throughout this pandemic, and to make decisions about how best to protect themselves and their loved ones, informed by the risks.

“I’m sure you will continue to reinforce that message locally and would like to again thank you and the efforts of residents locally.

“Thank you for your support in stopping the spread of COVID-19 – including concerning variants – to protect the NHS, and save lives.”

Plymouth hospital declares critical incident over bed shortages

A Plymouth hospital has declared a critical incident over bed shortages as its emergency department becomes overrun by coronavirus cases.

www.independent.co.uk 

A spokesperson for University Hospitals Plymouth NHS Trust, which runs Derriford Hospital near Devon, said that the service is experiencing its highest rate of Covid-19 occupancy of the virus’s third wave.

The critical incident declaration means that all hospital departments must focus on tackling the problem. Already, bed capacity has been reconfigured to try to meet the demand of patients with and without Covid-19.

The hospital has also cancelled routine surgery appointments and temporarily banned visitors to try to prevent the virus being spread.

Jo Beer, Chief Operating Officer at UHP, said: “The incident was declared due to high bed occupancy and a sustained high level of emergency department attendance converting into an above-average level of admission.

“We are experiencing our highest level of Covid occupancy of the third wave and expect this to increase further – as a result we have reconfigured our bed capacity to manage both Covid and non-Covid capacity, but this needs continual review.”

Paul McArdle, Deputy Medical Director at UHP, said that the increase in Covid-19 hospitalisations reflects a “pattern that we’re seeing right across the country”, but added that it has been “compounded by a recent surge in Covid prevalence in our community”.

In a video message shared by UHP, he said: “We’d just like to inform patients that we’re currently experiencing high levels of attendance in our Emergency Department and in association with that, quite long waits.”

“For instance, last night we had I think about 130 patients present in our Emergency Department at 11 o’clock in the evening when we’d expect things to be a lot quieter.”

Covid-19 case rates are currently rising in all English regions except London and Yorkshire & the Humber, according to Public Health England.

Music festivals such as Boardmasters Festival in Cornwall and Latitude Festival in Suffolk have recently been blamed for coronavirus outbreaks.

Coronavirus: Waning immunity and rising cases – time to worry?

A month ago, coronavirus cases were falling and the lifting of nearly all restrictions looked like it had been a success.

Nick Triggle www.bbc.co.uk

But just weeks later, infections levels are rising again, with more than 30,000 new cases being confirmed each day, and there is growing evidence immunity through vaccination is waning.

How worrying is waning immunity?

Immunity through vaccination was always expected to wane.

Two studies – one based on data from the Zoe Covid Study app and another from Oxford University – suggest this may now be beginning several months after the second dose.

Chart shows fall i n protection against infection for Pfizer and AstraZeneca

Although it is also possible something else is at play here. The apparent drop in effectiveness could be related to the fact people are likely to be repeatedly exposed to the virus as time passes, increasing the opportunities for the virus to break through the immune system’s defences.

Either way this illustrates, once again, why we need to get used to Covid circulating.

Experts have been clear we should expect to be infected repeatedly over our lifetimes.

But each reinfection should be milder than the previous one.

And, for most, even those early infections will be milder than they would have been, because the vaccines remain highly effective at preventing serious illness.

The “good news”, Prof Adam Finn, of the Joint Committee on Vaccination and Immunisation (JCVI), says, is the vaccines, having effectively taken the edge off the virus by giving our immune system a head start, are still working very well.

How worrying are rising cases?

When infection rates started to fall in mid-July, scientists said we should not expect a continuous drop like we had seen during the lockdowns.

Instead, the modellers predicted a period when infection levels would bob around – a series of mini-peaks.

That seems to be exactly what is happening now, with infection rates climbing but only gradually.

Chart showing that the number of daily cases has seen a slight rise recently

Experts believe we have effectively reached an equilibrium whereby small changes – either in immunity across the population or behaviour and the number of contacts people have – can make the difference between infection levels rising or falling.

How worrying are local hotspots?

The national picture can mask what is happening locally. And parts of the country are seeing significant spikes in infections. In places such as Cumbria, Cornwall and Devon, tourism has been cited as a factor.

And health chiefs are urging people to:

  • think twice before visiting
  • be cautious
  • use rapid swab tests to check if they are carrying the virus

But there is also an acknowledgement our approach and attitude to Covid needs to change too.

About 4,700 cases have been linked to a festival in Newquay, Cornwall.

But local councillor and emergency doctor Andy Virr says the Boardmasters festival was held in the knowledge this could happen and he is reassured the cases are not translating into serious illness.

There are “no regrets” about allowing the festival, he adds, as it brought people a lot of joy.

But this, of course, does not mean we should abandon all caution.

There are other reasons some areas are seeing a spike in cases.

And in parts of Northern Ireland, with low vaccine uptake and high deprivation cited as factors, doctors say too many people remain at significant risk.

How worrying is the autumn?

Overall, the number of people dying remains very low compared with previous waves – showing just how effective the vaccines have been.

At this point in the winter wave, there were 10 times more Covid deaths than there are now.

Chart showing that the number of Covid deaths remains low

More than 100 people a day on average are still dying with the virus.

But during a bad winter, 300 to 400 people a day can die from flu.

The big unknown – and the thing causing government scientists most concern – is what will happen in the autumn.

Prof Mike Tildesley, an infectious disease modeller at the University of Warwick, says September will be the crucial moment, when schools are back and people return to work.

“August is such an odd month,” he says, “it makes interpreting what is happening more difficult.

“In September, normal behaviour and contact levels return.”

And if the signs from Scotland are right – the holiday season has already ended and cases are rising sharply – there could be quite a jump.

“We are already at quite a high base level in terms of infection,” Prof Tildesley says.

“So if they go up across the board from here and that translates to a rise in hospital cases, there could be problems.”

But there are no guarantees that will happen – especially if we are truly close to an equilibrium whereby the levels of immunity in the population can keep the virus at bay.

“The truth is we just don’t know,” Prof Tildesley says. “And it will probably be the end of September before we can say with any certainty.”

Attempt to force release of Johnson’s messages on Covid in care homes fails

The government has successfully resisted disclosure of potentially explosive WhatsApp messages between ministers and Boris Johnson about decisions to send hospital patients into care homes without first testing them for Covid.

[The High Court has now listed the final hearing of Cathy Gardner’s claim. This will commence on 19 October 2021 and is likely to last for three days. – Owl]

Robert Booth www.theguardian.com 

Two bereaved women whose fathers died from Covid in care homes that received infected NHS patients in April and May 2020 asked the high court to force disclosure of the texts, as well as emails sent from a private account by the then health secretary, Matt Hancock.

But Mrs Justice Eady ruled the government did not need to provide them in evidence for a judicial review of the legality of the government’s care home policy.

Discharging hospital patients into care homes without testing caused “thousands, if not tens of thousands of unnecessary deaths”, the bereaved argued.

Dr Cathy Gardner, one of the women who claim the care homes policy breached human rights laws and discriminated against the elderly and disabled, described the decision to block the release of potentially “highly significant” informal communications as “very disappointing”. They are considering an appeal.

Dominic Cummings, the PM’s former aide, has already published excerpts from WhatsApp messages with the PM about Hancock, including one where Johnson described Hancock’s testing strategy as “totally fucking hopeless”.

Lawyers for Gardner and her fellow claimant, Faye Harris, claimed crucial advice “was given via informal channels, text messages, WhatsApps, personal emails”. Without its disclosure the truth about what the government knew about the risks of discharging would remain hidden, they said.

Government lawyers argued that demands for extensive disclosure amounted to an attempt to conduct a public inquiry through the courts.

Sir James Eadie QC described the informal messages as “chit chat” and said they were “unlikely [to] contain materials of relevance”.

The court also ruled that the government did not need to release records of a meeting between the prime minister and Hancock at which, Cummings told MPs in May, the health secretary promised patients would be tested before being discharged into homes. Hancock subsequently denied that, saying he pledged instead to increase testing capacity.

The bereaved also wanted to see advice from England’s chief medical officer, Chris Whitty, and the chief scientific adviser, Sir Patrick Vallance, to ministers about protecting care homes, plus evidence of what was known about the risk of asymptomatic transmission and the limits on testing capacity.

The ruling comes amid rising pressure on the UK government to announce the terms of reference for the public inquiry, after the Scottish government said on Tuesday its would be established by the end of the year.

The Covid-19 Bereaved Families for Justice group, which represents more than 4,000 bereaved families, is separately seeking Hancock’s private emails under the Freedom of Information Act and a response to its request is weeks overdue. On Thursday the group marked a year of waiting since Johnson said he would meet the families.

A government spokesperson said: “As the prime minister said, we have committed to holding a full public inquiry which will start in the spring. Terms of reference will be set out in good time for the inquiry to begin, and we will consult with bereaved families and others before they are finalised.”