‘Homes highest risk of infection’
A NEW study of coronavirus, carried out in the South Wales Valleys, suggests that pubs and mixing in the home can increase the risk of passing on the virus but that gyms, leisure centres and restaurants do not.
The study from Public Health Wales (PHW) looked at the evidence from mass testing in Merthyr Tydfil and the Cynon Valley.
It suggests households are the most significant source of infection, while working in the hospitality sector or visiting the pub are also significant risks.
According to the study, smoking or vaping appears to have a small but significant effect on transmission too.
No evidence was found that education settings such as schools provide a significant risk of transmission to adults, while visiting facilities such as supermarkets, restaurants, gyms and leisure centres also did not appear to increase risk of infection.
The study’s findings on gyms comes following the First Minister’s suggestion last Friday that gyms and leisure centres would not reopen until at least the second half of April and that, even then, some less modern gyms may remain closed for longer.
The study takes its findings from the responses to an online questionnaire completed by 199 people with a positive test (cases) and a sample of 2,621 negatives (controls), with questions asked about demographic and social risk factors.
These included: age, ethnicity and occupation, area of residence, people who you share a household with, caring responsibilities, and social interactions in the previous 10 days.
Conducted between November 21 and December 20, the study focused on risk factors for catching coronavirus in a community setting rather than risk of serious illness/ hospitalisation or death – with 99.6 per cent attending the testing pilot being asymptomatic at the time.
Data was collected during the height of the second wave of the pandemic, in an area that had some of the highest rates of infection in the UK.
The main findings of the report are: ■ In this community, transmission within the household was the highest source of infection; ■ Working in the hospitality sector and visiting the pub were significant risks but at the time of this study were relatively infrequent exposures, due to restrictions at the time; ■ Smoking or vaping had a small but significant effect on risk of transmission; ■ Working in social or healthcare had an increased risk; and, ■ In this community, and at this point in the epidemic, reducing transmission from a household contact who is selfisolating would have the biggest public health impact.
No evidence was found that education settings provided a significant risk of transmission to adults: Working in education, living with someone working in education, or living with school age children were not important risk factors in this study.
And visiting facilities such as supermarkets, restaurant, gyms and leisure centre also did not appear to increase risk of infection.
Professor Daniel Thomas, consultant epidemiologist at PHW’s Communicable Disease Surveillance Centre, said: “There is growing evidence that certain population groups are more likely to be affected by severe coronavirus including older people, males, pregnant women and people with pre-existing chronic disease or disability.
“People in certain minority ethnic groups and those in public-facing occupations are also disproportionally affected, but it is unclear whether this is related to increased risk of acquiring coronavirus or increased risk of severe disease once infected.
“Compared with the evidence that exists for risks associated with hospitalisation and death, limited information is available on the social, demographic and behavioural factors associated with transmission of coronavirus in the community.
“The conducting of mass testing provides a good opportunity to explore these risks by conducting large-scale epidemiological studies, and, with sufficient sample size, can provide information to help inform and support the ongoing response to the pandemic.
“This study reminds us that while education settings do not appear to present a significant transmission risk for coronavirus, there is a much greater risk of catching the virus at home, in a hospitality setting, or in the pub.
“This reinforces the need to avoid mixing with other households and
sticking to coronavirus restrictions by working from home if you can, wearing a face covering where required, washing your hands regularly and staying two metres from anyone you do not live with.”
Regarding gyms there seems to be a confusing picture.
The First Minister has previously said that there is evidence from abroad that gyms can be a setting for super-spreader events though some industry bodies have accused Mr Drakeford of misrepresenting the science.
The community mass testing was carried out by Cwm Taf Morgannwg University Health Board.
Dr Kelechi Nnoaham, director of public health at the health board, said: “It’s fantastic to see the information gathered from our mass testing programme in Merthyr Tydfil and the Cynon Valley being used to keep people safe all across Wales. We are now running a new community testing programme in the Cwm Taf Morgannwg region, open to any resident without symptoms of Covid-19.
“This will help us to identify and isolate asymptomatic cases and stop the spread of coronavirus in our communities. We encourage people to check their local authority website to find out where they can get tested.”
The Communicable Disease Surveillance Centre is the epidemiological investigation arm of PHW.
It protects the population from infection through surveillance of infectious disease, support for outbreak investigation, provision of health intelligence and applied research.
Meanwhile, in a separate development over the past week, a significant cluster of cases caused coronavirus levels to rise again in Merthyr Tydfil.
The number of daily reported cases doubled on the daily figures being reported in the area in the previous week, leading to Merthyr having the highest coronavirus infection rates of any local authority area in Wales.
On Monday, that rate rose to 144.2 cases per 100,000 population. By comparison, the all-Wales average was 39.1 cases per 100,000 people.
Merthyr Tydfil County Council said the cluster of “significance” was in the Swansea Road area of the borough.
At the end of February daily case numbers from Merthyr Tydfil were as low as three new positive cases a day.
By March 8, cases in the area spiked to 19 new cases on one day.
However, compared to the spike experienced over Christmas, the increase is low.
As a result of the increase in cases, a new mobile drive-through testing unit was set up at Merthyr Valley Homes, 22 Lansbury Road, Gellideg.
The spike comes amid falling rates across Wales as the latest lockdown appears to be having an effect on the R-rate.
But there nevertheless remains a risk of a further coronavirus surge in Wales after this summer, the nation’s deputy chief medical officer has warned.
Dr Chris Jones told a Welsh Government press conference on Monday that the situation is currently “really encouraging” despite the presence of the Kent variant.
The seven-day incidence rate in Wales has plummeted from more than 600 cases per 100,000 people in December, to 39 cases per 100,000 earlier this week.
More than 1.1 million people in the country have received their first dose of a Covid-19 vaccine, accounting for over 35% of the population.
More than 264,000 people – almost 10% of the population – have been given their second dose.
Dr Jones said the Welsh vaccination programme is “one of the most successful” in the world, with all adults due to be offered a vaccine by the end of July.
“There will not be total control of the pandemic at that point because the vaccines are not 100% effective, not everyone will have the vaccine or can have the vaccine, and for a long time until we get to July, very few people will have had both doses,” he said.
“After July, there will still be half a million children who are not vaccinated. So even once the vaccine programme has completed the rollout to all adults, there will still be a risk from coronavirus.
“The vaccine programme is increasingly important to us and provides increasing protection but it won’t be a complete level of protection and it won’t enable us to be completely free of concern.
“The virus is not going to disappear as a result of this programme.”
Dr Jones was asked about the likelihood of a third wave of Covid-19 later this year, as well as the need for further full lockdown restrictions.
He replied: “We recognise that this is an extremely transmissible infection and we also realise that relaxing restrictions will increase, potentially, the risk of transmission.
“It feels like controlling this pandemic is like trying to control the speed of a car in which the accelerator is stuck to the floor and the only way you can control the speed is by applying the brake, which is what we do with lockdown measures.
“As soon as you relax your foot on the brake, the car will accelerate off again. We do know that if we relax too much too quickly, we will see a surge in cases and another wave.”
Dr Jones said the Welsh Government was “showing considerable caution” in easing restrictions and trying to assess the effects of any changes.
He added: “The vaccination programme, as I’ve indicated, is important in this but it’s not going to provide us with complete protection.
“This is still going to be a problem going forwards. We will certainly have to watch out for the risk of a further surge after the summer.
“We’ll also have to consider whether some of the social behaviours that we require – hand hygiene, social distancing, mask use – may still be needed in the autumn.”