FLU FEARS AFTER COVID

HEALTH MINISTER’S WARNING OVER WINTER FLU

Wales is facing a September Covid peak along with flu returning ‘with a vengeance’, while the backlog of NHS operations won’t be cleared for five years, according to the Welsh Government’s Health Minister. In a wide-ranging interview, Eluned Morgan also maintained that there would be no Welshspecific inquiry into the handling of Covid in Wales. This is what she told us...

WILL HAYWARD: Why will masks not be required in pubs and restaurants but will be required in shops and on public transport?

ELUNED MORGAN: It’s really important that people understand that Covid is not over and there are still real issues in relation to the spread of the virus. In public places where people have to go to live, such as shops and public transport, we think it is really important that people continue to wear masks. When it comes to pubs and restaurants, obviously we are in a different situation because you don’t have to go to a pub or a restaurant and you need to eat while you are there. So there are some obvious reasons why we are going to release the restrictions on pubs and restaurants.

WH: So you aren’t enforcing maskwearing in a pub or restaurant because people are not wearing it for long anyway?

EM: It’s a question of choice. You can choose whether or not to go to a pub or restaurant, whereas actually you do need to go to shops and on public transport.

WH: Workers in the pub don’t have as much choice though, do they?

EM: No and there is an issue with that and that is why we are asking for all pub landlords to take precautionary measures to make sure their staff are safe. So hopefully this will hopefully come out when they are making their risk assessment.

WH: Let’s talk about those risk assessments. You have said that it will be up to hospitality venues to carry out risk assessments. Even under the current restrictions, there seems to be a lot of discrepancy between how different pubs are handling it and that is with some very clear guidance. When it is based on a risk assessment, it seems weird that some pubs might have long queues at the bar and others might not and they will both be fine. Will there be any monitoring?

EM: Various guidance is in place for what people can use to mitigate the risks. So they can consider things like two-metre distancing or masks and that will then be up to them. And of course the ventilation is crucial here. What is important is that people understand that they discuss this with the people who work in their employment, and that is a requirement as well. Also, once the risk assessments have been published they can be monitored by the local government. There will be provision for local governments to come in and inspect.

WH: Is that something you expect to happen? Will every venue at some point in the early months be inspected?

EM: We have been speaking to local government about that and what capacity they have, so clearly when we think there are breaches that is where local government will be focusing their attention.

WH: So if someone is in a pub and they are queuing five deep at the bar but the landlord says, “Don’t worry, we have the door open” – if they feel insecure should they be reporting up to their local authority?

EM: Customers are being very sensible. They are being very responsible and my guess is that they will stop going to those pubs or maybe would report it to the local authorities and then the local authorities could come in and inspect.

WH: What do you think the chances are of another lockdown? What about a fourth wave? What does the modelling say?

EM: So we are expecting another small peak perhaps in September. The thing I am as concerned about now is winter flu.

So we are expecting a significant increase in the number of people who will be suffering from flu this winter because it wasn’t something that was spreading in our communities to the last 18 months.

That is likely to come back with a vengeance. We will be rolling out a booster campaign at the same time as the flu campaign. It’s really important that people come forward for both vaccines and that is especially true for anyone over 50.

WH: You have spoken strongly this week about international travel and the threat posed by new variants. What countries in particular are you concerned about? Is there any particular advice you have for people who are travelling internationally, above and beyond what is mandatory?

EM: We are clearly most worried about those countries where they have variants of the virus which will evade our vaccines.

So clearly there are examples of a South African variant and the Brazilian variant that exist in some countries already – not just in South Africa and Brazil but that has now spread to other areas. We are concerned about that.

We are very keen to encourage people not to go abroad this year. Should they go abroad, then it is really important that they take the PCR tests before they go but also when they come back. Now of course there won’t be a requirement for them to self-isolate if they have been double-jabbed but we do require them to take that PCR test on day two.

WH: Which countries in particular are you concerned about which have cases of those variants?

EM: There was concern at one stage earlier on that in Portugal there was a new variant from Nepal for example. The case with France was about the Beta variant of the disease.

Now we have got more data on that, we know that a lot of it was

restricted to an island close to South Africa, so we have more detail on that than at the beginning.

WH: Are there any plans to introduce a list of countries that have variants that are concerning? EM: Our advice this year is to simply not to travel. If you look at the chaos which is caused when these traffic-light systems changed, and clearly we have very little faith in the UK Government to do anything systemically and in an organised way.

This is why you can see people scrambling back from Mexico to try and get back before things turned red. They are being charged over £2,000 to stay in a hotel and isolate for 10 days.

There are a lot of countries that are amber at the moment and they could turn red. I would strongly advise people to take serious precautions if they are thinking of going abroad. Just be aware that you can be caught out and you could be facing a massive bill.

WH: The NHS is under an enormous amount of pressure at the moment. One worker told me if a family member fell ill right now they would never rely on an ambulance and would drive them straight to hospital. A&Es have been under severe pressure. Why is this? And what plans are in place to manage this as cases go up in the winter? EM: One of the key problems we have here is that there is massive pressure on the care workforce. It is difficult to get people through the front door because we can’t get them out the back door. We are having real trouble recruiting for care workers at the moment in our communities. We are trying to put as much support in as possible.

Brexit has made a difference as well, so for example in Pembrokeshire there are lots of jobs available in hospitality and tourism, so some of those care workers have gone to work in hospitality and tourism, so hopefully that situation will get better as the seasons change.

There are real shortages of care workers so that is part of the reason why there is such an issue at the moment in terms of trying to get access to A&E because we can’t get people out through the back door. WH: How is not being able to discharge people impacting on the ambulance service? EM: Because they take people to the hospital and they can’t discharge people into hospital once they get there, so that becomes the problem. Clearly there’s also been a significant increase in demand. That is something else that we are very concerned about. This is unusual for this time of year but it looks like we have had delays in people calling the NHS so the numbers of stacked up and now are at a point where they have become more serious.

So the demands on accident and emergency and GP surgeries is huge. There is about a 20% increase in the number of people trying to get access to GPs. If people can’t get access to the GP they will often go to A&E instead. We have put in £25m to try and alleviate this situation, to try and give alternatives for people to go to other places other than A&E. WH: Aren’t there 1,000 cancer patients who you would have expected to come forward over the past 18 months but haven’t, so are just out there in the community? Do those figures ring true with you? EM: I think those figures are now not as high as they were and things are coming down in that space. I think we are in a situation where cancer services have always been essential services, so you have never cut off access to those services, and we have had quite a big campaign to try and get people to come forward if they think they have got anything that looks remotely like cancer. I think that has paid off and the numbers are now lower than we expected, but there is obviously a lot of work to do to catch up.

WH: When you say flu is coming back with a vengeance, do you have figures for the number of cases and deaths on that in terms of projections? EM: Not yet because we are still not sure in what form it will come because this is all new and we have never had the situation where it has had over a year without spreading, so it is very difficult to model and plan. But there is massive preparation been put in place by the NHS.

WH: The First Minister has said there will be no Welsh-specific inquiry into the handling of Covid. Given that so many of these decisions which would lead to lockdowns are Welsh Government decisions, how can we justify not having a Welshspecific inquiry? I accept the argument that you are not operating in a vacuum and the UK Government have made decisions that have sometimes made it harder for you to do your job, but ultimately the Welsh Government is accountable to people in Wales and it seems bizarre that we won’t be having a Welsh-specific inquiry into this. EM: The interconnection between the decisions made in Westminster and Wales is very strong. If you just take something like the Delta variant being introduced into the UK, that was a decision made around international travel and that was a failure to close the borders sooner.

The Delta variant has now ravaged our communities and is the dominant variant and we would have done things differently. The decision not to close the borders sooner was very much at the feet of the UK Government.

WH: The second wave was far more deadly and a second wave was well under way when the Kent variant entered Wales in December. We had already had the “firebreak” and we had already had a warning in September from Sage saying “You need to lock down” and we didn’t until October. They are Welsh Government decisions. They are not to do with the UK Government. Surely those families who lost loved ones in a second wave deserve to have answers about what happened in Wales, not to be a footnote in the UK Government inquiry? EM: There are so many things we have learnt going along with this virus and we are all learning as we went along.

If you remember, in that autumn we were trying to lock down areas where the virus was rising. You will remember in Caerphilly, for example, we locked down the area and then we locked down another area. That was a different approach. We did have the firebreak and there have been independent assessments which have demonstrated that actually this firebreak was effective in slowing things down.

Clearly there will be different decisions in retrospect that we would have made and those will come out, I am sure, during the course of the inquiry and that inquiry will include, not just a footnote, but also I am sure a comprehensive look about what decisions the Welsh Government made.

WH: The lockdowns in Caerphilly were not really lockdowns in the real sense. Pubs were open. You could drive out of the area for several reasons. However, I want to move on to elective procedures. Many people are waiting for hip replacements, for example, and that is a very horrible way to live. Given that most of the pandemic is hopefully behind us and this will be one of your top priorities, when do you expect these waiting list to return to pre-pandemic levels? Is there any time-frame on that? Can you offer any hope to those people about when you expect to be where we were? EM: I think my predecessor made it very clear even before the election that this would take the entirety of the Parliament before we can clear the backlog.

It is going to be a long time and of course what we are trying to do now is put measures in place.

Those people waiting for operations have already been contacted by the NHS and given advice on how to look after themselves during this time. Clearly, though, we are going to do everything within our powers to speed up this process.

The NHS is not back to normal in terms of hospitals have to still be Covidsecure and be careful not to introduce Covid into hospitals.

It is not easy, especially when you have hospitals where you have accident and emergency next door to elective procedures. So the way our hospitals are built doesn’t make it easy to separate off elective surgeries, which is what can be done in the larger cities in England.

We have asked the health boards to come forward with a proposal for how we can address the backlog and what measures they would like to put in place and they are being assessed now. We’ve already put £100m into trying to tackle the backlog and there’ll be more money to come in.

WH: So half a decade until the backlog is cleared. Will you be offering incentives for young people to get vaccinated? The UK Government have offered Uber rides and takeaway vouchers. Are there any plans for something like that in Wales? EM: We won’t be doing this in Wales. We have already got fairly high vaccination rates compared to England. We’ve got about 75% of our young people who have been vaccinated.

Clearly we need that to rise, but if you compare both levels to some of the areas of England where they are really struggling to get people in, young people in Wales have heard our advice and have heard the cry to not just protect themselves but also protect their loved ones, and that is another reason why you are seeing them get the vaccine.