Covid risk greater in pubs and homes but less so in gyms and restaurants – study
A NEW study of coronavirus carried out in the South Wales Valleys suggests that pubs and mixing in the home can all increase the risk of passing on the virus but that gyms, leisure centres and restaurants do not.
A 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 appear 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 of coronavirus to adults while visiting facilities such as supermarkets, restaurant, gyms and leisure centre also did not appear to increase risk of infection.
The study’s findings on gyms comes following the First Minister’s suggestion on 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 last year between November 21 and December 20, the study focused on risk factors for catching coronavirus in a community setting rather than the risk of serious illness/hospitalisation or death, with 99.6% of those 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 mass testing in Merthyr was heavily criticised at the time. Within weeks, the virus was spreading faster in Merthyr than anywhere else in Wales, residents appeared to be no more protected than before. The limited data that was available suggested most residents were not tested, and it was hard to get hold of more detailed information about the project.
One of the authors of the new study is Dr Giri Shankar, incident director for the novel coronavirus outbreak response at PHW, who has had a prominent role in the Welsh Government’s response to the pandemic.
It is important to note that this is just one study.
The science around coronavirus is constantly changing and developing. Just because one study says something doesn’t mean it is a fact.
Each study adds to the pool of knowledge which in turn informs policy makers on how to proceed during the crisis.
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;
■ in this community, and at this point in the pandemic, reducing transmission from a household contact who is self-isolating 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.
Regarding gyms there seems to be a confusing picture.
First Minister Mark Drakeford has previously said there is evidence from abroad that gyms can be a setting for so-called “super-spreader events”, though some industry bodies have accused Mr Drakeford of misrepresenting the science.
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.”
The community mass testing was carried out by Cwm Taff 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 (CDSC) is the epidemiological investigation arm of PHW. It aims to protect the population from infection through surveillance of infectious disease, support for outbreak investigation, provision of health intelligence and applied research.
The survey findings come as Wales’ deputy chief medical officer warned there remains a risk of further corona
virus surge this summer. Speaking on Monday, Dr Chris Jones said 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 40 cases per 100,000 yesterday.
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.
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.
But he added: “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.
“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.”