What needs to happen next for lockdown to be relaxed?
WHILE the Welsh Government has eased some restrictions in the current lockdown at the latest three-week review, there is still nothing set in stone about what the next steps are.
There’s certainly light at the end of the tunnel but significant restrictions on our daily lives remain.
Scientists and health officials continue to study a range of key indicators, or “circuit breakers”, which will help determine if and when Wales can move out of the Alert Level 4 lockdown.
According to Wales’ new Coronavirus Control Plan, released on Friday afternoon, there could be a widespread reopening beginning from April 22 and continuing over the following three weeks
Once completed, Wales would officially have moved into Level 3. So, with that in mind, this is what needs to happen in the coming weeks if lockdown is to be relaxed even further following the next review, which is on Thursday, April 22.
Cases need to fall
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The number of cases is the first and foremost measure of how many people with Covid-19 symptoms are presenting themselves for tests which then come back positive.
It is only a snapshot of the virus as it is reliant on people being tested, which not everyone does.
Infection rates are still higher now (41.9 cases per 100,000) than they were in August last year (5.8 cases per 100,000) but it’s important to remember testing is considerably more widespread now than it ever was.
The case rate in Wales as a whole was, for a period in December, one of the highest in the world. But it has been falling since the week before Christmas and for more than a month now, we have the lowest rate of the four home nations. While the updated Coronavirus Control Plan no longer publishes specific, quantifiable benchmarks for indicators, the infection rate is now well below the “trigger” figure of 50 cases per 100,000, which was a key benchmark for bringing in restrictions before Christmas.
A couple of weeks ago, Education Minister Kirsty Williams told the daily press briefing that while cases were going down across Wales, there was still a marked difference between certain areas, like Pembrokeshire and Gwynedd. That was why restrictions couldn’t be lifted yet, she said.
There has been a dramatic drop in previous hot-spot areas like Bridgend, Neath Port Talbot and the south Wales valleys with all local authority areas recently falling below 100 cases per 100,000 for the first time since early-September. However, local outbreaks in Merthyr Tydfil and Anglesey have caused figures to increase to above 100 in recent days and there have been confirmed cases in some schools in other areas leading to pupils being forced to stay at home.
The latest advice from the Technical Advisory Cell (TAC) said that, as of March 11, cases in Merthyr Tydfil had seen a 90% increase from the previous week, with 126 cases per 100,000 population. Cases in Anglesey and Conwy were also on the rise, it noted, although this was attributed to “localised outbreak clusters” and did not appear to be indicative of widespread community transmission. Ideally, all council areas need to have infection rates below 50.
Fourteen councils are under 50 cases per 100,000 and 17 of these also have positivity rates under 5%, both conditions likely to be required for restrictions to be lifted.
■ Positivity rates in all areas need to be below 5%
Positivity means the proportion of people who get a test who come back positive for Covid. The World Health Organisation suggests areas need to see a 5% positivity rate or below for a couple of weeks before restrictions are lifted.
Wales as a whole was at 3.9% on Friday, its lowest point since late September, although there are some local differences. All council areas are now in single figures and 17 are below the 5% threshold. These include Ceredigion (1.2%), Pembrokeshire (2.2%) and RCT, once one of the highest for case rates, on 2.1%. The highest are largely in north Wales with Anglesey on 9.1% although positivity in Mertyhr Tydfil has jumped to 8.1% recently.
It means that Wales as an average and 14 local areas are within the “circuit breaker” thresholds for both positivity rate and case rate.
■ Patient numbers in hospital need to fall
One thing ministers have repeatedly referred to when discussing lockdown measures is the “headroom” in the NHS. It’s clear that the more Covid cases there are, the more people will be in hospital and the strategy has largely been to avoid the NHS being “overwhelmed”.
In January, we saw record numbers of patients with Covid-19 in hospital beds. There were large numbers too of “recovering” patients. The peak of the number of people with Covid-19 in ventilated intensive care beds in Wales lasted much longer in January than it did in April but numbers have since dropped dramatically.
Admissions to hospitals of confirmed and suspected Covid-19 cases were running at a daily sevenday average of 40 on Wednesdaythe lowest number than at any other point in the pandemic and just below the average in July when restrictions were eased.
Covid admissions now make up 3.8% of all hospital admissions. The fewer Covid patients there are, the more capacity there is in the NHS.
■ Deaths need to go down
The most reliable figures are from the Office for National Statistics. Deaths involving coronavirus in Wales have seen drastic falls over the past six weeks as the impact of both the vaccine and lockdown efforts starts to show. The number of registered deaths involving Covid-19 is at its lowest level since late October. It is clear now that the pandemic’s second wave brought more deaths than the first. We saw 3,049 deaths involving Covid-19 in Wales in December and January which is 44% higher than during April and May, the worst two months of the first wave.
The deadliest day of the second wave of the pandemic came on 11 January, when there were 81 deaths. This is even higher than the peak of the first wave, which happened on 12 April, when there were 73 deaths involving Covid-19.
Public Health Wales has shown a fall for some weeks now.
The daily average is about five deaths a day but at the peak in January, the average daily deaths reached 48.
There is an inevitable lag between community cases, hospital admissions and deaths, but it’s clear that the current death rate is around the same as it was back in July as Wales emerged from the first lockdown.
■ Infections, the R-number and the variant
Another snapshot of the virus’ progress is the ongoing ONS swab survey which has asked thousands of people in Wales to take a throat and nose swab. This can pick up people who may unknowingly be carrying the virus.
The latest survey on Friday indicated infections were continuing to fall and estimated that 8,300 people in Wales had Covid-19 in the week to March 6, the lowest number for five months.
This is one in 365 people – down from one in 285 people.
The R-number – the transmission rate – which is calculated using several of these key factors remains within a range between 0.6 and 0.8 in Wales. The growth rate indicates virus infections could be shrinking between -7% and -4% per day. That means as at March 9, PHW estimated the time it takes for the number of cases to half to be 16 days. The next review needs to be sure new strains of the virus aren’t circulating in Wales and the UK.
As at March 10, the Kent variant continued to be the dominant Covid-19 variant in Wales and the UK.
There had been no further cases of South African variant since the last report with 25 cases in Wales detected to date.
Reducing the total number of cases continues to be the most effective way to reduce the risk of new variants emerging, said the TAC report.