Inside Health
As infections rise, it’s vital that people stick to Covid rules, writes Professor Harry Burns
When Covid-19 hit Scotland in early March, the number of cases rose rapidly. We had one or two cases a day in the first week of March but, by the end of the month, we were seeing more than 300 a day. The rate of increase slowed in May and, by early June, daily numbers had fallen to around 30.
For most of June and July, the First Minister report was able to report cases in single figures and, by mid August, Covid-19 seemed to be under control. Two-metre distancing, mask wearing, and hand washing were effectively reducing risk of spread. While these rules were practiced consistently, the protective effect was considerable.
However, easing of lockdown predictably allowed further transmission of the virus and case numbers have increased. We have seen localised, spo - radic outbreaks. Local public health departments have been actively engaged in local contact tracing and quarantining. The first few outbreaks were contained. However, the economic damage caused by lockdown gave politicians a huge dilemma. Businesses which depend on footfall were facing collapse and their employees were facing financial disaster. Pubs and restaurants were allowed to open. Two-metre distancing was modified to allow more people to enter and, of course, you can’t drink or eat while wearing a mask.
The more people socialise, the more likely an infected person is to spread it to others and this is what is now driving the increasing number of positive cases. Relative to the number of positive tests, the number of hospitalisations is rather less that we saw earlier in the year. The explanation seems to be the virus is being spread by younger people who believe they are less likely to become infected and have serious symptoms. It may be too early to make that assumption. It can take two weeks between having a positive test and requiring admission to hospital. We may be on the verge of more admissions to hospitals and intensive care units as the virus spreads to elderly relatives. It is also too early to be complacent about the long-term effects of Covid. The syndrome of “long Covid” is now recognised. Sometimes, after a mild infection, people can experience a prolonged period of exhaustion, breathlessness and some can have more serious problems with blood clotting. This is not an illness to be complacent about.
The greatest increase in numbers of infections is occurring in the 20-40 age range and contact tracing seems to be pointing to infections acquired in domestic settings. The present local lockdowns are restricting social contacts in homes and now England has banned gatherings of more than six people in homes. Unless limits on the numbers of people allowed to meet indoors are rigorously followed, we will have a problem. As we move into winter, we can expect increased numbers of peo - ple developing a cough and a temperature. Many will have flu rather than Covid-19 but the NHS may have difficulty in differentiating the two conditions unless rapid testing for the two viruses becomes available.
Flu, of course, can be prevented by vaccination and everyone offered the vaccine should get it. A vaccine against Covid-19 is not yet available but, hopefully, we will have one in the next few months. How effective it will be is not certain and booster doses might be needed. Until we have the vaccine, we are absolutely dependent on people following the rules to limit transmission of the virus. The next week or two might give the politicians some difficult decisions on shutting down businesses again. When Jason Leitch tells you to wear masks, socially distance and wash your hands, listen to him!