Plan B or not Plan B?
Local council and Public Health chief call for cautionary action
In September the national government revealed its ‘Plan A’ to combat the further spread of Covid-19 infections. It involved no further lockdowns and few social restrictions within the UK’s borders, but relied upon a combination of pharmaceutical interventions (mainly vaccines); test and trace programmes to identify and isolate positive outbreaks; and support for the NHS and social care.
An alternative ‘Plan B’ was mooted, involving the introduction of mandatory vaccine-only Covid-status certification in certain settings; a return to compulsory wearing of face masks in shops and workplaces etc; and a general request for people to return to working from home if they can. This less liberal regime was to be implemented only if increased infection levels put the NHS “under unsustainable pressure”.
The Prime Minister Boris Johnson and Health Minister Sajid Javid continue to declare confidence in Plan A provided that there are sufficient takers for the current vaccine booster programme.
But on 27 October Hastings Borough Council issued a press release stating that they were keen for the government to implement “some or all” of their ‘Plan B’ “as soon as possible”. The population of the town were encouraged to keep themselves and others safe by wearing a face covering in indoor areas, getting double vaccinated, and doing regular lateral flow tests.
The reasons the Council gave were as follows:
• The level of virus [positive tests] had risen to nearly 300 per 100,000;
• “We know how busy local GPs and the Conquest Hospital already are”;
• “Our population is one of the most deprived in the country”;
• There are still a large number of residents who are unvaccinated, and many of these have underlying health conditions which put them at greater risk;
• With no protective measures in schools and colleges, cases are high here, and that is putting families and the community at risk;
• Several members of the Council’s own staff have caught Covid-19 from their children, and that is impacting its ability to deliver services.
The Council press release went on to state that its own staff would continue to work from home wherever possible; and that any officers who are in the office are required to wear face coverings when not at their desks, to sit socially distanced, and to undertake regular cleaning and hand washing.
In fact by 1 November the positive test figure for Hastings had risen to nearly 360 per 100,000, though according to the Public Health Department (PHD) of East Sussex County Council, positive tests are “particularly high” among children aged 10 to 14, who are generally at very low risk of suffering symptoms that require medical treatment.
As to hospitalisations, the last two weeks in October saw a significant rise in the number of Covid-19 patients being treated in East Sussex hospitals (the great majority in the Conquest and Eastbourne District General). From a figure of just 15 earlier in the month it had jumped to 38 as at 2 November. Nevertheless, according to the East Sussex Healthcare Trust (ESHT), this represents less than 5% of the 769 open adult general and acute beds available, and only three of these patients required ventilation beds. The graph on this page suggests that current pressure on local hospitals, which a Trust spokesperson described last week as “at just above the 92% safety threshold”, comes not from the kind of spike of Covid-19 infections experienced last winter but principally from other causes.
The spokesperson acknow-ledged multiple pressures: “Winter is always a very busy time for the NHS. Our staff have been working tirelessly to manage both the continued pressure Covid is having alongside restoring other services to pre-Pandemic levels. But we are here to help when you need us and would encourage people who need medical advice to call NHS 111 or go to 111.nhs.uk.”
On the GP front, current NHS Digital data suggest that East Sussex patients are having on average to wait shorter times for appointments than two years ago – but that’s because a much greater proportion are conducted on the telephone or on-line. It may also reflect the fact that patients with Covid symptoms are discouraged from making any contact with GPs, other than participating in the vaccination programme.
Public Health advice
East Sussex PHD Director Darrell Gale issued a statement last week in parallel to Hastings Borough Council: “Please act as though Plan B has already been put into place to avert further increases – that simply means making sure you are up to date with your vaccines and wearing masks, especially in crowded places. For indoor events make sure there is adequate ventilation.”
So far, the mood on and off the streets of Hastings does not seem to reflect this cautionary plea or at any rate is divided. The proportion of mask-wearers in streets, shops and bars continues to fall. Use of public transport remains far lower than pre-pandemic levels, but is gradually rising.
A good index of popular feeling about Covid risks and plans to combat them might be gauged from the numbers attending Lewes bonfire celebrations ten days ago on 5 November. In 2019 there were around 60,000 paraders and spectators jammed into the streets of the town. In 2020 the event was cancelled. This year, Sussex Police advised people, in the light of Covid risks, to “consider their social responsibility” and stay away – or, if they were coming, to wear masks and take advance lateral flow tests. In the event, around 30,000 came, the proportion in masks difficult to assess.
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