Covid-19 may now be endemic in parts of the country that combine severe deprivation, poor housing and large BAME communities, according to a highly confidential analysis by Public Health England.
The document, leaked to Observer, and marked as “sensitive officer”, suggests that the national blockade in these parts of northern England has had little effect in reducing the level of infections and is now firmly established in such communities.
The analysis, prepared for local government leaders and health experts, specifically refers to the Northwest, where several local lockdowns have recently been put in place following spikes in numbers. But it suggests that the lessons could be applied nationally. Based on a detailed analysis of the number of cases in different local areas, the study creates links between the highest concentrations of Covid-19 and problems of deprivation, poor and crowded housing and ethnicity.
Produced in the last few weeks and containing data through August, it states: “The overall analysis suggests that Bolton, Manchester, Oldham and Rochdale never really left the epidemic phase – and that nine of the 10 districts [of Greater Manchester] they are currently experiencing an epidemic phase “.
The five hardest hit areas are currently all in the Northwest. Bolton had 98.1 cases per 100,000 people last week, with 63.2 in Bradford, 56.8 in Blackburn and Darwen, 53.6 in Oldham and 46.7 in Salford. Milton Keynes, by comparison, was 5.9 out of 100,000, and was 5.2 in Kent and 3.2 in Southampton.
Comparing other British regions, the study states: “Each region has experienced its own epidemic journey with the next northern peak and the NW [north-west], Y&H [Yorkshire and Humber] and EM [East Midlands] failing to return to a near-zero Covid state even during the lockdown, unlike other regions that have been able to return to an almost pre-Covid state. “
He also asks, under a heading marked “discussion”, why would anyone expect new local blocks to work in these areas now: “If we accept the premise that in some areas infection is now endemic, how does our strategy change? If these areas were unable to reach near-zero Covid status during the full lockdown, how realistic can we expect the current escalation of restrictions to work? “
The comments indicate friction between British public health and the government over the strategy to address local epidemics as a potential second wave of Covid-19 threat.
Last night, Gabriel Scally, a visiting professor of public health at the University of Bristol and a member of the Sage Independent Committee, described the results of the leaked report as “extremely alarming” after being shown by the Observer.
“The only way forward is to build a system that provides better and more personalized answers locally,” said Scally. “There is currently no integrated system of research, verification, tracking, isolation and support. The data on housing are of extraordinary importance. Overcrowded families are part of the history of public health. Housing conditions are so important and always have been, whether it was because of cholera or tuberculosis or Covid-19.
“Doing something about the housing conditions of someone who has an active infection is extremely important and not something that can be handled by a call center run by a commercial company hundreds of miles away.”
Scally said helping people isolate themselves by providing financial support was also crucial: “Taking two weeks off on a zero-hour contract is not an option for people.”
Matthew Ashton, director of public health at Liverpool City Council, said on seeing the study: “This report shows a strong link between our most deprived areas, our BAME communities and poor housing communities, and this can lead to virus that becomes endemic. I totally agree with that. But I think it’s even more complicated as there are different types of outbreaks and different types of ways the virus could become endemic, such as opening up the night economy and young people who asymptomatically catch the virus and then pass it on. “
Last night, amid continued confusion over quarantine rules on return to the UK, Labor called for a “quick review” to restore public confidence. In a letter to the interior minister, Labor urges the government to consider introducing a “robust airport testing regime” that could help safely minimize the need for a 14-day quarantine.
There have been more than 340,000 confirmed cases of coronavirus in the UK so far and more than 40,000 people have died, according to government data.
Local lockouts are now being rolled out or eased across the country in response to spikes. Most recent have seen Norfolk, Rossendale and Northampton added as “areas of increased support,” which means the government will work with local authorities to provide additional resources – such as testing or contact tracing – to help reduce the number of infections. .
Improvements in Newark and Sherwood in Nottinghamshire, Slough in Berkshire and Wakefield. West Yorkshire means they have been removed from the checklist. Restrictions already in place in parts of Greater Manchester, Lancashire and West Yorkshire have been relaxed.
In Scotland, restrictions on visiting other families in Glasgow, West Dunbartonshire and East Renfrewshire were reintroduced this week.