Lancashire public health boss wants "smarter" exit from lockdown when it ends

The month-long lockdown which begins across England tomorrow will give Lancashire a chance to “change its destiny” in the course of the pandemic.

Wednesday, 4th November 2020, 8:03 pm
Updated Wednesday, 4th November 2020, 8:08 pm

That is the message from the county’s director of public health who says that the region would have been on track to remain under its current Tier 3 restrictions when they were reviewed next week, had the national shutdown not been ordered.

However, Dr. Sakthi Karunanithi held out the hope that the measures in place for the next four weeks could see Lancashire emerge into Tier 2 if the lockdown ends as planned on 2nd December and the country returns to localised restrictions.

But he warned that a “smarter” approach to lifting the lockdown must be taken whenever the time comes.

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Dr. Sakthi Karunanithi, Lancashire County Council's director of public health

It is almost three weeks since Lancashire was placed under the “very high” Covid alert level – which outlawed the mixing of households in all indoor settings and required businesses including non-food pubs and bars to close.

However, parts of the county – including Preston – have been under some form of local Covid regulations since late summer, with the whole region subject to additional measures from mid-September.

“Essentially, Tier 3 hasn’t been sufficient,” Dr. Karunanithi told the Lancashire Post.

“The good news is that there are signs of infection levels falling – it just would have taken a lot longer within Tier 3 and probably needed more interventions to bring the rate down [sufficiently].

“I think these new lockdown measures will give enough headroom to bring the flightpath to a point where much lower levels of restrictions are needed at the end of [the period] – subject to people adhering to the guidance in the next few weeks.

“However, if we don’t follow the lockdown in its entire spirit, it will not be enough – we need to think of it not as a curfew but a ‘care-for-you’.”

The “stay at home” rule of the spring is now the guiding principle for the next month – although there are more exceptions than earlier in the year, with schools remaining open, unlimited outdoor exercise allowed and meeting with one person from another household permitted outside if social distance is maintained.

However, much else will feel wearily familiar – with non-essential shops closed, a requirement to work from home where possible and, with the exception of support or childcare bubbles, an almost total ban on household mixing.

For Dr. Karunanithi, it is the relaxing of the latter rule which needs much more careful consideration when the county comes out of its second full-scale lockdown.

He has long warned that household mixing, in various settings, was the source of the spike in infections that hit certain areas of Lancashire back in the summer – and has since spread and accelerated right across the county.

“The key thing that we would need to do is maintain, for some time, avoiding meeting people from other households.

“We need to release from the lockdown much more smartly.”

However, for a man whose ambition is to exit lockdown into Tier 2, that could pose a problem – because under that set of restrictions, which Lancashire briefly entered for five days last month, mixing of households is allowed in private gardens and outdoor public spaces, subject to the rule of six, although it is still outlawed in homes.

Even in Tier 3, groups of up to six can meet outdoors in parks and beaches.

“We either have to influence [the shape of] the national tier system after this lockdown or we will have to ask for some guidance and will need to advise people,” Dr. Karunanithi said.

The potential dilemma harks back to the situation during the period when Lancashire was under localised rules which advised people not to meet in indoor public venues – but did not specifically outlaw it. Nor were outdoor gatherings banned at that time – but local public health leaders issued “strong advice” to residents not to do either.

The other main difference between Tiers 2 and 3 is that most businesses are able to remain open under the lower restriction.

Dr. Karunanithi says ongoing efforts to strengthen local testing and tracing arrangements are a vital part of how the four-week lockdown is spent.

“There are more tests than we have ever had in Lancashire, so if you feel you need one because you are symptomatic, you mustn’t hesitate.

“And if you are symptomatic or have been asked to stay at home, you must do so.

“Everyone has a role to play – so the shops and businesses that are going to be open need to remain Covid-secure as well.”

However, Dr. Karunanithi’s final message as the county heads into a tough few weeks was not one of compliance – but care.

“We need to remain in solidarity and look after each other during the dark winter days ahead – in the usual way we Lancastrians do.”

WHO SHOULD GET A COVID VACCINE WHEN IT COMES?

Dr. Karunanithi said that the hope offered by a Covid vaccine is also on the horizon as Lancashire heads into lockdown.

However, it emerged last month that the head of the national coronavirus vaccination task force was intending only for the most vulnerable part of the population – roughly about 30 million people – to receive it.

Kate Bingham said in an interview with the Financial Times that “we just need to vaccinate everyone at risk”.

The government said that it was taking advice from the Joint Committee on Vaccination and Immunisation and wanted “as many people as possible to access a Covid-19 vaccine”.

Offering his thoughts on the subject, Dr. Karunanithi said the national policy had not yet been finalised – and things will “chop and change” depending on how long immunity is shown to last from any jab.

However, he added: “The priority will be those that would be more significantly affected [by Covid] – the over 50s, those with pre-existing conditions and key frontline workers – that’s how it will start.

“I don’t recall any situation where at the end of an epidemic, we went for the whole population [with a vaccine].

“It will probably join a vaccination schedule and eventually we may [vaccinate everybody], but because it is a huge logistical exercise, takes time and not everybody is equally affected [by the virus], we may just keep it as the population at most risk.

“But that policy hasn’t been fully determined yet,” Dr. Karunanithi said.

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