REVEALED: the reasons Lancashire has been put in Tier 3
Almost a quarter of people in a Lancashire hospital bed and nearly half of those receiving critical care were Covid patients at the time the decision was being made about the post-lockdown restrictions that will apply in the county from next week, the Post can reveal.
There was widespread criticism amongst local leaders of the government’s move to place the entire region under the toughest Tier 3 rules - ignoring a plea from councils for the fate of each of Lancashire’s 14 local authority areas to be considered separately.
The government has since released the reasoning behind its decision about the regulations that will come into force across Lancashire when the national lockdown ends on 2nd December.
The brief summary acknowledged that Covid rates had shown “improvements in some areas” - but noted that “pressure” remained on the health service in the county.
NHS data obtained by the Post reveals some of the considerations that may have weighed on the controversial call to impose Tier 3 status.
As of Tuesday (24th November) - just 24 hours before the final tiering decision was made - there were a total of 682 people being treated in hospital for Covid across Lancashire and South Cumbria.
That was marginally down on a week earlier, when the 700 mark had been crossed for the first time during pandemic - but far higher than the 563 peak reached during the first wave in mid-April.
Of the 682 Covid patients in hospital earlier this week, 617 were occupying general and acute beds, with a further 15 in a high dependency unit and 50 receiving treatment in level 3 ventilated beds.
That means Covid patients accounted for 48 percent of all those in critical care across the region and 24 percent of those in general and acute wards.
Meanwhile, the Covid death rate across Lancashire and South Cumbria the week before the tiering announcement was only slightly below its April peak, based on a rolling seven-day average.
Along with pressure on the NHS, other factors listed in the reasoning for the government’s Tier 3 decision include a “very high” case rate in the over-60s in six unnamed Lancashire districts - of over 200 per 100,000 people. The Post approached Public Health England (North West) for details of which areas exceeded that level, but was not directed towards the relevant localised data.
The explanation for the county-wide Tier 3 status also referred to a continued “high” positive rate amongst those who come forward for testing. Published data shows that in the week ending 18th November, the average proportion of Lancashire residents receiving a test who were then confirmed to have Covid was 10.7 percent, compared to an England average of 9.0 percent. In Central Lancashire, that figure ranged from 9.5 percent in South Ribble, to 10 percent in Chorley and 10.7 percent in Preston - and was falling in all areas week-on-week.
South Ribble's Conservative MP Katherine Fletcher - who is also a biology graduate who studied immunology and infectious medicine as part of her degree - says that having looked at a full range of data, it was with “a heavy heart” that she concluded Tier 3 was the right decision.
“This isn’t politics, it’s people’s lives - it’s the most fundamental aspect of our job.
“There is not one data point that I can look at and say it justifies us being in Tier 2. Our hospitals are coping, but there is no spare capacity in the system - so it's not just about the case rates, it’s about where those cases go and get treated.
“The scientist in me says that [Tier 3] is the correct decision, painful as it is - if you say we want to stop people dying.”
South Ribble’s case rate in the seven days to 21st November stood at 213 per 100,000 people - below the Lancashire and England averages - and was on a downward trend, lending weight to those arguing for a district-by-district approach to the tiering system in the county.
However, Ms. Fletcher says that statistics like that have to be put in context.
“When we started to introduce quarantine for arrivals from other countries over the summer, the case rate per 100,000 was 40. Yet we have got a very strong lobby now saying you can’t justify Tier 3 because our case rates are only [in the 200s].
“I advocated very strongly to keep South Ribble out of the initial [additional Lancashire restrictions] - so it is not like I am some kind of dove about this. But right now, there is no way - we are at too high a level.
“Bluntly, if we take restrictions off now, there is a really good chance that one of the people I love will not be around at Christmas.”
Meanwhile, Preston Labour MP Sir Mark Hendrick has suggested that he does not believe even Tier 3 will be sufficient to bring the virus under control.
Answering a question on Twitter asking for his opinion on the new rules, he said: “We are in Tier 3 and I don't think it goes far enough to deal with the spread of the virus. We will still see rising infections, albeit more slowly.
“The government's Christmas guidelines are too lax. My views are shaped by Lancashire's Director of Public Health.”
He added: “There has been a decline in the rate of increase of the virus, but not a decline in the number of people suffering from catching Covid. I don't think Tier 3 goes far enough, but without a stronger alternative to Tier 3 on the table I will support it.”
Preston City Council leader Matthew Brown last week pushed for the area to enter Tier 2, arguing that the Tier 3 restriction did not address the sectors where the virus was most prevalent.
Preston’s rolling case rate in the week to 21st November was 268.3 per 100,000 people - and showed 11 consecutive days of decline, apart from one marginal increase on the latest date in the range.
Lancashire County Council leader Geoff Driver has repeated his call for the tiering system to be implemented at a more local level - with local politicians having more of a say.
"We know there are still serious pressures on the hospitals and we really want to see that number come down.
"We also know rates have come down significantly since the time when we were placed in the original Tier 3, three weeks before this lockdown began and in the west and north of the county this is particularly pronounced.
"I am naturally disappointed by the decision to put the whole county into the same tier, and we will be speaking to the government about what the measures will be for coming out of Tier 3.
"I also think it is important that local leaders have more input on these decisions as we know our areas best and I shall be stressing that more support should be available to people who test positive so that they can afford to self isolate.
"I would ask that everyone in Lancashire continues to work together and follows the rules to drive the infection rate down even further to strengthen our argument that restrictions should be eased - and I would also like to thank everyone for their sacrifices throughout this difficult and unprecedented time."
The first fortnightly review of the tiers will take place on 16th December.