UKH

Four boroughs have a rate of over 600. Today, about 400 new cases reported for Wigan and 12 deaths yesterday in local hospital.  One of our local areas (roughly Atherton) has a rate of about 950.  In Wigan we had 3 months with no Covid deaths, recent weeks we’ve had about 20/wk. The recent deaths relate to when infection rate was less than half of current rates, so I expect to see death rates reach similar to April’s in next few weeks. Unless drastic measures put in place, Grter Manc hospitals will be the same or worse than the April peak and will stay at this level. 

Our local leaders have gone noticeably quiet of late. Time they spoke up. No point in delaying the inevitable. 

What's happened to Wigan?
It seems like only a few weeks ago you were 'boasting' (I don't mean that in a derogatory way, you know what I mean ) that Wigan had next to none.
I don't think you've got a massive student population, can't blame them.

I'm not now convinced "drastic measures" are going to work, unless you're thinking of bringing the Army in and having them go around checking houses.  It would appear to me that people are meeting at home instead of in the pub, and whatever the law says about it that is basically unenforceable.  The Chinese have the level of policing to control that, we don't.

If anything, the pubs being open but COVID secure and well-policed may actually be better.

We probably need a UK wide lockdown. Labour were backing SAGE's idea of a "circuit breaker" 3 weeks ago. But the govt can't be seen to do anything that SAGE or Labour suggest, like feeding hungry kids, so we're screwed.

You’re right. In early August or thereabouts Wigan has below average rates. Neighbouring areas have been able to part explain their increases: students, multi-generational over crowded housing (linked with south Asian communities), food processing, language  and cultural issues (big spike in Salford linked with Orthodox Jewish community).  None of that here really, perhaps a warning to other areas. 
Most people I know simply blame a mixture of the: Can’t Be Arsed attitude, No Southern Government is Telling Me What To Do and Ive Not Got It So What’s The Problem attitude. 

BBC NW tonight did quite a good article 2-3 weeks back about why it was so bad in NW. As well as the usual non-compliant idiots playing russian roulette with their own and everyone else's lives, we also have a lot of very deprived areas with people on zero hours contracts who can't afford to isolate, people in low paid public facing jobs potentially exposed to high viral loads, and families in crowded housing. Hard to see a way out of this. So we're basically suffering the effects of idiots plus the years of austerity.  "Levelling up" - don't make me laugh.....

Paul

I was rather appalled to see that deaths in Rochdale so far are 1,133/1,000,000, however it gets worse, as with that metric Rochdale ranks fairly well against other GM areas. Only Manchester and  Trafford are better. Tameside is 1,678/1,000,000.

Greater Manchester as a whole is around 1,150/1,000,000 with 3,333 deaths recorded. I just so happened to be looking at some US figures last night Los Angeles County, which has a population slightly larger than that of GM has recorded 7,000 deaths or approximately 2,333/1,000,000.

My experience/observations is that is not a key factor.  School transmission is massive, the 3 week circuit breaker over half term was the correct thing to do.  Other than that, it’s the aggregation of everything else.

The thing about that, though, is that schools are basically the same everywhere in the country - classes of 30 with no social distancing.

So why would that affect some areas but not others?

Something else has to be different for such a dramatic difference.  What was normally quoted was that in the big cities people tend to be in and out of each others' houses more than in rural areas?

I'd originally have thought it was students, and then it spilling out of there into other things.  But Wigan doesn't have a university, nor indeed is it an attractive place for student housing as it's too far out.

So what is different?  I think finding that is the key.

Beyond that, yes, a full March-style lockdown would *work* but at huge economic damage.  (Though I do agree with you that a "circuit breaker" with schools closed was a missed opportunity, and Wales is worth watching).

A lockdown not far off March *didn't* work in Bolton.  So we need to be more strategic than that.

Why? Parts of Scotland are anticipating being moved down a tier, not up.

Even as a   Northerner I can pull holes in that argument. Some of the most deprived area in the Uk are in London- Newham for example. London is far more diverse culturally.

One of the obvious benefits of London though is there is a superb infrastructure for fast delivery of products everywhere. As an example you can get Argos to same day deliver stuff to you virtually any time of the day. Its a 24 hour city.Unlike say Atherton or Leigh. So test kits and turnarounds can be done really quickly.That must make a huge difference in the way people respond.

Wigan has some anomalies: l live Standish, considered relatively affluent, but we have very high rates (9th and 10th either in GM or north west, can’t remember). I am mystified (and have been for some time now). We did have a high death rate: possibly obesity and related factors and general poor health I guess.
I agree - need to find out why. 

Twenty of the top twenty most deprived areas are n the north. A London Borough was in the top twenty, but was replaced by another northern area. Check out indices of multiple deprivation. 

Was reading earlier London testng is not as efficient as NW England, will try and find that. I know 5 people who have got covid in last week - all got rapid testing. 
Many people in London and SE have home working options available, fewer people in post industrial areas. And coming out of lockdown was based on London levels of infection - many parts of UK came out too early. 

Edit: few areas in the midlands are also in top twenty. 

Why should Devon go into lockdown when rates are high in the northwest?

Seems very selfish to me.

I reckon areas should be dealt with on a Borough size scale. Devon etc etc shouldn’t suffer a lockdown. 
 

<stolen from twitter>

I heard Wigan was being put in Tier 3.14159265359 to begin with

Why do you want to kill people in Devon?

Excellent  

How’s about:  The Road to Wigan Tier 3.142

I don’t - they currently have a very low rate of covid which isn’t growing significantly. There’s no need for a lockdown there.

Why do you want them to lose their jobs?

I don’t. There you go with your false equivalences again.

Just for information, all of Devon seems to have higher levels of infection that the levels that triggered Greater Manchester going in to additional restrictions.

If it's work related, likely those outbreaks can be tied back to workplaces.  And in that case, something like SSP being full wage (with funding provided for it) would fix the problem.  Who wouldn't stay at home on full pay and watch telly?

Come again?

Would you care to explain why Devon needs the same level of social restrictions as the northwest when they’re polar opposites in terms of r rate and the level of infection in the population.

Why destroy the economy in Devon to make people in Manchester feel better about the restrictions imposed on them.

I'd also add to it why are we just piling restriction onto restriction when they don't necessarily work, and why aren't we being more strategic and looking at what does work - including how schools can be made COVID safe, which they presently demonstrably are not.

March worked because we restricted everything, of course, but that knackers the economy.  Why not look into different things?  SAGE produced an analysis of them a while ago.

Only a fool tries the same thing several times and expects different results.

No it isn’t.

Its current under 70 cases per 100,000 (https://www.devon.gov.uk/coronavirus-advice-in-devon/coronavirus-data/).

My understanding is that 100 per 100,000 is usually the benchmark for tier 2.

The northwest is currently well above this and was well above this when it went into tier 3.

That’s quite funny. You got two dislikes for your post, but I got nothing for saying exactly the same thing about Scotland. Go figure....

I know... sad isn’t it.

I disagree with a Labour policy and there’s down votes, you agree with an SNP policy and there’s no reaction, despite us saying exactly the same thing.

You might even think that’s there’s left wing group-think going on here. Wouldn’t it be nice if people could think for themselves for a change.

You have prompted me to compare the rate of growth of Covid in Greater Manchester with Devon.

I have taken three authorities in GM, including Wigan, which has had the greatest percentage growth of the last week.

Manchester + 15%, Rochdale +25%, Wigan +43%.

I then looked at authorities in Devon.

West Devon +21%, East Devon +37%, Plymouth +57%.

Your assumption that the R rate in Devon is the "polar opposite" of Greater Manchester is very wrong. My view is always that early mitigation is always best as it means less action is required in the long term, that is less "destroying the economy" in your language.

GM went in to an equivalent of tier 2 months ago, when the average in GM was around 30 and Wigan was about 5.

Wouldn't a better conclusion be that Manchester etc would have been far better closing for say three weeks two months ago, rather than having this dragging on.  If so, Devon would be wise to do that now, rather than end up like Manchester in  six weeks.

I believe the SAGE idea of a national circuit breaker is based on the idea that regardless of geographic distribution at the moment, not getting  handle on infection rates now inevitably means a wider national transmission of the virus later down the line. Nothing to do with making people feel better about restrictions in other regions. The first wave was concentrated around the South East initially and everyone agreed with this strategy back in March. Failure of any form of effective public health infection tracking is making this whole thing a massive pain in the backside, don't blame some poor sods in the North West for feeling aggrieved about being hung out to dry they have been in some kind of lockdown a lot longer than the rest of us.

Interesting point, but I think that this assumes that after a short sharp lockdown we’d be able to get covid under control.

A point I’ve made a few times is that compliance is falling (the scientific advisors were definitely right to talk about lockdown fatigue in the first few press conferences they held) and because of this I think anything short of a March style lockdown won’t work. In a slightly macabre way I think you need high levels of cases in the local area to get the levels of compliance needed for the measures to work.

If Devon went into lockdown now I think compliance would be poor and the impact would be limited. Devon is also much more rural and this will impact how the virus spreads (presumably slowing it down). 

I know the obvious response will be, “but we could get test and trace to work/ aren’t serco awful”, but given that less than 20% of people are estimated to have complied with isolation orders there doesn’t seem much hope of this happening, even if test and trace was working perfectly.

Because of the above, to me it makes sense to keep as much of the economy moving until you really need to lockdown I.e. hospital capacity is looking grim.

The local system definitely seems the best way forward at the moment.

We know what works - full lockdown to suppress the virus to a manageable level, and then contain it with an effective track and trace system. It's been done in other parts of the world.

What's failing is the test and trace part. We gave billions to private sector contractors with no experience in public health to design and run a system that is a shambles. 

We can't get around that fundamental failure simply by tinkering with the lockdown measures.

We won't get the virus back under control without another widespread lockdown. If we invest in the public health track and trace infrastructure this time, so we can have a proper functioning system, we might find ourselves in a position to avoid further lockdowns in future. 

If we continue to throw money at the private sector, we'll go through the same cycle again.

Do you really think we can suppress the virus with track and trace? 

It’s only worked so far in countries with non-existant  privacy laws. China, Korea ect.

Given that less than 20% of people are estimated to have complied with the order to isolate (https://www.google.com/amp/s/amp.theguardian.com/world/2020/sep/11/less-tha...) I don’t think that even with the best system in the world it would be enough.

It's not, however, worked really well in any part of Europe - they are all on the up again, and we can't afford to be fully locked down pending a vaccine, so we do need to work out what measures are most effective and do only those.

You can forget the UK ever having Asian levels of compliance as we simply aren't culturally like that, and we don't have a Police force of the size of China to force it.

I think we need to be more clever than that before destroying our economy.  If it's schools, we need to bite that bullet, for example.

Because experience tells us that local lockdowns aren't effective.  When lots of people are regularly commuting from outside a locked-down area into it for work (or out of it to socialise), the effectiveness of the lockdown is vastly reduced. Dividing England into quarters would be about the right level of granularity for 'local' areas to lockdown.

^^this. and they've all been on the up since mid-summer, albeit slowly at first.  The critical thing is that cases were rising, and unless behaviour changed or herd immunity was reached they were always going to continue to rise at an ever-increasing rate as the infection rate increased due to higher prevalence levels. It's like watching one of those people on You've Been Framed trip and stumble for 10 paces across the yard before ending up in the pool - you can see it coming from the start.

Elimination and strict border controls. It's more and more obvious that the level of restriction required for the autumn/winter months in Europe is substantially more than a bit of social distancing and mask use even with good track&trace.  The level of ongoing restrictions required to maintain the virus at a constant level is more than the economy, government, and community can handle in the long term; therefore it makes more sense to eliminate within decent borders in order to open up the internal economy.  The only drawback is the hard border, but as other jurisdictions eliminate you can eliminate the border with that country and expand your 'safe' bubble.

I don’t think you can make that conclusion. The r rate barely fell below 1 in March/ April with a full lockdown. It’s the measures put in place that haven’t worked yet.

I’ve yet to see any compelling evidence that the r rate can be driven below 1 without schools closing (which of course shouldn’t be considered as a measure).

The most recent data seems to suggest that mixing between households in people’s homes is the biggest driver of the spread of infection. It would seem therefore it’s compliance with the rules (or rather lack of compliance) that’s keeping rates high.

I’d bet £1000 that the Welsh lockdown doesn’t work. It will flatten off rates in the short term, but then they’ll spike back up again.

The fundamental problem with T&T with COVID, which applies even if you have "the best in the world" (!), is that you're infectious for a period of time before symptoms are shown.  So unless you contact trace to perhaps 3 or 4 degrees of contact it simply isn't going to stop it.  The question is whether it will get R<1, but it seems from other European countries that indeed, no, it won't.

Yes, full lockdown works, but that's because it contains things that work, and it's too blunt an instrument to do for any length of time as it knackers the economy.

It would appear that closing (COVID safe) pubs and restaurants isn't working, for example.  So why keep doing that?  It has cost.

If schools and universities are the "big game", as it seems they might be, we need to redesign them.

The restrictions in Bolton, were a very, very long way off the lockdown in March. It is also very simplistic to say that they did not work, they did not put the infection rates in reverse, but for a time they slowed increases to levels much lower than neighbouring areas. Tier 3 restrictions appear to be slowing increases to a rate which is lower than Tier 1 areas, but it isn't enough.

National lockdown, even if only for a limited time, is the only thing that has been proven to put infections in reverse.

But again that's way too simplistic.

I venture again that the big thing there was education.  Not pubs and restaurants (at least not in their COVID safe form, I'm sure "vertical drinking" was).

We need to do the things that make a difference and stop doing the things that don't.

I suppose half term might tell us something - if it goes into reverse in about a week's time, that proves education is the issue.  We can't just close schools, so we have to redesign education.

Hmm, being in Devon I dont think that's correct.

I can see what others have put in terms of percentage increases etc and the local news ran all those sorts of scare stories last time. When you actually looked, the 100% increase in deaths was 1 to 2....etc etc

Near where I am (Exeter) the headlines have been about the huge increase in cases due to students. That was in early Oct.

...many fewer headlines now as the numbers are falling back again I think and are still pretty low outside of the city anyway.

Commuting Devon style is driving 40 mins further than the nearest village......still well within the county boundary.

Tier 4 or Tier 2.5?  

With Tier 2.5 being much clearer messaging, guidance and enforcement on inter-household meetings inside private and semi-private venues?

A lot of different posters whose judgement I pay attention to are saying the same thing across different threads.  

Which would suggest it is working. Is it? Has it put the infection rates in reverse, it hasn't in England, although it has arguably slowed the increase slightly.

Edit: I have just looked at figures for Liverpool, Halton and Sefton, obviously Liverpool City Region were first to go in to Tier 3. They are all falling, Liverpool much more than Halton and Sefton, but I suspect that is the student spike correcting itself. Tier 3 might be working, let's hope so.

I still think a short national lockdown, with full support, would have a greater impact and be less damaging to the economy and result in fewer deaths.

Simple, at least in messaging is key.

No, I disagree.  I'd go with "easy to comply with".  We are past the point where "project fear" will work any more.

By which I mean if you are telling people who may be infected to stay at home, you have to pay them their full wage to do so, for example.

Please don't use the term project fear.

Wharp to Tier 7!!!!

I'll use the term if I want, thank you very much, let me know when you become a moderator if you want to be telling people what terminology to use.  It quite accurately describes what went on in the early stages (both as a matter of policy and as a matter of people doing it themselves) and it's well documented that it did.  It also worked quite well, but it won't work again, unfortunately, it was a "one shot".

It will not be possible to get twentysomethings (say) to fear something that poses a much lesser threat to them than the likely standard of their driving.

So for them it is necessary to make the measures easy to comply with.  For instance, as I said, if required to self isolate this has to be on full pay, regardless of what the normal situation is - even if they are self employed.

Fear project?

I asked you nicely. No need to get your knickers in a twist.

It really doesn't, especially as it is an incredibly loaded phrase. The phrase suggests that the threat isn't there, I don't think that you agree with that, or do you?

How "locked down" can we be at a local level? (by local, let's say by Local Authority) Does the govt / LA have the powers to enforce a legally binding, stay-at-home-unless-you-have-permission-from-the-mayor style lockdown on one area?

Through July and August the trigger for local measures was around 40-50 per 100k. What Nick says is correct. They only abandoned this approach in September when everything shot up fast.

The threat *isn't* meaningfully there for the majority of people under 35-40 ish to any significant extent.  Which is why we need to make it easy for them to comply; most people aren't altrustic enough to go much further than avoiding visiting their parents too often.

Scaring the life out of people did work when it was a big unknown, it's not any more.

Things were unlocked too quickly, Boris basically said it was our public duty to stop working from home and go back in to the office, at the same time Schools and universities went back and we were encouraged to eat out to help out too. 

We had no chance. 

Personally I would close all hospitality and increase everyone's tax to pay their wages. If we can't go out spending we can all afford to chip a bit extra in. I know my savings have never looked so good as this year.  Either this or employ a raft of people to do food deliveries to limit the numbers going to the shops. 

Schools are always going to be a problem but without hospitality being open it should limit the spread when little Billy brings it home and infects their parents. 

I keep hearing the pricks on talk radio bleeding on about the infection numbers in homes being far higher than in pubs but they never question where does it come from to get in to the home. Most work places I go round are pretty covid secure. The 2 main changes that happened at the same time as numbers going up was education and hospitality re opening. 

I agree, with the caveat that opening hospitality and beginning eat-out-to-help-out started a month before schools and infection rates here clearly started increasing before the schools went back, so I lay most of the blame at the door of eat-out-to-help-out. 

I disagree and there’s a much more simple explanation.

And that is we’re entering cold and flu season - who doesn’t usually catch something at this time of year? I normally get a cold in September and then get other sporadic colds through to February/ March. I really think it’s as simple as that.

I think people are too keen to try to attribute changes in the pandemic to something the government has or hasn’t done.

We’re now seeing rises in cases across Europe. I don’t think any other country had a eat out to help out scheme.
 

What eat out to help out did do is throw a lifeline to struggling hospitality businesses - but that’s a different story/ discussion.

Weren’t you claiming to be licking people with COVID-19 a couple of months ago.

Sorry, that's bull. The rise here began in August and symptomatic cases began an obviously exponential rise from around 30/08. End of August is not cold season.

Eat-out-to-help-out killed the hospitality sector in the north west by going too fast. It could easily have been designed to provide a stimulus over a slightly longer period, perhaps a bit less of a discount and spread out over the whole week. Instead every restaurant was packed to the rafters three days a week and quieter than usual the rest of the time. It was ridiculous. Now, many are either shut or running reduced hours because people are starting to hole themselves up again.

The whole point of Eat-out-to-help-out was to get people used to crowded spaces and more confident in them again. Unfortunately it was a poorly judged policy. Being kind, perhaps the Govt under estimated take up levels.

I note you haven’t compared the rate with regions in Scotland. NE England 35x that of Moray. 

Edit: I’m struggling to find anywhere in England with a rate anywhere near that low.
 

But why did other European countries see a modest increase in covid cases and a much bigger increase in September?

You’re using anecdotal evidence about eat out to help out without considering the wealth of other data sets out there. 

Rates across the region flattened and fell slightly after a peak in October week 1, with the biggest reduction in Liverpool itself as you say. However it's a small fall and the rates in St Helens and Wirral now show an increase over the last few days. In reality, if you look at the detail the variations are much more localised, there is no one common trend across an entire local authority area. The broad picture is that the rate has definitely flattened (initially due to the restrictions on indoor mixing that we picked up a couple of weeks before Tier 3) but is not substantially dropping, at least yet.

I'm asking you that question, I don't know the numbers for Scotland. Also, when I talk about national measures, I am talking about England.

I accept my observations are anecdotal but the reported take up of Eat-out-to-help-out was country wide. Obviously it doesn't explain Europe-wide increases, but similar relaxations in behaviour had occurred in many places, remember they had been out of lockdown for longer than us.

The change in behaviour here in August was significant and the increase in infections that subsequently occurred in the areas with highest existing background infection rates was significant. Schools then reinforced it and universities seeded it outside the areas of highest infection to those that had previously been low, from where it is now spreading to all areas.

You are seeing 2+2, refusing to make 4 and then coming up with BS as an alternative.

Sorry to be blunt.

Edit to say : perhaps you could argue that the same would have happened regardless of Eat-out to help out, just slower. Perhaps the rise was inevitable once people's confidence rose sufficiently that the number of outbreaks occurring in hospitality was enough to take the local r values above 1.

I measured the average across the City Region (I now realise Halton isn't in the Liverpool City Region) as a 10.6% fall, but Liverpool's fall makes up a large part of that. I am yet to be convinced that Tier 3 is working, but this did give me a little hope. Time will tell, but of course when we get it wrong, time really punishes us.

The problem I have is that Tier 3 is quite punishing to a lot of businesses, yet the benefit isn't clear. We know that a supported 2 week lockdown could half more than half the number of new cases and give us a fairly decent window of low level restrictions for a good way through the winter.

So national lockdown in England only? I’m fine with that. I’ll bow out, I assumed you meant UK national lockdown as per the original post I responded to.

The peer reviewed science suggests that restaurants aren’t a major vector of transmission (https://wellcomeopenresearch.org/articles/5-83).

I don’t know what more I can say.

Governments of Scotland, Wales and NI have there own powers and obviously in Wales and NI they have implemented “firebreak” type lockdowns.

I’m just advocating an evidence based, risk focussed approach to the issue. 

Cant argue with that.

Restaurants where not a major course of COVID spread during lockdown, when restaurants were mainly closed. Research published in June 2020. I think we can agree on that. I don’t have strong views on Eat Out to Help Out, but I don’t think this research proves anything.

Fwiw, it is (although not part of Merseyside.)

Have you asked the 5 people how and where they contracted Covid? It would be interesting to find out the transmission points from people at a local level rather than relying on government blaming certain places. 

That would be an interesting U.K. climbing/hillwalking experiment we could all do. I know some people won’t know where they were when they contracted it but I suspect a lot will have a fairly good idea. 

I spoke to a customer the other day, they were Covid +ve and said the only place they think they could have picked it up was at their football training session as a couple of the other players had tested +ve.

The problem is, people often won't know. A friend of mine contracted it recently, she is a teaching assistant and assumed that she got it at school. However, the week before her 18 month old daughter had been quite ill with Covid type symptoms, but tested negative, but a false negative is quite possible, especially when trying to take a swab from a complaining child.

One teaching assistant, one social worker, one Manchester uni student, two primary aged children. As New Nick says, not 100% sure where they got it. 
My hunch is that schools are worse than the stats suggest - many children not showing symptoms. My wife teaches in Warrington - not one case, but a secondary school had 15 staff off with Covid and my nearest primary school has had five classes isolating due to positive tests. 
I think the levelling of uni students, school half term and tier restrictions slowing the increase will have an impact on slowing down the increase, but not enough. Local hospitals already feeding the strain and that’s from people catching it a few weeks back - we are miles worse than then and hospitals will buckle in 2 weeks. 

It'll happen when the shit hits the fan in London again (as thats the only bit of the country the Govt really care about) and "if" an R rate of 2.8 in London is to be believed then it won't be long now.

With an incubation period of a week, almost nobody will be able to answer that with any level of certainty.  They'll have suspicions, sure, but they won't know.

It's entirely possible that a week ago they went to an illegal house party with 50 odd crammed in, but nobody there had it, but then they picked it up at Tesco the day after.