Health Matters - By Matt Ashton

“Things are likely to get worse before they get better”

Director of Public Health Matt Ashton explains why the Covid-19 situation in Liverpool is a real cause for concern.

The Covid-19 situation in Liverpool continues to escalate quickly – and today it has been officially been announced that the region will be placed on the very high third-tier lockdown.

We have now had over 3,000 people testing positive for Covid-19 in the seven days up to 9 October, which gives us a seven-day rate of over 600 positive tests per 100,000.

This is significantly higher from July when we were seeing around 36 people testing positive a week, August when we were seeing around 72 people test positive a week, and 864 people testing positive a week in September.  This clearly demonstrates the exponential growth potential of the virus.

There is some concentration of cases in wards around the city centre, and in the 15-29 age group, however it is evident now that cases are now spread across the whole city and across all wards, as well as across all age groups.

It is important to note that it is only a couple of weeks ago that Liverpool was made an area of interest by the government, and that’s when our rates were around 80 per 100,000.  All wards of the city, and all age groups, have much higher rates than that now.

This is important, as it is at this point when the virus starts penetrating older age groups and more vulnerable communities that hospital admissions start to increase, and Covid-19 deaths will sadly increase again. This is what currently makes Liverpool and Liverpool City Region different from other areas such as Manchester, Leeds, Nottingham, and Newcastle, where the virus is mainly within younger age groups. However, it is likely that even in these areas the spread will eventually end up in older and more vulnerable populations.

(Note: there has been a change to the way Public Health England calculates positivity rates, which means our test positivity rates are now showing as just over 17 per cent.  This is still significantly higher than the positivity rates of under 2 per cent we were seeing at the end of August, indicating levels of the virus in the community are much higher than they were previously.)

Our local hospitals are indeed now under significant pressure. We now have over 250 patients in Covid-19 positive beds in Liverpool hospitals which is the highest in the country. This is now around 15 per cent of the total bed base, and is over half of the numbers of Covid-19 positive beds there were at the peak of the pandemic in April.  Around 10 per cent of these Covid beds are ICU or HDU beds, representing the people who are most seriously ill.  This level of hospital activity will now very likely result in wider hospital activity also being impacted upon, so the issue becomes not just a Covid-19 issue, but a wider health and social care issue. In addition though, the very real cost of Covid-19 in our communities is becoming clear, with 28 Covid-19 deaths registered in Liverpool in the last week. And we also need to remember the long-term effect that Covid-19 can have. Nationally, it is estimated that around 60,000 people are now living with Long Covid, a condition in itself that we currently know little about.

We are seeing outbreaks in a number of different settings, including pubs, food outlets, restaurants, hotels, shopping outlets, workplaces, private houses, care homes, and schools. It is therefore evident that there is no single source for cases, and that the virus will spread whenever there is an opportunity for it to do so, which in effect is when people are in close physical contact to each other.

Clearly this is a very concerning time for all of us and new restrictions will come into on Wednesday for the whole Liverpool City Region. Things are likely to get worse before they get better, with hospital admissions and deaths over the next couple of weeks already “baked in” due to the high levels of community cases.

However it is clear that we still need to do everything within our power to stop further transmission of the virus, to prevent further admissions and deaths, and to keep ourselves, our communities, our city, and our economy safe.  There is a nice illustration that I found on Twitter @MackayIM), which shows that no single intervention is perfect at preventing the spread of the virus, but that if we all play our part, by keeping our physical distance, by using face coverings, having good hand hygiene, and good infection control measures, getting tested when we are symptomatic, taking part in contact tracing and following any instructions we are given, and maximising our time in outdoor settings and in areas with good ventilation, then collectively we will be helping to stop the spread of the virus.

Covid-19 has had a devastating impact on this city, but now is the time for us all to pull together to prevent further harm, so please all play your part.

More information can be found on council website and on gov.uk

Liverpool Waterfront