England COVID Briefings 12th October 2020

 England COVID Briefings 12th October 2020

"Within Greater Manchester, we have seen a three-fold increase in the number of patients admitted to intensive care in the last 5 weeks, and an eight-fold increase in the number of patients admitted to our hospitals. The situation at the moment is that 30% of our critical care beds are taken up with patients with COVID, and this is starting to impact on the services that we provide for other patients.....  I stress to you the importance of us taking this disease extremely seriously."
Dr Jane Eddleston, Greater Manchester Medical Lead.

This morning Jonathan Van Tam, Deputy Chief Medical Officer for England, gave a Coronavirus Data Briefing, along with Professor Steve Powys of NHS England, and Dr Jane Eddlestone, Greater Manchester Medical Lead.
Case numbers are rising rapidly, and hospitalisation will follow around 2-3 weeks later. Losses of life will inevitably follow suit.
The UK picture is visibly getting worse by the week.
Steve told us The Netherlands and France are seeing record numbers of cases, around 40% of Paris intensive care beds are occupied by COVID patients. Spain has declared a State of Emergency in Madrid, around 40% of their intensive care beds are taken up with COVID patients. The situation in the UK is no better.
"We now have more patients in hospital with COVID-19 than we did when the Government announced restrictions on March 23rd."
We are reminded about the improvements in understanding about the virus, treatments and therapeutics. We are getting much better at this and saving lives.
In areas where COVID is especially high risk, NHS staff will be regularly tested whether they have symptoms or not.
The Nightingale Hospitals in Manchester, Harrogate and Sunderland have been asked to stand by and prepare for the possibility of having to treat patients over the next few weeks.
We will try to avoid delaying treatments for anything else during this wave. Go to your GP or ring 111 if you are ill, have a lump, get chest pain, etc. The NHS is open to everyone.  

Tonight Boris gave a much anticipated UK Coronavirus briefing, and alongside him were Chancellor Rishi Sunak and Chief Medical Officer, Professor Chris Never-Blinks Whitty.
Many details have been leaked over the past week or so, but some weren't thrashed out until at least late yesterday, so we know it's unlikely to please everyone. To be honest, it really isn't as startling or exciting as the build up suggested. 

The UK will have a 3 tiered system of Local COVID Alerts. All tiers will have to follow the Rule of 6, with no more than 6 people gathering at any time, and have a 10pm closing time for hospitality: 

TIER 1 - Medium Alert (will cover most of the country)
- Rule of 6
- Closure of hospitality at 10pm
- Includes most places which currently don't have any extra local restrictions.

TIER 2 - High Alert (pretty much applies anywhere with extra restrictions currently)
- Pubs and bars open
- No household mixing indoors in any setting.
- Household mixing outdoors allowed
- Gyms etc. open
- Includes - Greater Manchester (including Oldham and Bolton), Nottinghamshire, East and West Cheshire, High Peak (I'm not sure which bits). Most of the West Midlands

TIER 3 - Very High Alert (with local leadership consultation, and from Wednesday)
- No household mixing indoors
- No household mixing outdoors in private gardens.
- Pubs and bars have to close. Hospitality may only open if they operate solely as a restaurant. Bar snacks do not count. Garlic Bread does not count. A 'substantial meal' does count.
- Guidance against inessential movement in and out of the area.
- Will be reviewed every 4 weeks and no area locked down indefinitely.
- Economic support will be expanded for people in these areas (see below).
- Includes Liverpool City Area (Liverpool leaders have agreed that in this area, gyms and leisure centres, betting shops and casinos will also close.)

The Government have had absolutely tons of flack for not consulting local leaders, so it is good they're going to talk to them before making decisions and/or announcements, however it means we don't as yet know which Tier everyone is going to be in. Here's the official word on why an area might be placed in Tier 3:
"The “very high” alert level will apply where transmission rates are causing the greatest concern, based on an assessment of all the available data and the local situation.
This includes incidence and test positivity, including amongst older and more at-risk age groups, as well as the growth rate, hospital admissions and other factors."

(I can see that they don't want the sudden {and hopefully one-off} influx of mass-tested university students to skew figures, but I still can't understand why they don't just set a number and tell us what it is. At least then we'd have something to go on. People need goals, or they don't know what they're trying for.)

More money will be available for all areas anyway, with extra cash for Tier 3 Very High Alert areas. This will help cover Track & Trace, and enforcement of regulations. Armed forces support is also available to support local services (not for enforcement - he was clear on that earlier today).

The expanded Job Support Scheme will cover 67% of employees wages when business are required to close, and businesses can claim up to £3,000 every 4 weeks. This will not help everyone, including the suppliers and support services for all of those businesses. I covered this in more detail on Sunday. 

In reality, today's 'Tiers' announcement means the difference to Greater Manchester is that for most of us, we CAN now meet in gardens (now it's wet and cold and dark at 5pm). That's it. Despite cases rising at a doubling rate of a week, we had a restriction lifted. I cannot see how that's meant to help the position. If I was a conspiracy theorist I'd say they were attempting to cull us. 

Chris did the UK slides to show us why these extra restrictions(????) are necessary. He mumbled a lot. (I bet he did...) They were the same slides from the Data Briefing and are mostly below. 

Boris says "we will do our absolute best to try to make sure that we get life back to as close as normal as possible before Christmas".
(He has no idea, but his fingers are crossed.)

Press asked some useful questions.
Are you delaying the inevitable lockdown? Boris says he hopes not.
Is the financial support enough? Rishi gave European examples and says it is in line. Very low paid people will get extra benefits with the decrease in 'wages'.
Jenny Harries will talk about people who were in the Shielding Group tomorrow. Chris says we are trying to avoid loneliness and mental health issues. 

Important and very forthright words from Chris: 
"I am not confident and nor is anyone confident that the Tier 3 proposals for the highest rates, if we did the absolute base case and nothing more, would be enough to get on top of it."
"There are quite a lot of additional things that can be done."

Nicola Sturgeon earlier today at the Scottish Coronavirus briefing said "the very minimum of the Tier 3 that may be published in England today may not be enough to get the R below 1."
Scotland will be publishing their own framework towards the end of the month. 

If you think tears instead of tiers, you can't unthink it. You're welcome.  

Back tomorrow with the regular news report... 

Sources:

https://www.gov.uk/government/publications/containing-and-managing-local-coronavirus-covid-19-outbreaks/covid-19-contain-framework-a-guide-for-local-decision-makers

https://www.gov.uk/government/publications/actions-for-schools-during-the-coronavirus-outbreak/guidance-for-full-opening-schools

https://twitter.com/10DowningStreet/status/1315592485658296321

https://twitter.com/JimfromOldham/status/1315665417600466948

https://www.gov.uk/government/news/prime-minister-announces-new-local-covid-alert-levels

Schools Tiers of Intervention - where do they fall? 

https://www.gov.uk/government/publications/containing-and-managing-local-coronavirus-covid-19-outbreaks/covid-19-contain-framework-a-guide-for-local-decision-makers#tier-1

https://www.gov.uk/government/publications/nhs-data-briefing-12-october