Coronavirus column: Health inequalities put us at greater risk

In his weekly column, Prof Dominic Harrison, our Director of Public Health,  reviews the current data and comments on the health inequalities that put areas like Blackburn with Darwen at a greater risk:

The good news is that it looks like the reported Covid Omicron case rate peaked in parts of Pennine Lancashire at or around the 5^th January.

There is some scepticism as to whether the reported case rate now accurately reflects the actual rate of infection in the community as testing rules, access to tests and case reporting behaviours have changed significantly over recent weeks. However, for Blackburn with Darwen, the positivity rate (the numbers of those testing for Covid who get a positive result) has also fallen from the 6^th January – albeit from a very high level of over 40%. This is an additional indication that actual case rates are indeed falling.

Covid hospitalisation rates at East Lancashire Hospitals Trust were at 161 on the 17^th January. These appear to be plateauing, albeit with still significant rises and falls day on day. Deaths have yet to show a similar decline, although there is always a gap between cases, hospitalisations and deaths, with some suggestions in the international data that the lag between infection and deaths may be slightly longer with Omicron than with the Delta variant.

Vaccination rates in January continue to rise – but at a much slower rate than in previous months. The first drive-through vaccination site in Lancashire at Blackburn Rovers has done a great job with many people not previously vaccinated now coming forward for their first jab.

It was always obvious that the current Plan B measures would not affect every local authority area equally. The Office of National Statistics’ review of working from home in 2020 had already demonstrated that whilst many southern and metropolitan city areas had up to 75% of the employed workforce who could work from home, areas like Pennine Lancashire had up to 75% of its workforce who could not. During Plan B restrictions, most workers in Pennine Lancashire have been out in frontline work, keeping society going, but exposed every day to higher rates of circulating virus.

That inequality in exposure is now very clear in the confirmed Covid case rate data of the 12^th January. Having been below the England and North West regional average case rates from August 2021 to December 2021, Blackburn with Darwen is now 12^th in the national league table. Blackpool is 14^th, Burnley 15^th, Hyndburn 16^th and Pendle 17^th.

The Covid risks in Pennine Lancashire are therefore currently higher than the national average.  Pennine Lancashire GPs and East Lancashire Hospitals Trust, with four out of six of their local authority areas in the UK top 20 for case rates, can expect a prolonged higher impact of the current Omicron wave than the UK average.

This will place an additional post-Covid burden on both our residents and our local health and care system. We will have longer waiting lists for treatment, which will take longer to fix.

Pennine Lancashire residents have contributed more than UK average to keeping the country running at every stage of the pandemic, by being out in frontline exposed work – in food production, transport, health and social care, and critical infrastructure maintenance. This has meant we have been exposed to higher transmission risks, hospitalisations and deaths, higher impacts from lockdowns, greater impacts on the health and care system, and a more severe economic impact.

The government has recently promised both a Levelling Up White Paper and extra resources for the NHS to address post-Covid waiting lists. These are intended to address both long-standing structural inequality and the unequal pandemic impacts.

Let’s hope the government base any allocations of funding from these policies on a true and fair assessment of what is really needed to give every UK citizen equal life chances in the years to come.