Coronavirus column: The Kindness of Strangers

In his weekly Coronavirus column, our Director of Public Health Prof Dominic Harrison considers the personal responsibility we will need to take to keep ourselves and others safe as we learn to live safely with Covid.

As of the 15^th February we have seen an astonishingly rapid fall in recorded Covid cases in Blackburn with Darwen with case rates now down to 307 per 100,000, a reduction of 44% in the last seven days. The North West regional rate is at 435 (down 35%) and England’s is at 625 (down 31%). Blackburn with Darwen now has the lowest rate of Covid-19 in the North West region and the borough’s rates are reducing faster than the regional or national average.

National research suggests that only about 50% of Covid cases are now being identified due to changes in testing and reporting behaviours since early January 2022. Whilst the reported case rates are now less accurate than they have been, positivity rates and hospitalisations are also falling rapidly so we are confident the reported fall in case rates is a real decline in cases.

This rapid decline in case rates is now almost universal across most English local authority areas. This is a trend which also now may accelerate due to the half term break reducing schools-based transmission.

The government’s announcement of a national ‘Living Safely With Covid’ strategy on the 21^st February will mark a change in national Covid management plans and priorities. There will be an increasing focus on local and voluntary, rather than national and legal, approaches to controlling the spread of the virus. The previous focus on breaking chains of transmission will remain – but we will have an increasing focus on protecting the vulnerable as the main aim of reducing pandemic-related harm.

A key message will be that Covid is not over but it looks increasingly like we can manage the risks.

We think much, though not all, of the current Covid prevention and mitigation regulations will be lifted as part of the new strategy, including much of the current testing, self-isolation, working from home, vaccine passports, mask-wearing and other regulatory enforced measures. We will still need to make personal and organisational judgements on these issues in the future, and we will all rely on the good sense of others to self-isolate if they think they may be infectious. Vaccinations will of course continue, as will specific arrangements for health and social care staff and some clinically vulnerable populations.

The government’s own most recent scientific advice however suggests that substantial risks may remain with this new approach.  SPI-M-O, the group of academic and professional experts who advise SAGE, currently estimate that a combination of behavioural change (e.g. increased homeworking, mask-wearing etc) and mitigations (e.g. testing, self-isolation) are currently reducing transmission by 20–45%. They suggest there is significant potential for Covid transmission to increase again if public behaviour reverts rapidly to pre-pandemic ways.

The message for the future then is that it’s going to be up to us individually and collectively to decide to do the right thing to keep infections low and manageable in shared public space. This will be particularly important for the most vulnerable so that they can live a full life with safety.

All of us are going to depend on the kindness of strangers.