PENNINE Lancashire has survived the first wave of COVID19 better than most ­— but there is a catch.

The good news is that in the last two weeks, the risks of death when ill enough to be hospitalised have reduced significantly. Research has shown the drug Dexamethasone can cut the risk of death by one third for patients on ventilators and by one fifth for those on oxygen.

This means those most affected by the virus now have a much higher rate of survival. The risk of being infected is also currently falling rapidly as the overall number of people infected falls - and continued actions are taken to reduce transmission or outbreak risk through the Test and Trace system.

However evidence from previous pandemics have a warning tale for us. Recent analysis of the 1918 global flu pandemic in the US give us some clues as to what might happen next. The 1918 flu pandemic played out differently across US cities. Those cities like Philadelphia that did not lock down early had a sharp rise and fall of deaths in the first wave and the most overall deaths. Those that did lock down early and maintained strong social distancing had fewer deaths - but some, like San Francisco and St Louis, had stronger second waves and in St Louis’ case, the second wave killed more than the first.

In Pennine Lancashire, we can now expect to see minor outbreaks in workplaces and schools from now on but these should be controllable through effective local outbreak control measures. If we do not see an overall rise in infections the next two months as a result of the big lockdown lifting on July 4, it is more than likely that we will see a second wave of Covid-19 sometime in the winter.

This second wave could present us with more risks than the first. The first wave came up from the south and moved out from metropolitan areas where transport hubs passed the virus on more readily. The second wave may be very different for Pennine Lancashire. Communities with lower income and higher BAME populations have higher infection risks and these may flare up more quickly into an early and harder impact second wave if we have a general national rise in infections.

This is going to mean two things if we want to prevent further avoidable mortality - getting very seriously fitter over the next five months and getting our winter flu vaccinations.

More than most, areas like Pennine Lancashire will now need to get ‘second wave ready’.