By DOMINIC HARRISON, Director of Public Health, Blackburn with Darwen Council

WE are rapidly reaching a critical point in the second wave of the Covid-19 pandemic.

We have some very difficult choices to make ­— both nationally and locally.

The Covid-19 confirmed case rates (per 100,000) for the principal local authorities covered by Pennine Lancashire health economy are collectively amongst the highest in the country.

At 6pm on Tuesday, October 6 they were: Burnley 443, Pendle 299; Ribble Valley 194; Rossendale 221; Hyndburn 267; Blackburn with Darwen 210.

As a result, whilst the Covid-19 cases in hospitals across Cumbria and Lancashire have risen to 185, 111 are in East Lancashire Hospitals Trust.

It is likely that at this point in the second wave of the pandemic, East Lancashire Hospital Trust, our GPs and our social care services (both children and adults) will currently be one of the most Covid-challenged health and care systems in the UK.

This week the government was due to announce a national strategy for Alert Levels which will place all local authorities in England in one of three layers of specific control measures with entry and exit points from each level dependant on the confirmed Covid-19 case rate.

It looks like this will now be delayed until next week before being put to MPs for debate.

Level 2 may involve special measures very similar to the current restrictions in place in the North-East of England. These are not so far from where we are now in Lancashire already.

We do have some evidence that special measures can ‘dampen’ transmission of the virus – with Blackburn with Darwen for instance falling from third worst in the country to 25th worst this week.

However, the confirmed cases have still risen consistently, so it is clear that these measures are simply not enough to fix the problem.

At national level, we are running out of any easy options to control the spread of the virus and we are not alone.

The situation is worse in parts of France, Italy and Spain and their challenges on what to do next are similar.

Some scientists are now calling for us to just ‘shield the vulnerable and let the rest of us get on with life’, allowing herd immunity to emerge as we all get gradually infected.

Others argue that this is unsafe and that herd immunity cannot be guaranteed – it would create an unacceptable level of avoidable deaths.

The other option is a time limited ‘circuit breaking’ lockdown. This may mitigate but not fix the problem. We may have to have a series of ‘stop-start’ circuit breakers until the vaccine arrives to contain the virus.

Whatever we do next, we have to hope the government does not delay too long.

We can expect hospitalisations and deaths to continue to rise for at least a further six weeks from the point of any lockdown.

The government needs to call it soon.