It now looks certain that we will see a third wave of Covid-19 – probably peaking in early February.

The pandemic will have had three waves in the year from February 2020 to March 2021. For Lancashire, the first wave peaked just after mid-April 2020, and the second about the 14th November.

In the first wave, Lancashire was a late adopter. The virus moved up from the south and out from big city metropolitan areas where the spread was fastest. By the time of the first national lockdown, Lancashire’s rates were lower than the national average and so the peak arrived slightly later.

As a consequence, as the first national lockdown was effectively lifted at an earlier stage in Lancashire than the rest of the UK, we exited with much higher infection rates. Those ‘hotter embers’ re-ignited more quickly across the county and this meant that we had higher rates than the UK from August.

The third wave is more like the first wave – it is coming up from the south and Lancashire is a late adopter. This is driven by the new variant, which is up to 70% more transmissible. Areas of London and the South East currently have some astonishingly high rates – Brentwood and Epping Forrest for instance are at about 1,500 cases per 100,000. The highest Blackburn with Darwen got to in November’s second wave was about 750 per 100,000.

The third wave and the new Covid variant are travelling fast. We have evidence that the new variant is present in Lancashire with some Pennine Lancashire areas seeing very big rises in the week up to 24th December – Blackburn with Darwen 33%, Pendle 25%, and Ribble Valley 52%. We can expect these rises in confirmed cases to generate rapidly rising hospital admissions over the coming weeks and East Lancashire Hospitals Trust is already under significant pressure on both staff and beds.

The Christmas relaxation of social mixing rules will also generate an added surge in cases with anyone infected on Christmas day probably likely to start seeing symptoms about now. The average time from infection to symptoms is about 5-7 days – although of course at least one third of those infected will show no symptoms at all but still be infectious to others.

For these reasons we can expect a very challenging January and February, particularly in the health and care system. This includes GP and primary health care services who are already under extra pressure to deliver the biggest ever vaccination programme.

Vaccination is the good news for 2021. As we get the clinically extremely vulnerable and those over 80 vaccinated, along with the front line health and care professionals who will be crucial to deliver the vaccination programme itself, we will be at the ‘beginning of the end’ of the pandemic. If we are lucky this will be completed in March. US research also suggests that when we have vaccinated 40% of the population (potentially March – June 2021) and if we have good early summer weather we may be able to relax many, but not all, of the toughest pandemic controls.

It is a race against time. It will get worse before it gets better; but we can be sure that 2021 is going to be an infinitely better year than 2020.