By Professor Dominic Harrison, director of public health Blackburn with Darwen Council

WE are now reasonably confident that the number of new cases of Covid-19 is starting to peak across Lancashire.

Whilst there is a mixed picture across the whole of Lancashire, about half of all the local authorities in the county are showing a daily reduction in cases and where cases are still rising they are rising at a declining rate each day. In Blackburn with Darwen, we have a rise in numbers of people being tested but we have seen a consistent fall in cases over a number of days now.

So, based on the experience of the previous two waves, we expect to see a peak in hospital admissions in the next two to four weeks and a peak in deaths sometime around four weeks from the peak in cases.

We have evidence that the new, more infectious, Covid variant is already dominant across the county.

We estimate it is now 71 per cent of all Blackburn with Darwen cases. This could mean that the time lag between the peak in cases, hospitalisations and deaths may be slightly different in this third wave, compared to the previous two.

What is clear is that the NHS and social care system will continue to be under increasing pressure over the next four weeks at least. The peak of hospital admissions is not the same as the peak of Covid patients in hospital.

Patients enter hospital with Covid at a faster rate than they exit. So the hospital will have a higher accumulating number of patients, when as admission rates drop.
This makes it even more important that we continue to keep the rates falling as fast as we can. This means continued compliance with the lockdown measures, getting tested and self-isolating when necessary.

The data on how well we are complying with lockdown is mixed.
Weekly polls show that compliance levels are not as good as with the first lockdown. Most of us are offering ‘strong if reluctant’ support for the third lockdown, but the numbers of calls to the police to report breaches, and the number of fines for non-compliance last weekend, were amongst the highest of the whole pandemic.

The age specific data is also showing us that children and young people still have rising rates.

Across Lancashire, the 0 to 15 case rate was at 154 per 100,000 on December 31 but had risen to 198 per 100,000 on January 13. This may well be because, despite the closure of schools to many (but by no means all) pupils, the number of school age children in school in this wave is up to five times higher than the first wave. We have also observed a big spike in cases young adults aged 20 to 24 years.

This is worrying, as up to 50 per cent of all infections in some areas of Pennine Lancashire are probably acquired through household transmission. Many such ‘household clusters’ occur where the first case is an asymptomatic young person who has no idea they are infectious.

The SMART testing programme continues to be successful at identifying asymptomatic cases. The schools SMART testing programme is now underway but we will need to get more young adults to get tested regularly using lateral flow device SMART testing over the weeks and months to come.