Wigan public health chief calls for local handling of Covid-19 crisis

Professor Kate Ardern also urged residents to continue following the current health measures and come together in the ongoing effort against the coronavirus.
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She said the current picture with case rates escalating rapidly both in the borough and across the country was not particularly positive, but stressed that Wigan’s experience back in spring put it in a strong position.

The borough is now in a second wave of the pandemic, Prof Ardern said, but this was because case numbers had been brought right down following the first peak in mid-April.

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That was not the case for other boroughs in Greater Manchester where infection rates have never come down sufficiently, leading to endemic transmission there.

Professor Kate Ardern, Wigan Council's director of public healthProfessor Kate Ardern, Wigan Council's director of public health
Professor Kate Ardern, Wigan Council's director of public health

However, Prof Ardern was scathing about the national test and trace service, calling for local organisations to run the entire system themselves and saying it is vital to get this right if the country has a chance of living with the coronavirus.

She described how far greater numbers of contacts than expected were effectively being dumped on local teams because the national service was unable to trace them.

She also said communication with the public also had to be far better if people were going to be able to comply with the rules and said the current mixture of semi-lockdowns and restrictions was making the situation tough to understand.

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Wigan, like many other boroughs across the north of England, has seen an alarming climb in cases in recent weeks from fewer than 50 new cases per 100,000 residents to the most recent rate of 195.

While that remains the second lowest in Greater Manchester, it still puts the borough in a challenging position.

Prof Ardern said: “We acted very quickly in Wigan, getting squads into care homes, organising local PPE because of the lack of it coming down from national level and putting in really important interventions for our most vulnerable citizens.

“Now cases are rising across the borough and there’s no room for complacency, but if anywhere in Greater Manchester can get a grip of this it’s us.

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“We have a window of opportunity over the next few weeks to work on our public health measures. It’s really important to limit household mixing as much as possible, to adhere to social distancing, to observe good hand and respiratory hygiene, to wear face coverings in public.

"If you get the symptoms of a loss of smell or taste, a new persistent cough and a high fever you need to book a test and self-isolate until you've got the test results. I've seen people order a test and then carry on doing things and that's not right.

People should act on the advice because it really will make a difference.”

However, Prof Ardern was strongly critical of some of the decisions made at a national level, saying Wigan and other parts of the north of England had their first lockdowns eased too early because the regions were several weeks behind London and therefore still experiencing a peak in cases.

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Her most negative words, though, were reserved for the national test and trace system, which has been beset by problems for weeks now, with the latest crisis involving an IT problem which meant thousands of cases went unreported for days and tens of thousands of contacts were not traced quickly enough.

Prof Ardern said it would be better if the whole business of track and trace was entirely devolved to properly-funded local teams and gave shocking examples of how the country-wide efforts, which have a number of companies and organisations involved, are failing.

She said: “We’ve got a 98 per cent success rate with our track and trace, handling all the complex cases such as care homes, schools and workplaces.

“We’ve also now started getting cases the national service can’t contact. The problem is we’re doing this without any extra resources. We were promised them but I’m yet to see them.

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“Demand is really high too. We might have expected nine or 10 cases a day but last Thursday we got 254 referrals from the national system.

“I want the national system to be managed by us locally. We’ve got an excellent Greater Manchester hub and we’re good at contact tracing, we do it for every other disease.

“People also respond better to calls from local numbers and local voices, and we can follow that up with a visit to offer support.

"We know our local areas and we know what assets can be deployed.

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“I would like to see local furlough schemes, local control of track and trace and much more local input into the development of measures.

“Many people don’t get their wages paid if they are self-isolating. We need to see that as a civic duty and support them so they are not worried about being able to pay their bills at the end of the month.

“We have got to get this right if we’re going to live with Covid effectively. We are not going to get back to any kind of normality without it.”

There has been much debate over the effectiveness of the local lockdowns which have been implemented in places with high case rates, with infections continuing to rise in many cases after restrictions were imposed.

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Prof Ardern said it is vital to recognise that Covid-19 has a 14-day incubation period, so expecting rapid falls in transmission very soon after measures were imposed was premature.

But she said she understood why many people are increasingly chafing at the upheaval in everyday life, though she offered little hope that these would no longer be necessary any time soon.

Instead she called on the authorities to do much more to make the rules clear, saying the current mixture of different restrictions being imposed all over the country was making it hard for residents to do the right thing.

She said: “I understand people are finding the restrictions we’re living and working under very frustrating. People have missed life landmarks during the last six months and I’m afraid that’s going to continue during the winter.

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“However, measures need to be proportional and acceptable to people. There are social and economic impacts and this is where support packages are absolutely critical.

“There are other problems as well, such as the long waits we currently have for non-Covid health conditions in Greater Manchester. People are going to become sick with other things if we can’t get some business as usual back.

“At the moment we have quite a confused picture. Leicester has been in lockdown for 94 days. It’s not clear what the entry and exit points are for restrictions.

“The Government is proposing to introduce a three-tier system but the mechanisms and threshold for exiting restrictions need to be clear.

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“That gives people an incentive to work towards and it’s crystal clear what is expected of them.”

One area which has caused concern is pupils returning to school, but Prof Ardern hailed this a public health success as Covid-19 has not spread in classrooms, with youngsters who have been sent home to self-isolate doing so because the coronavirus has been contracted elsewhere and then brought into educational settings.

She also said the increased efforts on hygiene could pay dividends in the colder months as many of the ways of preventing Covid-19 spreading also worked to deter other winter viruses and illnesses such as flu.

Attempts to prevent flu and Covid circulating simultaneously in winter have also been given a boost as take-up of the flu vaccine has so far been good, with Prof Ardern urging residents who have been invited to have a jab to do so.

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Residents are also being urged to ring NHS 111 if they have Covid-related concerns or speak to their GP practices about any other health matters.

Overall Prof Ardern said Wigan was in a good position to get through what could be some tricky months ahead, pointing to the borough’s networks of volunteers and community groups which had jumped into action to help out during the first wave.

She said: “Compliance with measures in Wigan has been good. If we all keep up the good work we can get through this. We got our numbers down in the first wave, we can do it again. There is no reason for us to despair.”