Dean Wallace director of public health for Derbyshire County Council, said that getting cases to a low of 500 per week would be a feat in itself, especially with schools going back and lockdown due to ease.
He said the county area, minus Derby, was recording around 650 cases per week – minus the recent outbreak at Sudbury Prison.
Mr Wallace said it would be ideal to get cases below 500 and definitely to keep them below 1,000 per week, particularly to maintain effective contact tracing.
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He said that getting cases back to a low of under 50 a week, which the county managed last August, would be highly unlikely due to the new variants.
He also said that he and his team were aware of the “tsunamis” of public health issues which would dominate the county once Covid-19 takes a back seat, issues which have been put on the backburner for the past year.
He also said that other diseases such as measles could crop-up again due to lower uptake of vaccines nationally during the pandemic, with measles far more infectious than Covid-19.
Vaccination roll out
Mr Wallace also warned of the need to roll out the vaccination programme as fast as possible and for residents to override fatigue and continue to follow hands, face, space guidance – including at school pick-up and drop-off.
This need was now greater than ever, he said, due to the risk of creating vaccine-resistant Covid variants.
Mr Wallace said: “We have had a downward trend, but have not fallen as fast as the national average.
“We won’t see the rates drop as low as they did in the summer and that is linked to the new variant, people’s fatigue and the season.
“It is what becomes the new acceptable level of background rate while we get the vaccination programme rolled out and you have schools and potentially other parts of society or the economy opened up.”
Mr Wallace continued: “With the new variant, we are not going to be able to get down to the level we saw in August.
“In one week in August we had 36 cases in a week with a rolling rate of something like 3.6 (per 100,000 people).
“We have probably hit the lowest point we are going to hit (86.5 cases per 100,00 in the week to March 5, totalling 694 in the Derbyshire county area, excluding Derby) because with schools going back I am not sure we are going to see rates fall any lower.”
Increase in cases?
Dr Jenny Harries, the nation’s deputy chief medical director recently suggested the country will see an increase in cases for the next two weeks as schools return, but hoped that this would then flatten or return to normal.
Mr Wallace said: “Ideally I’d like to get to 500 cases (in a week) and that would feel more manageable, but we have definitely got to keep it under 1,000.
“Anywhere around 500 we can cope and mitigate onward spread and can bring in additional contact tracing when we see outbreaks and contact every contact ourselves to do enhanced tracing.”
“It is really important that anyone with children access lateral flow testing to try and make that safer and that in and out of school gates, bubbles are maintained, there is social distancing and face coverings.
“At the moment it is focussed on the most vulnerable, which is the right thing to do, to protect people at greatest risk of the worst outcome, but the biggest group spreading the virus are the 19 to 50 year old age group, the age group which is still going out to work and who provide care.
“That’s where the virus is really spreading and that group has not really been touched yet for vaccination, so vaccination will not have much of an impact on the spread for some months yet, until that roll-out goes further.
“The risk is, if we have higher case rates while we have the vaccination programme in place, and because the virus likes to mutate, you create a space for more and more new variants to arise.
“When that happens, while vaccination is available, there is a greater chance of a new variant becoming vaccine-resistant or making the vaccine less effective and you end up taking one step forward to take two steps back.
Next phase of pandemic
On the next phase of the pandemic, after lockdown has been eased and the country aims to return to a new normal, Mr Wallace said: “I think we will see a whole new set of the population who will have issues around anxiety.
“Lots of this pandemic has played out on the impact on adults, but we shouldn’t underplay the impact that this is going to have on children and particularly younger people who have missed out on all those experiences.
“If we are not careful we will end up with an endemic new virus in specific communities which could create a space where variants could develop.
“There is the potential for waves or tsunamis of issues, including one for public health, which will create issues for a long time to come.
“Measles and MR (measles, mumps and rubella) uptake has fallen further and what we don’t want to do is see other diseases we got on top of, start to get reintroduced.
“There are certain diseases that have been around for a long time that people don’t think are an issue any more and if we do get large unvaccinated portions of the population it will very much be an issue again.