Deputy Chief Medical Officer statement on latest 21 day review.
I note and support the recommendation to retain the current alert level zero requirements for this review period.
We have observed the highest number of new case diagnoses since the start of the pandemic. This appears to be driven by the infection rate in young people – the case rate for the under 25s is over 1,000 per 100k. Some reassurance is provided by the much lower and stable rate in the high risk over 60s age group, suggesting the protective effect of the vaccination programme is continuing. Young people are less severely affected by COVID, but so many cases will come with the risk of educational disruption and long COVID.
There are over 600 patients with COVID-related problems in hospitals in Wales, a figure which has declined slightly over the last week. Although this is a much lower number of cases than during previous waves, the NHS remains under huge pressure as it seeks to manage backlog and pent up demand. Should numbers increase, some pressure could be eased by limiting non-COVID care, but this will result in greater harm.
The situation is therefore one of high case rates with levels of harm reduced by vaccination and currently stable. There is huge pressure on testing and contact tracing services, but as the case incidence rate for the 7 days to 30 September is 530, down from the peak of 652 during the previous 7 days, I hope that this is the start of the decline in cases as predicted by the modelling.
I welcome the start of the booster programme, with the focus on the most vulnerable and those who work in our health and social care settings. Young people aged 12-15 are also being offered the vaccination for the first time using a model for delivery in Wales which involves the vaccination centres, which should avoid some of the difficulties experienced by teaching staff and schools in England recently.
Airborne transmission of SARS-CoV-2 is significant and should be controlled as much as possible. I support any reinforcement or changes to building operations, including the operation of heating, ventilating, and air-conditioning systems, that can reduce airborne exposures, although I recognise that changes will take time. I am also cognisant of the need to ensure that these infrastructure measures are compatible with our efforts to limit the impact of climate change.
Communication remains an important strategy, we need to remind the Welsh population that the pandemic is not over, that the long-term impact of COVID infection on individuals is still emerging and that there are personal and community responses which can help to reduce transmission. With fewer regulations in place, maintaining behaviours to protect ourselves and those around us, remains fundamentally important, this means self-isolating at home if unwell and seeking a test if displaying COVID-19 symptoms; self-isolating if displaying COVID-19 symptoms or having been advised to do so by TTP; supporting others required to self-isolate; and getting vaccinated, including boosters, while encouraging others to do so.
In addition, where possible, the following advice remains important: minimise time spent mixing with others; meeting outside; keeping windows and doors open when inside; practising good hand hygiene; and working from home when feasible. As is still required in most indoor public places, wearing a face covering will also contribute to reducing transmission.
We can expect to see a significant resurgence of influenza and other respiratory infections in the next few months. The impact of co-infection with influenza and COVID-19 is unknown. Every effort should be made to encourage update of influenza vaccination in all eligible groups.
Dr Chris Jones
Deputy Chief Medical Officer