Wales moved to alert level zero on August 7, removing all limits on meeting others, and allowing all businesses to reopen. The impact of the relaxations and increased social mixing during the summer is reflected in rising numbers of Welsh cases. There are around 481 cases per 100,000 people at the time of writing, with a positivity rate of 18.7%.
Coronavirus cases in the community are likely to increase further now schools, colleges and universities have returned. The most recent data on cases is published by Public Health Wales (PHW). Currently, Wales has the highest coronavirus case rates since the second wave in the pandemic (in December 2020). Most cases are in the younger population.
Comparatively few people have been admitted to hospital with suspected or confirmed coronavirus in this third wave. High vaccination rates in Wales have helped weaken the link between recorded infections and serious illness.
The Welsh vaccination programme is now focused on furthering take up of first and second doses for all adults and encouraging younger cohorts to come forward. Vaccination coverage still varies between socio-economic, age and ethnic groups. Vaccine hesitancy is discussed in our guest blog by Dr Simon Williams from Swansea University.
Our vaccination data article provides the latest information on vaccine uptake in Wales. Vaccination coverage continues to increase with 84.2% of the adult population now fully vaccinated. The Welsh Government says “Wales is leading the way with vaccine uptake in 16 to 17 year olds”. PHW data suggests that more than 67% of 16 and 17 year olds have now received a first dose.
Earlier this week, the Joint Committee on Vaccination and Immunisation (JCVI) published its final advice on whether children aged 12 to 15 years should be offered a first vaccine. Clinically vulnerable young people aged 12 to 15, or those living with adults at increased risk from the virus, are already eligible.
The Welsh Health Minister approved the move on Tuesday 14 September. But. Wales’ Chief Medical Officer Dr Frank Atherton said whether or not young people opt for a vaccine is for children and parents to decide. Earlier advice from the JCVI said there was not enough benefit to vaccinating healthy children – but it is now being recommended on educational as much as a health grounds. It is hoped vaccination of 12 to 15 year olds will help reduce education disruption this winter, and protect young people from the risk of long COVID.
The JCVI has also published its final advice on the roll-out of an autumn booster programme. The First Minister previously pointed to Israeli data showing that immunity from the vaccine dips over time; possibly within six months.
Interim advice from the JCVI in June told NHS bodies to prepare for a widespread booster jab programme in September. It has been reviewing data from the Cov-Boost trial; a UK Government-funded study assessing the safety, efficacy and effectiveness of several different coronavirus vaccines when administered to patients as a third dose.
The Health Minister has confirmed that Wales will begin rolling out the booster jabs to priority groups from next week.
Uncertainty for the months ahead
Despite high vaccination rates, we are starting to see a small increase in hospitalisations associated with coronavirus and coronavirus-related deaths, though these remain much lower than in previous waves. Fortunately, the number of coronavirus-related admissions to intensive care remains lower than the same point in previous waves. According to the Office for National Statistics, average daily deaths in the second wave was eight times higher than it is now.
However, keeping the number of hospitalisations manageable is important when entering the winter months when pressure on health and social care services normally increases.
The Welsh Government’s Winter Protection Plan sets out the contingencies to be put in place across the health and social care system to manage the pandemic, and provide services over winter.
Hospitals are already coming under pressure.
Last week Betsi Cadwaladr health board, which covers North Wales, decided to postpone some operations. Hwyel Dda health board has suspended some planned orthopaedic surgery and most hospital visiting is banned in Cwm Taf Morgannwg.
Pandemic pressure is starting to increase on the NHS again, impacting on non-COVID activity levels. At last Friday’s press conference, the First Minister urged the Welsh public to think carefully about how they seek care to help ease the pressure on hospital services. He suggested patients should visit their GP or pharmacist for non-emergency care, as opposed to visiting A&E departments.
Flu will also affect services. It’s too early to say whether this will be a difficult flu year, but encouraging uptake of flu vaccination to reduce hospitalisation and pressure on the NHS and social care system will be a priority in the coming weeks. Last winter, uptake of the flu vaccine was the highest ever recorded.
It is possible we’ll see higher levels of flu circulating, along with other seasonal cause of respiratory infections this winter – given the low levels recorded throughout 2020-21.
A week of decisions
The Welsh Government will need to make other decisions this week too. Ministers are currently considering the ethical, legal and practical considerations of vaccine passports, and whether they will be needed for entry to some Welsh events. We already know that vaccine passports will not be needed to access crucial public services.
On International travel, the Chief Medical Officer in his advice to Ministers has been clear that this presents “the major risk looking forward”; He emphasises the risk of importing infections and new variants into the UK from abroad. The risk of a variant that evades the vaccines, or leads to more severe illness, remains a possibility.
Working together to keep Wales safe
The key message from Wales’ leading medical experts is “now is not the time to be complacent”. The First Minister has asked the Welsh public to behave in ways which limit the spread of coronavirus, including:
- being fully vaccinated;
- self-isolating when symptomatic and getting tested;
- observing good hand and respiratory hygiene;
- limiting contacts and staying in outdoor settings where possible;
- keeping indoor environments well ventilated;
- wearing a face covering in certain indoor public places and public transport; and
- working from home whenever you can.
The First Minister emphasised that actions like these will help stop the need for any future restrictions, though modelling is much more uncertain now that society is more open. The coming months are likely to be unpredictable. The First Minister has stressed “the pandemic is still with us”, and has warned the winter may prove challenging. Urging continued caution, he reiterated:
Over the last 18 months people have worked together to keep Wales safe. The need to do this is as strong as it has ever been.
The Welsh Government’s next three-weekly review takes place on September 16. The Senedd’s Health and Social Care Committee will take evidence from the Chief Medical Officer, Chief Scientific Advisor and Chair of the Technical Advisory Cell on 23 September. It will also hear from the Minister for Health and Social Services, the Deputy Minister for Mental Health and Well-being and the Deputy Minister for Social Services. You can watch the Committee’s session on Senedd TV.
Article by Sarah Hatherley, Senedd Research, Welsh Parliament