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What needs to happen for coronavirus restrictions to be eased in Wales – North Wales Live

https://www.dailypost.co.uk/news/north-wales-news/what-needs-happen-coronavirus-restrictions-19601431

Ten months on from the start of Wales’ first national lockdown and the number of people catching the coronavirus is higher than ever.

There has so far been 23,556 cases in North Wales since the pandemic started in March and with 488 cases and eight deaths recorded in the region over the past 24 hours, the scale of the task ahead for the Welsh Government is immense.

Wales is currently at alert level four which is  the strictest set of restrictions of all the alert levels, mirroring those of the previous national and firebreak lockdowns.

More detail on the tier system and how Wales expects to move up through the alert levels have now been released by the Welsh Government, WalesOnline reports.

The Coronavirus Control Plan, as it is called, has been designed as a way to get the country through the anticipated difficult winter period ahead and allow time to formulate a plan for the latter half of 2021.

And while there are some basic requirements as to what will have to happen before restrictions are eased and the country can enter a new, lower tier, some aspects of the plan are more ambiguous than others.

The basic key indicators the country will have to meet before restrictions begin to ease

There are about a dozen indicators for each level. We have listed some of them below but you can find the full list here.

Alert level one (low risk)

Key indicators include:

Many restrictions on everyday life would still be in place, but they’d be far less significant than what we are dealing with now. For example, you’d still have to follow social distancing rules with people you don’t live with but you’d be able to once again meet a limited number of people indoors and outdoors and pubs and non-essential shops would be open.

Alert level two (medium risk)

  • Confirmed case rate between 50 and 150 cases per 100,000 people rolling seven-day average
  • Confirmed case rates for over 60s not suggesting rapid growth
  • Test positivity more than 3% over seven days
  • Forecast of Welsh population estimated to have Covid-19 is between 0.25% and 0.75%

Alert level three (high risk)

  • Confirmed case rate more than 150 cases per 100,000 people rolling seven-day average
  • Test positivity over 5% over seven days
  • Forecast of Welsh population estimated to have Covid-19 is between 0.75% and 1%
  • Hospital capacity concerns and likely pressure from increased cases is four to five weeks away

Alert level four (very high risk)

But it is not as simple as those points listed above. There are other factors such vaccinations, school transmissions and geographic mapping to consider.

For example, under the control plan, schools would still be open even under level four (the level we’re at now) but the decision has already been made this week to once again close schools and they are likely to stay shut until mid-February.

How will vaccine roll-outs impact when restrictions are eased?

While vaccines will undoubtedly have a huge effect on a return to normality in the long term, in the short term they will not.

According to the Welsh Government plan, until more is known about how much the vaccine roll-out has impacted community transmission, then it is too early to consider removing restrictions.

The plan suggests that safety measures around social distancing will be in place well into 2021 and says that until more is known about the effectiveness of the vaccine roll out in reducing transmission the Welsh Government “do not expect to be able to make substantive relaxations until the spring and summer of 2021.”

That being said, the report also notes that the approval of vaccines opens up a range of possibilities and “may influence our approach to future restrictions.”

So, with three vaccines now approved for use in the UK, should the roll-out of vaccination process go to plan and with enough priority groups vaccinated, this may influence the Welsh Government’s decision on when and how to ease restrictions.

What has to happen before schools can go back?

Under alert level four of the government’s coronavirus plan, schools, childcare and universities would remain open.

However, just days before schools were due to reopen after Christmas, the continued high number of positive cases meant that the Welsh Government announced that pupils would not be going back to school and would be home-learning instead.

The situation across the country is now considered so serious that on Friday January 8, Education Minister Kirsty Williams announced all schools would remain closed until at least the start of February but likely until half-term unless case numbers drop.

But what exactly has to happen before schools go back? Is it as simple as lowering the infection rate?

Reopening guidance to schools and colleges is now being reviewed in light of concern over the more easily spread new variant of Covid. Matters being looked at include:

  • All staff and pupils wearing masks in classrooms
  • Higher quality masks and other PPE
  • Size of class contact “bubbles”

Schools will only re-open when Covid rates have fallen significantly, pressure has eased on the NHS and risk assessment and guidance has been reviewed. The return may also be phased in, rather than all years coming back at once.

It is still somewhat unclear what the role of schools is in spreading the virus, although experts agree it spreads more among secondary school pupils. But ultimately, if coronavirus is in the community it will get into schools.

Questions have also been raised as to whether teachers being included in the government’s vaccine priority quota would ease the return of schools – however the First Minister has said they are not currently being considered.

Will restrictions be lifted nationally or will local lockdowns be reintroduced?

There are four lessons the Welsh Government say they have learnt from previous restrictions:

  1. Local lockdowns do not work as well as national ones
  2. National lockdowns work well to start with, but then lose their effectiveness
  3. High level restrictions do manage to repress the virus
  4. Lower level restrictions do not have a clear impact

According to the plan, different parts of Wales can be at different alert levels – although it acknowledges that this will reduce the effectiveness of the measures.

It seems unlikely for measures to be hyper local as the plan states: “Our experience of the local health protection areas in Wales has shown that a micro-targeted approach was not effective over a period of more than a few weeks. This has also been recognised in England, where a more regional approach has been adopted in the approach to tiers.”

The Welsh Government says regulations are currently applied at an all-Wales level because previous patterns show that while some areas lag behind others, widespread community transmission means it is only a matter of time before all areas catch up with one another.

The guidance also notes that national lockdowns are preferred because they are generally easier for people to understand, and creating geographical boundaries can be difficult to define.

The plan notes that while local lockdowns can focus on hotspots it creates the risk of disproportionate response if indicators are heavily skewed by small populations.

Therefore, while technically the plan states different places can be at different alert levels, the fact that this has not been able to be sustained for longer than a few weeks means it is unlikely to be the route the government goes for.

It is perhaps worth noting that in the plan, if there is evidence of a sustained and clear difference between some parts of Wales compared to others the government will consider whether a regional approach would work better for those areas.

Importantly, this might involve a region of neighbouring local authorities – all interconnected and with similar patterns of infection – moving into a different level to other parts of Wales.

In considering any options, the government says it will take into account the underlying trends in those and neighbouring areas as well as the views of local health professionals, local leaders and local partners.

How do areas move between the different levels?

According to the plan, areas could move up several levels at once if needed.

For example, one point of the plan states: “We should intervene quickly when cases rise and cannot be easily explained, rather than wait for thresholds to be breached.”

So in practice, when local lockdowns were implemented in September 2020, an area generally would be at a level of 50 cases per 100,000 people before one came into force. This will not necessarily be the case going forward.

It also says that once an area moves up, going back down a level “would be unlikely for a number of weeks, as it takes around two weeks to see an effect and further time to establish whether that change has been sustained”.

The plan does state that level four may be for a shorter period “to provide a short sharp shock before the situation necessitates a longer period of time at that highest level”.

It also says that moving down the alert levels should not take place until there is a sustained decline or stabilisation in infections at a suitable rate.

The table translates the principles to illustrate that moving down an alert level will only take place once an improvement is established. Moving downwill be one level at a time.
(Image: Welsh Government)

How long is this plan in place for?

The plan stresses the need to be flexible to adjust to fast-moving situations. It states that many events are unlikely to be allowed until well into the summer.

“We need to be realistic,” the plan reads. “The winter will be very challenging and it is likely to be the spring or summer before we can even think about large events or other riskier activities. We realise this will be difficult for those sectors that have been severely constrained, closed for long periods, or who have not been able to restart at all since the lockdown in March.

“We will work with those sectors to put in place plans for gradually restarting activity in the spring and summer of next year, should conditions permit it.”

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