More restrictions may need to be imposed to bring the rate of infection of Covid-19 under control, one of the nation’s top medics has said.
Professor Jonathan Van-Tam said that “we may have to push on the pedal a little harder” to get the R rate under control.
But England’s deputy chief medical officer said he does not currently support a full national circuit-breaker for England like those introduced for Northern Ireland and Wales.
Prof Van-Tam did however say that the NHS cannot be “consumed by Covid” and must be able to continue with its other work.
His concerns were echoed by Professor Stephen Powis, national medical director of NHS England, who said: “The last thing we want to do is eat into the capacity that we have in hospitals that we use to treat other conditions.”
Prof Powis did warn that Liverpool University Hospitals are expecting higher numbers of Covid patients by Wednesday than they had during the peak of the first wave in April.
And he said that at the current rate of growth in Manchester, the number of patients in hospital with Covid-19 could reach peak pandemic levels in a fortnight.
Speaking at a Downing Street press conference, Prof Van-Tam said that at the moment, a national lockdown would be “inappropriate” for communities where there are lower rates of infection – for instance, Cornwall or East Anglia.
When asked whether the argument for a short national ‘circuit-breaker’ lockdown was stronger or weaker than when it was recommended by scientific advisers in September, Prof Van-Tam said: “I think a national lockdown at the moment would be inappropriate for communities in Cornwall or East Anglia for example.
“But it is a kind of scientific feature of the effect a lockdown – that if disease levels are higher when you effect lockdown, the effect will be less overall than if the lockdown had been inflicted at a point when disease levels are much lower.
“So I suppose what I am saying is that I wouldn’t expect the same magnitude of effect if one were done now as if it were done early in September or mid-September.
“But I repeat my point that epidemiology is so varied across England that I think it would be very difficult to justify in some communities.”
But he expressed concern for the rate of change in infections among the over-60s across the nation.
“I really want to emphasise that it is the over-60s that really worries us most because these are the people who become severely ill with Covid-19, they are more likely to be admitted to hospital, if they are admitted to hospital they stay in hospital for longer and sadly they are more difficult to save,” he said.
He said that infections among younger people are now penetrating those older age groups.
“This means that the hospital admissions and the deaths linked to those cases are now baked in for the next two to three weeks,” he added.
Prof Van-Tam continued: “Pretty much everywhere in England is now heating up to some extent and we are trying to walk a very fine line between getting the virus under control in areas where it is out of control and incurring the minimum amount of economic damage in doing so.
“It is clear that in the areas that are out of control, hard measures are needed.”
But he said that insisting the same measures should be put in place in areas where levels of disease are much lower would be inappropriate.
Prof Van-Tam added: “We just can’t afford just to let our elderly die.
“And we can’t afford to allow our NHS to be completely consumed by looking after Covid, so it can’t do its other businesses as usual.
“So we’ll have to take as tough measures as are necessary to stop that.
“We’re running now with the brakes partially on – and the R is 1.3 to 1.5, according to the latest estimates – so we can’t take the brake off on this, and we may have to push on the pedal a little harder to get it back under control.”
He said that he did expect death rates to “continue upwards”.
Prof Powis said: “There is variation around the country and that is reflected in the number of patients we see in hospital.
“For example, there are more patients in hospital in Greater Manchester at the moment than there are in hospitals in the entire south east and south west of the country.”
He added: “We can all play a part, it’s for everybody in the public to comply with the measures to reduce the spread of the virus and that will then reduce hospital admissions.
“It will benefit not only people with Covid but other patients who don’t have Covid because the last thing we want to do is eat into the capacity that we have in hospitals that we use to treat other conditions.”
Prof Powis said the number of patients in hospitals in Greater Manchester doubled in the last two weeks, and if it doubles again, hospital admissions in the region could be similar to the peak in April.
“In two weeks’ time, we could well be seeing, at the current rate of rise, the sort of numbers of patients in Greater Manchester that we saw at the peak in April,” he said.
Prof Powis added: “I expect that Liverpool University Hospitals will have as many patients or more patients by tomorrow with Covid in their hospitals than they had at the peak in April.
“And I think that shows just how fast we can see infection rates and hospital admissions rise, if we don’t get this under control.
“So it’s really critical for everybody to comply with these measures to maintain social distancing and to ensure quite simply that the virus doesn’t have a chance to spread.”