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Coronavirus: Directors of public health in Notts talk Christmas and what we need to be doing to give ourselves the best possible time of the year




It's beginning to look a lot like a very different Christmas.

With an expectancy that the rules on socialising over the festive period could be relaxed for just a few day, but with repercussions, the director of Public Health for Nottingham, Alison Challenger said: "Hearing from Public Health England there is real interest in trying to bring people together for some time over the Christmas period and that will be really important for families to be able to connect, but I think what they were also saying is that there is a potential cost to this as well and that could mean that we have to have a greater period surrounding that with more restrictions.

"An important message is that whatever comes through (from government) it will still be important to try and minimise household contacts. So, if the rules allow for that, we can meet with friends and family.

"We still have work to do to bring the rates down across the country and across Nottinghamshire.

Coronavirus.
Coronavirus.

"It's important to make sure we meet people but we don't meet lots of people if that's at all possible.

"I do think it will be a different Christmas this year - hopefully it will be one where we can meet and come together and enable families to come together, but it's not a time where we can completely relax everything that we're doing.

"It will still be important that if you get symptoms over Christmas to get a test and isolate straight away.

The director of Public Health Nottinghamshire, Jonathan Gribbin said: "National lockdown was introduced to save lives and protect our local care systems by bringing down infection rates and in Nottinghamshire we've seen some reduction in rates, including those aged over 60, but in real terms those reductions have been pretty modest so far and, certainly in Nottinghamshire county, they have yet to develop into what I think we would recognise as being a sustained downward trend.

Jonathan Gribbin
Jonathan Gribbin

"Our health and care systems for the time being continue to face some severe pressures so, whereas looking into 2021 we can, I think, have some optimism with the prospect of the vaccine round the corner, more immediately, the measures we would look to the government to take when we come out of national lockdown will have to continue to make that balance between the imperative to open up the economy on the one hand, but the really pressing need to avoid a resurgence of infection on the other.

"The underlying importance is to urge everyone right across Nottinghamshire to take the steps that each of us can to protect ourselves and those close to us.

"We can remind ourselves that if we stick to these lockdown restriction and the Hands Face Space guidance, then we are each playing a really important role in reducing the number of people who end up in our hospitals or our care system facing extra care needs with covid this Christmas."

While from an NHS perspective, Dr Andrew Haynes, medical director for Nottingham and Nottinghamshire, said: "We have to take data over the next few weeks to make decisions and I guess it's worth remembering that currently we've got about one in ten staff off sick and about half of that is due to covid or due to isolation due to covid contact.

"That puts enormous pressure on us. Of course January is usually a time when the NHS comes under seasonal pressure anyway so I think we need to be circumspect here.

"We need to let people have the best Christmas that they can but we wouldn't want the cost of that to be more sickness and sadly more deaths in the January window and bringing that continued pressure to the hospital and care system, which is already experiencing significant problems."

Mr Gribbin said: "In most areas of Nottinghamshire we have been seeing reductions in headline rates of infection for some time now.They peaked about November 4, or thereabouts, and have been reducing since - so that's positive.

"I am pleased in regard to the city that in people over 60 we have seen a sustained decrease over the last several weeks, but in the county I have to flag up that in fact we have yet to see a sustained reduction in people who are over 60.

"We saw some sharp rises leading up to round about the 4th of November. We saw a decrease in rates in people over 60 for five days or so, but then that was interrupted and, in fact, if anything for the past five days for which we have complete data, if anything, we're seeing a slight increase in rates among people who are over 60.

"So last week I talked about a couple of reasons for cautious optimism. I have to say that for the time being in the county, I remain very concerned about rates, particularly in the over sixties."

Alison Challenger said the decline in the city was thanks to the effort of everyone - that it was hard but lockdown was necessary.

Of the situation within hospitals in Nottinghamshire, Dr Haynes said: "Up to second week of November we had 450 beds occupied in the system by patients who were covid-positive so the situation has been really stable with between 400 and 450 people occupying beds for the last three weeks.

"We had that rather rapid rise in October and that's been followed by that levelling out so I think that is a consequence of the public engaging with us and I'm very grateful for that and I probably should point out is that plateau is a very different shape to the first wave where there was a very rapid rise, a distinct peak and then a gradual fall away.

"Here we have hit that sort of consistent level for the past three to four weeks, which is putting huge pressure on hospitals and the wider health and care system as a consequence.

"I think it's important that people understand that difference.

"We are expecting the infection rate in the over sixties to continue for the next couple of weeks so we think the pressure in the healthcare system will continue throughout the rest of lockdown.

"I think it's critical that we thank the public for their efforts but we ask them to continue both through the rest of lockdown, and as we emerge from lockdown, to comply with the basics - do Hands Face Space well, avoid mixing indoors particularly with people from outside your household and to comply with the restriction measures.

"You'll have heard the press around the vaccination programme, which has been really encouraging, so it's good that were likely to have vaccines emerge and pass the safety and regulatory hoops that they're required to so we are optimistic we will have some vaccine to deliver to the most vulnerable groups this year, this side of Christmas.

"It's a huge programme, probably the biggest vaccination programme ever undertaken."

Nottinghamshire was in the very high tier 3 covid restrictions prior to the national lockdown.

Regarding what will happen post-lockdown and what tier Nottinghamshire will emerge into, Alison Challenger said she didn't expect the same measures and restrictions as before.

Mr Gribbin said: "It is likely we will see a system of far more standardisation across the country - so less local variation. I think that would be helpful.

"I think what I am also hoping for is an arrangement which is much more agile and responsive than the one that we encountered in the autumn.

"We are dealing with a situation that is dynamic and changes fast and we need an arrangement of tiers that is as responsive."



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