England has now reached the halfway point of its second national lockdown, and in many ways the country is now at a tipping point. As this analysis by the New Statesman shows, the situation is going to have to improve fast if lockdown is to be lifted nationwide on 2 December.
The first thing to note is that this second national lockdown is not like the first. Restrictions this time around are looser: schools and colleges are still open, and people are allowed to leave their home more than once a day.
Figures published by Google – collected using anonymous mobile phone location data – show that people are moving around far more than they were during the first lockdown.
Google’s data is subdivided according to the type of place people are recorded moving to or from. Movement related to shopping, transport and workplaces has fallen much less than during the first lockdown. People are also visiting parks in greater numbers than they did last time, despite the shorter days and grimmer weather. The only type of mobility that is seeing lower numbers than last time is “residential” mobility – a measure of the duration spent at home – meaning people are staying in less.
Google also publishes the figures at a local level. These suggest that London in particular – or parts of it – seems to be locking down the least compared to last time, as people in the capital are spending less time in their homes than during the March/April lockdown.
It’s impossible to tell how much of the overall increase in mobility compared to last time is simply down to the change in restrictions, and how much is possibly down to people breaking the rules. The National Police Chiefs Council publish monthly updates on the number of fines handed out – but has yet to release any data from November.
Either way, greater mobility means this lockdown is probably going to be less effective at bringing case numbers down than the first one.
The headline indicators of confirmed cases, hospitalisations and deaths are all continuing to rise in England, according to the latest data from Public Health England. Newly confirmed cases are around 10 per cent higher than they were a week ago, while hospitalisations are 15 per cent higher and deaths 11 per cent higher.
While it is obviously not good news that these numbers continue to trend in the wrong direction, it is at least encouraging that the rate of increase is slowing.
We would also not expect the effects of the lockdown to be felt on hospitalisations and deaths for a couple of weeks yet. These indicators naturally lag behind the data on confirmed cases because it generally takes a week for somebody infected with Covid-19 to become ill enough to need hospital treatment and a roughly week more for them to die.
Delve beneath the surface, however, and some of the figures start to become less encouraging. The start of the second wave of the virus was driven by an explosion of confirmed cases among young adults, particularly those of university age. These increases were worrying, but initially largely confined to people at low risk of developing symptoms requiring hospitalisation.
The figures show that cases have declined among this age group in recent weeks but have continued to rise among older, more vulnerable, groups. Although case rates are affected by the volume of tests being conducted, these increases in older age groups are backed-up by pre-lockdown data from the Office for National Statistics’ weekly infection survey.
As previous trends have shown, this is almost certain to translate to an increase in hospitalisations in a couple of weeks’ time; just as Boris Johnson will be taking the decision on whether to lift national lockdown measures as planned on 2 December.
The figures also show that one element of the UK’s Covid-19 epidemic hasn’t changed: there are multiple localised epidemics happening concurrently across the country, all of which are at different stages.
There was a huge gulf between the areas with the lowest and the highest case rates prior to the announcement of the second national lockdown, and this is still the case two weeks in. At the top end of the scale, Hull is seeing weekly case rates in excess of 700 per 100,000 people, more than ten times higher than rates being seen in Suffolk.
Trends in the number of Covid patients in hospital also vary significantly across regions, with numbers in the north-east and Yorkshire and the Midlands higher than they were during the peak of the first wave of the virus and still rising. Numbers elsewhere are lower – but only the north-west, which had high numbers of “second wave” earlier than other regions, has started to see a levelling off in their growth.
There are slightly more encouraging signs when we look specifically at the progression of towns and cities that were at the top of the leaderboards a few weeks ago. Places such as Manchester, Nottingham and Newcastle – all of which were under the strictest local restrictions prior to the national lockdown – have seen substantial decreases in case rates of late.
This is good news because it suggests that these restrictions do, in the long-run, reduce case numbers. (Again a note of caution must be struck based on the ages of those testing positive. While Manchester and Nottingham have seen decreases across the board, Newcastle is still seeing increases in cases among older groups, especially in the 80+ category.)
While we do have a lot of timely data at our fingertips, there are some important indicators that don’t yet cover the period spanning the first fortnight of the second national lockdown. Case positivity rates are crucial for understanding the prevalence of the virus, but these are not yet officially available for the period in question. They may, for instance, show that the increase in cases in some areas of the country is down to increased testing rather than increased virus prevalence.
[See also: NHS Test and Trace is struggling in the hardest-hit areas of England]
Further data from the ONS infection survey will be published in the coming days and this should give us a better idea of the direction the epidemic is heading. It isn’t affected by testing capacity and has been showing increasingly lower levels of growth in case numbers.
Because of the lag in these indicators it is difficult to know with certainty exactly how ready England will be to lift restrictions on 2 December. Keeping an eye on what happens in Wales over the next two weeks will likely give us some indication about what could happen. The “firebreak” restrictions imposed in Wales ended last week and have had the effect of reducing the number of confirmed cases and case positivity rates. Hospitalisations, however, are still on the increase.
The truth is, we are unlikely to really know whether it’s going to be safe to lift the national lockdown measures in a fortnight; or, to put it another way, it is unlikely that we will have compelling evidence lifting restrictions would be safe. Unless the government has some compellingly positive modelling up its sleeve, it seems probable that tough restrictions on daily life will remain in place for at least some of England into the middle of December.
[See also: Devi Sridhar: How the UK can avoid an endless cycle of lockdowns]
Content from our partners
Related
