A director at Public Health Wales has detailed the individual clusters of cases causing the climbing coronavirus infection rates in three areas of Wales under lockdown.
Transmission rates have continued to rise steeply in Blaenau Gwent, Merthyr and Rhondda Cynon Taf – with Blaenau Gwent now seeing 304 positive cases per 100,000 population.
In comparison, Burnley, Lancashire, recorded an infection rate of 269.9 per 100,000 people in the same time frame ending September 24, making it the worst hit areas in England, the Mirror reports.
And while Rhondda Cynon Taf is now on its 12th day of lockdown, it is now seeing 176.2 cases per 100,00 – compared to 83.3 recorded as a seven day rolling total on September 21.
We asked Public Health Wales incident director Dr Giri Shankar why cases are continuing to rise in some areas of lockdown while they are falling in Caerphilly.
It is nearly a week now since Blaenau Gwent entered local lockdown on September 22. At the time, its cases had been fairly stable compared to the sharp rise in numbers seen in Merthyr.
While the borough saw a 60.1 cases per 100,000 people in a seven-day rolling total on September 21, that figure is now 304 , with a positivity rate of 10.4%. In comparison, the national average is 4.7%.
Last week, 214 cases of coronavirus were confirmed across the borough.
When announcing lockdown restrictions for the borough, health minister Vaughan Gething said cases were linked to pubs and a lack of social distancing but added there had also been cases in a care home and in secondary schools in the area.
According to Dr Shankar, these outbreaks are continuing to cause cases, as well as outbreaks in healthcare settings including mental health facility Ysbyty’r Tri Chwm.
He said: “Initially we had cases clustered around a pub, and there were a number of contacts, the pub owners, that required a number of other contacts to self isolate.
“There were a lot of pub clusters and then there were lots of other locations where cases were occurring. This was also in one of the comprehensive schools then there was one in a care home so I think it’s a combination of household transmission, hospitality premises, schools and care homes that is driving the case rate.
“We are seeing some cases in health care settings, for example community hospitals.”
Asked whether Blaenau Gwent’s case rate was expected, or a concern for Public Health Wales, Dr Shankar added: “There are two things to say about that.
“One, Blaenau Gwent is a small local authority so whenever there is even a handful of cases, in percentage terms it makes a big difference because the denominator is small.
“Secondly, there is also active case finding going on. There was a mobile testing unit, including walk in testing so easy access to testing has actually meant that we are looking hard to find the cases. Because we’re looking hard, we are finding higher numbers.”
Rhondda Cynon Taf
The second county to go into lockdown, measures were put in place across RCT at 6pm on September 17. It is now seeing 176.2 cases per 100,00 – compared to 83.3 recorded as a seven day rolling total on September 21.
Last week, 450 cases of coronavirus were confirmed across the borough.
Cases were initially linked to two clusters – one at a rugby club and another linked to a group from Abercynon that spent a day in Doncaster when entry to the racecourse was closed.
Public Health Wales have now moved on from those clusters, Dr Shankar said, as the authority was able to stop a further chain of transmission in a number of those outbreaks.
The incident director said: “We would expect to see the case numbers go down after a period of time, we think about three to four weeks is what it could take.
“In RCT we are also seeing a large outbreak in the Royal Glamorgan Hospital which is also leading to cases there and they are considering actions in the hospital.
“Newer cases are starting to appear in work places, and also hospital settings. Likewise a number of schools, both primary and secondary, are also contributing.”
In Merthyr cases currently stand at a rolling seven day total of 227.1 per 100,000 people. This time last week it was at 102.8.
Last week, 145 cases of coronavirus were confirmed across the borough.
Like Blaenau Gwent, the area is less than a week into lockdown as restrictions came into force at 6pm on September 22.
At the time Mr Gething said a large number of cases was linked to a single employer.
Other clusters are now adding to the daily tolls.
Dr Shankar said: “We are seeing new locations where clusters and cases are arriving. Schools, work places, hospital settings.”
Do the case numbers match the levels expected by Public Health Wales?
Asked if the cases across the three areas are where Public Health Wales expected them to be at this stage in local lockdowns, Dr Shankar said: “It’s very difficult to put an accurate estimation on what we expected. Partly it’s dictated by societal behaviour – if everyone who is symptomatic comes forward for a test we know that what we are testing is truly reflective of what is happening in the community.
“Sometimes that might not necessarily be the case.
“Secondly, when the lockdown are introduced a lot of the infection would have seeded in the community so for the next one or two weeks what you see is what already happened two weeks ago rather than what has happened post lockdown. That’s why we have a lag period.”
Are people following the rules?
While Public Health Wales is still seeing case numbers linked to behaviour from before lockdown, communication with South Wales Police can build a picture of compliance within the three boroughs.
Dr Shankar said: “Our police colleagues monitor the number of calls and call outs they get for non compliance, the fines they issue, how the night life in terms of regulation, licenced premises.
“All of these give an indication whether it’s going in the right direction. There isn’t anything drastically alarming in terms of community behaviour.”