Advice presented to First Minister on retention of health protection regulations.
I have reviewed the proposal to retain the existing Health Protection restrictions aligned to Alert Level Four in Wales and I agree that this is a necessary response to the serious situation that we face with cases of coronavirus increasing in most parts of the country.
A new variant strain of the virus, identified before Christmas, is contributing to this increasing trend. Preliminary analysis suggests that this variant is significantly more transmissible with an estimated potential to increase the reproductive number (R) by 0.4 and an estimated increased transmissibility of up to 70%.
Viruses continually evolve through mutation so the emergence of a new variant is not in itself a cause for concern; however, the fact that this strain is more infectious and spreads very quickly is worrying. It is likely that this new variant will account for the majority of cases in Wales in the near future.
Although there is no evidence at the moment that infections with this strain are more severe, the impact of increased transmissibility on the number of infections, hospitalisations and deaths is high, particularly for those in older age groups or with co-morbidities. There is a material risk, that without further action, the NHS capacity could be overwhelmed in the next 21 days in several areas of the UK.
This real threat has led me and my fellow Chief Medical Officers from England, Scotland, and Northern Ireland to raise the risk level for the UK to the highest level (Level 5). We have called for on-going or tighter restrictions where possible, and greater emphasis on public compliance with risk reducing behaviour. Existing mitigation measures (staying at home, social distancing, ventilation, hand hygiene and face covering usage) remain vitally important, but, given the increase in risk associated with the new variant, more effective messaging on the avoidance of all unnecessary social contact is needed.
Vulnerable people will need to be particularly careful; a letter has been sent to those who are Clinically Extremely Vulnerable to advise caution and making finely balanced choices between the benefit of reducing contacts with the harms of isolation until the next review on 7 February. The vaccination programme offers a welcome path forward, but, given the low levels of coverage in this early phase, does not alter the need to be especially vigilant.
I have issued guidance to all healthcare settings to remind services of the necessary infection prevention and control measures, that appropriate personal protective equipment should be readily available and used by staff at all times, that cleaning and ventilation protocols are followed and optimised, and that patients and visitors wear masks at all times unless clinically impossible to do so.
We are at a difficult phase in our management of the pandemic and, while recognising the economic and social harms that they represent, I support the continued restrictions for the duration of the next review period.
Dr Frank Atherton
Chief Medical Officer
7 January 2021