This advice is informed by the outputs of the UK Scientific Advisory Group on Emergencies and the Welsh Technical Advisory Cell, WHO guidance and through discussions with Chief Medical Officers in the 4 Nations and Chief Economic Advisor in Wales.
The public health situation at present enables further easing of lockdown. As a result of the public compliance with our lockdown measures, the incidence (new infections), prevalence (existing infections) and deaths from COVID-19 are falling and there is, as a result, improved capacity within the NHS. The current prevalence of COVID-19 in Wales is around 1 in 10,000. The R value is below 1 but is a less reliable measure due to the daily variation that we see with low numbers of cases. Furthermore we are now in the Summer season, important because we know the risk of transmission is much lower outdoors than indoors, because of sunlight and ventilation, and that social distancing outside is relatively acceptable and achievable. We also now have surveillance and case management procedures coming into place, including the community testing and contact tracing, which will help limit the local spread of infection.
In addition to the direct impact of the virus, it is evident that the longer term societal impacts of COVID-19 are likely to be very significant due to the known harms that result from economic downturns, and particularly from the associated increases in unemployment. Learning from previous recessions shows this can have the hardest impact on those already disadvantaged and will almost certainly increase inequalities. Persisting adverse effects include increased risks of recurring periods of unemployment, lower pay, lower well-being and a higher incidence of chronic health conditions. Particularly pronounced and long lasting adverse effects are likely on young people entering the labour market for the first time, who may incur life-long socio-economic penalties, including – for some - reduced life expectancy. Children and young people whose education has been disrupted also face the risk of worse socio-economic outcomes. Recommend that our focus on harm should now be cautiously rebalanced towards reducing the wider economic and societal impacts of the pandemic.
While ensuring continuing measures to avoid direct harm from COVID-19 infection, a cautious and step-wise approach to easement should be taken to minimise long-term socio-economic effects of the pandemic.
A further important benefit of easing lockdown can be to reconnect families and reduce the distress caused by loneliness and isolation, which can have negative impacts on young people as well as the elderly or vulnerable. I recommend we permit a degree of flexibility in travel for wellbeing checks on relatives especially those who are elderly or distressed and for those in special circumstances. If these visits occur outside in gardens or parks with appropriate social distancing they would have very low risk of viral transmission.
A permissive allowance for compassionate family visiting outside could help public confidence in preparing for easement of the current stay local guidance. Adequate time should be allowed for safe protective arrangements to be put in place at visitor destinations – these might include car parks and public conveniences as well as social distancing and hand hygiene.
The summer period presents a safer opportunity to ease restrictions. Greater freedoms however, should be supported by continuing emphasis in Welsh Government communications on levels of risk to enable the public to make responsible decisions to guide their safe behaviours. Strong messaging should continue, as in recent advice on wearing face coverings, for preventative measures such as social distancing and personal hygiene, and what individuals must do when they have symptoms of possible coronavirus infection, including self-isolation and self-referral for testing and contact tracing.
We should advise the public, as in other countries, to avoid the 3Cs
- Crowded places
- Closed settings (with poor ventilation)
- Close contact
Professor Chris Jones (with contribution from Jonathan Price, Chief Economist)
Deputy Chief Medical Officer
18 June 2020