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Contents

This report provides advice on the proposed relaxations considered as part of the 5 August 2021 review, covering:

  • Face coverings
  • TTP and Self-isolation rules
  • Nightclub mitigations
  • Any use of a ‘COVID pass’

TAC advice is sought to inform this review, ensuring the revised basket of indicators to reflect the emergence of the delta variant set out in the updated Coronavirus Control Plan published on 14 July are encompassed.

This advice is informed by a range of evidence sources, including from the Scientific Advisory Group for Emergencies (SAGE), the Welsh Government Technical Advisory Group (TAG) and subgroups, Public Health Wales, the Wales COVID-19 Evidence Centre, and the wider academic literature and surveillance data.

Advice from previous review cycles is referred to where relevant and is not repeated here.

Summary

  • Overall, the most recent modelled scenarios from Swansea University suggest that it is likely cases, hospitalisations and deaths will remain flat or increase slightly during July, and then begin to increase again in August as restrictions are eased further (on 7 August).
  • Cases peaked in mid July 2021 and are estimated to peak again around September 2021. Hospitalisations and deaths are estimated to peak a couple of weeks after cases but at a lower level than previous waves.
  • In this third wave, we are still in a race between vaccines and the Delta variant, with school closures acting as a potential firebreak but increased mixing from easing restrictions acting as an additional opposing force.
  • Vaccines are having to do more heavy lifting in a high prevalence world – vaccines might be less effective as force of infection increases.
  • Even when high uptake of vaccination is successful in reducing the harm arising from severe clinical outcomes in infected individuals, high levels of community transmission remain associated with significant risks, not least the emergence of new variants of concern.
  • When schools return there will likely be continued high transmission in children and young people so a measured policy response needs to be developed to this.
  • Although there has been a recent signal of declining case numbers, the wastewater signal suggests the infection cases have not declined in several areas.
  • Evidence on the effectiveness of face covering to reduce the spread of transmission of SARS-CoV-2 in the community and efficacy of different types of face coverings remains limited and conclusions rely on low quality sources of evidence with high risk of bias. Evidence suggests that face coverings may provide benefits in preventing transmission of SARS-CoV-2 but higher quality studies suggest these benefits may be modest.
  • Recent TAG advice on nightclubs and adult entertainment venues remains extant. This advice concluded that nightclubs represent a higher risk of transmission. It is unclear at present what impact a fully vaccinated population would have upon the risk and probability level of infection.

Revision of the TTP system such that isolation of double vaccinated individuals is relaxed is likely to lead to a small increase in the reproduction number (Rt), with a slightly bigger increase if the policy also applies to under 18s, who are largely unvaccinated. Modelling does not consider any potential impacts of periodic PCR testing of vaccinated contacts or the likelihood of vaccinated contacts becoming infected.

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