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The number of patients with Covid-19 in East Sussex hospitals has been steadily rising since the end of September, though it is still below the spring peak. Meanwhile the number of patients on ventilators remains in single figures.

Coronavirus statistical update: rising cases take  Hastings and Rother closer to Tier 3

Coronavirus cases in Hastings and Rother have risen sharply in the last fortnight, prompting East Sussex director of Public Health Darrell Gale to issue a new warning and strengthening the likelihood of these areas being placed in Tier 3 when the current allocations are reviewed this week. Report by Nick Terdre, research and graphics by Russell Hall.

“We’re seeing a worrying rise in Covid infections in parts of East Sussex. We must act now to change this trend, or our lives will get much more difficult,” Darrell Gale, East Sussex director of Public Health said last week.

“The number of people with new cases of Covid has doubled in the Hastings area in recent days and is climbing sharply in Rother. We aren’t seeing the same rises in other parts of the county yet, but that could change quickly.”

In the first few days of December, the coronavirus seven-day case rate per 100,000 population in Hastings increased from less than 100 a day to more than 300. The rate to 9 December, as reported to 13 December, was 370.2, up 255.8 on the previous week. For Rother it was 226.9, up 71.8.

The incidence of the infection elsewhere in East Sussex, though on the increase, was much lower: in Eastbourne 72.3 (up 3.9), in Lewes 67.8 (up 13.6) and in Wealdon 119.5 (up 7.4). For East Sussex as a whole, the seven-day case rate was 161.3 (up 60.3), still somewhat below the rate for England of 172.8 (up 22.7).

One of the Hastings hotspots was West St Leonards, where a more than eightfold increase put it among the worst affected areas in England. As the above graphic shows, Hollington also turned purple while parts of east Hastings stand out as being much less severely affected.

Going granular?

The new tier allocations are due to be reviewed on Wednesday 16 December, and will be announced the following day and come into effect on 19th. Having assigned areas to tiers largely on a regional basis when the second national lockdown ended in early November, with Sussex as a whole put in Tier 2, expectations were raised that the government would decide allocation at a more local level when prime minister Boris Johnson promised in Parliament last week that the situation would be viewed in “granular detail.”

But a different line was taken by health secretary Matt Hancock who wrote in a letter reported in today’s Sunday Telegraph that such ‘decoupling’ was problematic: “…we know from lived experience over recent months that where narrow carve-outs take place in the face of higher rates in neighbouring areas, time and again these carved out areas simply catch up, and often overtake their neighbouring areas.”

Separating Eastbourne, Lewes and Wealdon from Hastings and Rother would hardly count as a ‘narrow carve-out,’ as they are in separate Travel to Work Areas. So there is probably a good chance that the latter local authorities will be assigned to Tier 3 while the rest of East Sussex remains in Tier 2.

Indicators for assigning tiers

Decisions on which tier an area is assigned to are based on five indicators.

1. Case detection rates in all age-groups
2. Case detection rates in over 60s
3. The rate at which cases are rising or falling
4. The positivity rate (the number of positive tests as a percentage of total tests administered)
5. Pressure on the NHS, including current and projected occupancy).

Of the five indicators Hastings has seen a significant deterioration in the first three since it was allocated to Tier 2 on 25 November and it is highly likely its positivity rate has risen markedly since the latest published figure of 3.4% up to 2 December. In the graph below, the number of positive tests sailed up in the early days of December, while the latest move for the number of tests was downward.

Hospital situation

In terms  of hospital bed occupancy by Covid patients, the Conquest and Eastbourne District General hospitals have fared relatively well compared to many other parts of England (see main graphic), but with admissions lagging case detection by around two weeks, and Hastings and Rother cases surging since the start of December, a steep rise may be coming that could easily exceed the spring peak.

HBC acknowledged that cases were rising, referring residents to Gale’s statement and existing guidance. On her weekly video broadcast, council leader Kim Forward said, “It is possible that some of us may have been lulled into a false sense of security.”

At last week’s East Sussex County Council Cabinet meeting, however, Labour county councillors Trevor Webb and Godfrey Daniel were more forthright, accusing Hastings residents of “complacency”, though without offering supporting evidence.

An analysis of Hastings cases by age-group shows a mixed bag. Five groups with totals of 49 or more are red-banded: 10-14s, 30-34s, 35-39, 45-49s and 50-54s. Towards the lower end are 20-24s, among the more gregarious sectors of the population and therefore often considered to be at higher risk of spreading infection. Also towards the lower end are all age-groups from 55-59 and above.

The director of Public Health considered the breakdown of cases by age-group and gender. “Many of the [Hastings] cases are in 10-19 year olds that are connected to school outbreaks and the majority of those cases in that age group are males,” Gale told the Cabinet meeting. “But then, in the other age bands it’s the 30-59 year olds with females being [of a] far higher prevalence than males in Hastings.

“There is some 10-19 spread in Rother, so some school-age young people. But the vast majority of the cases [are] in the 50-59’s which will include the care home staff – male and female are equally impacted – and also the 80-89 and 90 plus year-olds which of course are generally care home residents.

“So this is quite a concern because all these cases will have become infected during the last weeks of lockdown. These are cases that have come in with symptoms last week and generally it take 5-8 days for symptoms to develop from infection, so that is a concern.

 “We’ve also had a look at some data from the [NHS COVID-19 contact tracing] app which isn’t published data but shows that Hastings in particular is a place where cases who are identified have more contacts than in other areas. That’s not to say that they’re contacting those people after they’ve been infected, it’s probably during the period though of infectivity that they have contacted a larger number than other areas of social contacts.”

Talking to schools

Gale said his department would be talking to affected schools to see if the Christmas holidays could be brought forward by a week for the affected age-groups. A mobile testing unit would also be present in Pelham Place car part last Thursday and Friday, in addition to the permanent test site established at the Helenswood Academy annex on The Ridge. It was important that anyone showing symptoms should get themselves tested and, if positive, self-isolate, he said.

“Working with the national Test and Trace, our local Test and Trace is picking up those cases that aren’t followed up and is making successful contacts and bringing those people to isolation.”

In a public statement, Gale urged people to  continue to follow the guidelines: only make contact indoors with other members of your household or support bubble; reduce social contact where possible; avoid crowded places – do your Christmas shopping at less busy times; and get a test if you have any symptoms.

Like many health experts and professionals, he also recommended caution over the Christmas period. “Think carefully about your Christmas socialising. Up to three households will be able to meet in a ‘bubble’ from 23-27 December. But could you manage with less contact just for this year?”

A temporary test site popped up in Pelham Place car park last week.

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Posted 20:50 Sunday, Dec 13, 2020 In: Covid-19

6 Comments

Please read our comment guidelines before posting on HOT

  1. Erica Smith

    Russell, I wondered how you would respond to my friend who posted this on Facebook:
    “Talking to my Mum yesterday she thought everyone who got Covid died, I can completely forgive her for thinking that… I enlightened her that it has a 0.03 % fatality rate, to date 42 people in the country have died under the age of 40…and most were over 80 and / or with additional health issues.”
    I know the death rate for younger people is really low, but it really cannot be only 42 people under 40 – even if you discount people with other underlying health condidtions.
    I really worry about inaccurate statistics being shared around. What is the best way of countering this.

    Comment by Erica Smith — Thursday, Dec 24, 2020 @ 13:02

  2. Cyril Gould

    Good clear, and sobering article. Thank you.

    Comment by Cyril Gould — Sunday, Dec 20, 2020 @ 11:58

  3. Rosemary Christine McAndrew

    Can anyone help me to understand why the Covid figures for Hastings have suddenly shot up from 65 per 100,000 on December 4th, to 679 on December 18th? That’s 1,000% in 3 weeks? Ten times. Multiplied by 10…
    Yes, I am particularly concerned because I live here, but my question arises from confusion, not fear. And yes, I know that a more virulent strain is on the loose, but why should it be targeting itself so specifically on Hastings?
    Throughout the pandemic, Hastings’ figures have been remarkably low. The sad toll of deaths remained at 10 for weeks, rising to 11 by September 25th, to 13 by November 27th, to 14 by December 4th, and even in the last two weeks it has stayed at 16.
    Meanwhile, total cases of infection remained below 200 throughout September; below 400 throughout October; and only exceeded 700 on December 3rd, reaching 732 on December 4th. Yes, they then rose more sharply, yesterday reaching 1,737. But a change from 732 to 1,737 does not constitute a 10-fold increase of 65 to 679 per 100,000.
    I do not know how the ‘per 100K’ figures are arrived at, but simple arithmetic suggests that this correlation is wrong. Perhaps some misguided statistician mistook an increase of 1,000 in numbers for an increase of 1,000 percent?
    No, I am not trying to wriggle out of Tier 4. I am all in favour of severe restrictions. I think we should have instituted the Circuit Break, closed our borders & imposed quarantine at the outset, like New Zealand. We should not have limited ourselves to measly measures like closing pubs at 10 rather than 11. We should have set up and enforced a real Track & Trace system, to keep this horror at bay.
    And yes, I do understand and sympathise with those in industries devastated by the restrictions. Of course I do. But if we had got on top of the pandemic much much earlier, that damage could have been minimised, as could the toll of deaths and suffering.
    I simply do not understand the mathematics…

    Comment by Rosemary Christine McAndrew — Sunday, Dec 20, 2020 @ 07:02

  4. DAR

    Excellent piece: thanks very much.

    Comment by DAR — Thursday, Dec 17, 2020 @ 11:26

  5. Edward Tuddenham

    This detailed analysis clarifies what is happening in way no figures at regional level can do. Thanks to Nick and Russell for their fine illuminating work.
    The safest area is the old town and around the net huts. Sea air and fresh fish are clearly a healthy environment. But it is worrying that such a surge in reported cases is occurring in and around Hastings due mainly to perfectly understandable reasons, school and care work contacts. We must hope that observation of sensible precautions and the vaccination roll out will bring the spread under control.

    Comment by Edward Tuddenham — Thursday, Dec 17, 2020 @ 08:32

  6. Andrew Colquhoun

    Depressing reading for Hastings and St Leonards, but the best and most timely local analysis that I have seen. I’m sure that a lot of work goes into the analysis, but please keep going

    Comment by Andrew Colquhoun — Monday, Dec 14, 2020 @ 11:43

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