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.

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?”

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