RFF was delighted that Ian Diley, Public Health Consultant accepted our invitation to speak at our April network on the topic of “Living With Covid“. Ian last met with us in July 2020 and we knew that he would give us a very comprehensive overview and answer our questions which indeed he did. The meeting was chaired by Mohamed Omer, Redbridge Faith Forum Chair and Director of the Muslim Gardens of Peace Cemetery.
Ian confirmed that although legal restrictions and free testing has ended we are still in the midst of a major covid pandemic. Thus a major source of information has disappeared, including the analysis of waste water, and less people are reporting positive test results. Currently 50-70 new cases are being reported but previously before free testing was withdrawn this was about 250 cases a day. There are still lots of people with covid in hospital but they may have been admitted for non-covid reasons but tested positive once in hospital. The fact that hospitals are still testing patients is supplying some data.
The reason restrictions have been eased is that the pandemic has been mitigated by the vaccination programme and by now everyone who wished to participate will have been vaccinated. So now covid is being treated as a respiratory disease, similar to flu and although flu is responsible for many deaths prevention measures are similar.
Viruses mutate rapidly with some variants being more transmissible (such as omicron) and others more serious in effects. There is still ongoing surveillance but a lot of that is dependent on testing.
The risks are being mitigated by 1) vaccination 2) handwashing 3) ensuring good ventilation and 4) appropriate mask wearing.
There is an “evergreen offer” on covid vaccinations with any dose of vaccine available anytime whether it be the first, second or booster required. Additionally, there is now a spring booster programme for those aged 75+, residents in care homes, and those aged 12+ with a weakened immune system – these vaccinations will increase immunity levels.
Additionally, vaccinations are being offered to 12-15 year olds and 5-11 year olds can have a first dose. These can be booked via the national portal.
The future of the covid vaccination programme is not known but it may become a seasonal vaccination programme similar to the flu programme.
Four antiviral treatments are now available for community use and can be prescribed to people who are aged 12+ and at risk of becoming seriously ill with covid. The treatments vary between IV drip (given in a hospital setting) and tablets (prescribed by GP to take at home). Patients falling into this category once tested positive and symptomatic should start treatments within 24 hours.
The Chair put in a plea for front line workers to be offered booster covid vaccinations because unvaccinated people are putting others at risk. Ian stated that the vaccination programme is a balance of evidence of clinical risk and logistics but it is proven that for those aged 75+ the immunity system will be weaker. The vaccination programme had been a monumental task taking many resources (time, staff and money) that had to be diverted from other focuses.
The question was asked as to what is being done to encourage the unvaccinated as the numbers coming through now for vaccine have plateaued. Ian explained that some communities that have been specifically targeted such as Roma and some Eastern European as they initially been harder to engage. A pilot project had offered vaccinations at home with the hope of encouraging first time vaccinations but in fact most of the slots were taken up by people having boosters so it was not cost effective. Redbridge CVS have been recruiting community vaccination champions and so far 800 have been recruited out of a target of 1000. Redbridge Town Hall and Sir James Hawkey Hall had been used as large vaccination centres but the move is now to offering this within primary care settings such as Fullwell Cross Health Centre. To get the highest level of immunity from covid it is necessary to be vaccinated and not just rely on immunity as a result of having had the virus.
A PCR test is very sensitive and can detect the virus for up to 90 days after having an infection but the guidance now states that a person is infectious for only seven days (unless fever is present) rather than the original 14 days. However, fever indicates that infection is still present but other symptoms such as a cough may linger longer but not be infectious to others.
Faith communities wish to safeguard their elderly or vulnerable members when gathering for worship so Ian was asked for his guidance on this. His answer was that handwashing and good ventilation should be a priority and although social distancing restrictions have gone a 2 metre distance was very good advice as that distance prevents emissions being transferred person to person. Regular cleaning is recommended but it is no longer necessary to undertake deep cleaning or quarantine objects for 72 hours. It is important to be disciplined with the wearing of facemasks to avoid infection from say touching them a lot. The national guidance remains to wear face masks and use sanitiser in crowed places.
A question was asked about the safety of resuming in-person teaching of children instead of virtual when there will be up to 80 children attending a session. Ian replied that there is a balance of risk and evidence is now that social isolation is causing more harm and mental health issues than returning to social interaction.
The Chair shared his experience that in the early days of the pandemic the cause of death was usually given as covid whereas now covid is being shown as a contributory factor. There is some unrest in the Muslim community about the ongoing impact of covid on medical services. Two attendees shared their personal experience of this.
Several expressed concern that hospitals are still imposing rigid restrictions on visitors to inpatients and making people be unaccompanied in A&E settings citing clinical risk – Ian will feed that back.
Ian closed by assuring everyone that public health exists to increase equity and help public decision making. He shared that throughout the pandemic public health had been supported by Redbridge council leaders and had been meeting with them.
Ian was thanked for giving up his time and providing such a comprehensive overview of the situation and answering all our questions.