Column by PROFESSOR DOMINIC HARRISON,

Blackburn with Darwen Council public health director

THIS week, political leaders in many northern regions, including Lancashire, have been in complex discussions with central government about the possibility of stepping up their Covid-19 Alerts Levels from level two to level three.

Directors of public health in Blackburn with Darwen and Lancashire County Council believe that most of Lancashire will need to move to level three as soon as possible, but that these measures are unlikely to result in a sharp downward trajectory in four weeks’ time and that further measures will be needed.

Local authorities agreeing to escalation of control measures to tier three are also making it very clear to government that vulnerable individuals will need to be protected, more resources will be needed for enforcement and community engagement and that businesses will need support to manage the consequences of lost income.

The rate of growth of new cases of the virus each day is rising exponentially in a number of regions of the UK. For most, the main source of transmission is still between family, friends and neighbours. The single most risky place for transmission of the virus is your own home but household transmission is the least easy place to regulate or control by inspection and compliance measures.

To effectively control household transmission between family, friends and neighbours, we really need to change hearts and minds. We need people to be persuaded that sticking to the social mixing guidance is the right thing to do.

This is now the key challenge to controlling the spread of the virus, but everyone has understandably, just had enough of Covid-19.

Our communities have what the World Health Organisation is now calling ‘Pandemic Fatigue’. WHO say Pandemic Fatigue is ‘a natural and expected reaction to sustained and unresolved adversity in people’s lives. It expresses itself as demotivation to engage in protective behaviours and to seek out information, as well as in feelings of complacency, alienation and hopelessness’.

The solution, WHO argue, is a different approach to managing the second wave of the virus. We need more local civic engagement at neighbourhood and community levels with communities identifying their own very local causes and solutions of continued Covid-19 transmission. WHO argue that community level solution seeking rather than solely relying on more laws, fines or inspections is our best bet for the next steps. Rules and compliance measures are necessary but as the rising rates show, they are not enough – and they are not fixing the problem.

It is also clear that some kind of ‘circuit breaking lockdown’ is more than likely as a next step. Just what this might involve, and how we make the measures really work, is going to need a much broader civic discussion. We don’t have long - both general and intensive care beds are now filling up again fast with seriously-ill Covid patients across the North-West.

We are going to have to find a way through the second wave together.