COLUMN - By Professor Dominic Harrison, Blackburn with Darwen public health director

We started the first big lockdown lifting step this week.

What are the risks for Pennine Lancashire and what are the five main things we can do now to control those risks?

On Monday, as things opened up across England, the Covid rate for Blackburn with Darwen, though at its lowest point for months, was about twice the national average rate.

We were at about 65 cases per 100,000 and the national rate was just over 30 per 100,000.

This presents the obvious risk that our rates will rise faster as each social contact will have double the risk of contact with an infected person.

We will have to work hard to manage this additional risk and the five things that will control it (in order of effectiveness) are as follows:

Firstly we must be assiduous in sticking to the hands, face space, fresh air/ventilation guidance and stick very carefully to the Covid safety rules for workplaces, faith settings, schools etc.

Second we need to maximise the uptake of vaccination which not only prevents hospitalisation and early death but is now shown to reduce community transmission.

As we have higher risks, we need the government to agree to allow us to accelerate vaccination in our area to match that and give us equal life chances to the rest of the country.

Thirdly, we all need to get a PCR test if symptomatic, and if not, to test ourselves twice weekly with Lateral Flow Devices. We can now apply for these free on line. We will need to get a confirmatory PCR test if we are shown as positive.

Fourthly we need to increase the percentage of those testing positive who fully self-isolate. National research shows full compliance with self-isolation is very low – maybe as low as 30%.

This means that many of us, even though we are positive are risking spreading the virus.

We know that it is harder for many communities to comply with self-isolation guidance for financial reasons.

Blackburn with Darwen Council is working with central government to see how we can help to improve self-isolation compliance and support.

Fifth, we need to be very careful to support and isolate family members in our household who do get a positive Covid diagnoses. Data for many areas with high transmission rates show that a very large percentage of our cases are in ‘household clusters’.

In the last two weeks we have had one case where a single household member became positive and inadvertently infected both their children and the grand-parents.

This one case generated six others in the family.

With low numbers this ‘multiplier effect’ of single cases becomes even more significant in the spread and rates across the borough. This one case doubled the rate in that electoral ward on that day.

It is very difficult to isolate an infected household member in a smaller house with a large number of household members – but to control the spread across Pennine Lancashire we do need to get better at managing this situation.

As we open up, there are things we need to do, and things we need government to do if we are going to continue to keep the rates down.