21st April 2020 – COVID-19 Briefing from Justin Varney, Birmingham County Council Director of Public Health

On Tuesday 21st April the Alliance Network hosted our first ever virtual event, with guest speaker Dr Justin Varney, Birmingham County Council (BCC) Director of Public Health, with a briefing on  COVID-19. This article is a summary of what Dr. Varney told our members on the call.

Enormous thanks to Dr. Varney for sharing his time with us.

Justin focussed on the current status of the Coronavirus from a Birmingham & Midlands perspective, what the next steps might look like in the short to medium future and concluded with some Q&A from the call.

First of all data; there are lots of figures out there, but from a BCC perspective, they focus on the local authority level information and information from the local NHS hospitals. Birmingham have over 2,000 cases that’s the most out of any local authority in the UK but this is expected as it is the biggest, with 1.1 million residents. Therefore it is more useful to monitor the infection rate, i.e. cases per 100,000 residents, this helps track how the city is doing compared to others. Compared to other areas in the West Midlands, Birmingham was 4th highest on infection rate in West Midlands behind Walsall, Wolverhampton, Sandwell at the time of the interview but has now fallen back to fifth highest rate as Solihull has overtaken the city. Compared to the other core cities (England’s major cities outside of London) Birmingham ranks 4th behind Sheffield, Newcastle and Liverpool.

Unfortunately there is little data on demographics, such as sexual orientation, gender or race, however both locally and nationally there is work to better understand more detail of how the outbreak is spreading.  We do know that the virus does dis-proportionality kill those in their 80s, and there appears to be worse outcomes for people with pre-existing long-term health conditions such as diabetes or high blood pressure.

A popular question which Justin is often asked is around lockdown and when we are likely to be out of this. Justin’s view on this was that if any decision is to be made on relaxing any form of lockdown, they will need to see 6 days’ worth of consistent data which they are not currently getting, and this also needs to be informed by those countries further ahead than us in Europe and learning from the steps they take to ease lockdown and the impact on cases and deaths.

Death figures are usually 2 weeks behind infection rates. However Justin expects that Birmingham is unlikely to see any changes to the lockdown until the very end of May, perhaps early June.  When any relaxation may occur, this will be in small incremental steps.  The UK is looking at Europe and what steps they have taken and when. All European countries have taken different steps,  no one has a fail safe way of doing it, for example some have let nurseries and some shops to open back up, and we will observe what impact this has on re-bound figures (if any).

The best way we can help at the moment, is for people to stay healthy at home.  This virus is being compare to the 1918 Flu Pandemic, which we can learn from, as this demonstrated, that if you break a lockdown too early, you will have a second peak of infections, and therefore deaths.

Care Homes

The outbreak is disproportionality affecting care-homes, however Birmingham and Solihull reacted quickly and so have been coping well with low infection rates in these locations. However we do expect more intelligence on deaths in care homes shortly. (This was subsequently published on the 28th April).

Testing

There are two different types of tests currently out there:

1)      PCR (Polymerase Chain Reaction) is a test which obtains a sample of the virus from your nose or the back of your throat, using a swab a bit like a cotton bud.

2)      Antibody Test – This tests for immunity but it is unclear if you have this for 1 month / 1 year / or not at all – it is just not reliable enough so UK are not using it.

Reflecting on the reasons why testing has taken a while to scale Justin explained that these are not tests the UK does routinely and lots of the raw materials are imported and it has taken to get the system moving at scale in the UK but the lab capacity has been steadily increasing, especially in recent weeks.

Health at Home

One way to help people’s state of mind, particularly those who are identified as “shielded people” is to set long term expectations that the lockdown will be in place for some time and it may take 12 – 18 months to move into a post-covid way of being. Hoping and expecting it to alleviate in 3 weeks’ time, or in time for summer, will be frustrating, but perhaps if we look more towards Christmas, it will help people adapt better. Although there are promising signs in terms of a vaccine this takes a long time to develop so if we get it rolling out before Christmas we will have done well. At present there is an emerging science to try and understand if people can be re-infected  again if they have already had it as we don’t know how long immunity lasts and if you develop it from a mild infection.

BCC are launching some good support programmes such as developing a range of youtube videos with local businesses on cooking, physical activity, mental wellbeing and learning more about our gardens and our city. Follow @healthybrum to keep up to date on what’s new and signposting to useful resources to keep healthy at home.

Questions & Answer posed to Justin:

Q1) Is there anything the Alliance Network can do to Help?

Justin: Follow on Twitter @drjv75 and @healthybrum, share with your businesses, the most damaging  issue is fake news, so please helps us share trusted sites

Q2) How are you finding your new role?

Justin  – has been in the role for around 14 months, and although this is the largest council in Europe, he has trained for this kind of emergency, however, like his colleagues, never expected to see this in their lifetimes.  SARS was not as big, the Coronavirus is the biggest most complex pandemic since 1918.  Justin shared that he maintains his mental health by pot gardening, getting on his “desk bike” and is lucky enough to have a balcony, where he as a prime position looking at how long the Tesco queue is!

Justin did also share, that like everyone else he has had periods of being overwhelmed, but works with his team to ensure he also takes time off and remind us all that it is important to talk about the emotional strain of leadership during these times.

Q3) How do you feel social-distancing is now in the City?

Justin shared that in general, the public are being responsible and behaving. The BCC worked with faith and community groups and local media to get messages out and continues to reiterate this as it is the steps we all take that really save lives.

Q4) My dad is 80 years old and so falls into the shielded group, what is your opinion on when his restrictions might be lifted?

Justin share his own thoughts on intermittent lock downs not being a good thing, as it will cause spikes in numbers.  The current thinking is that there will be small steps over the next year to reduce the lockdown and he expects these will start towards the end of May, beginning of June.

To help your dad’s mental health, if his mind-set is adjusted to aim for a Christmas, then if the restrictions are lifted it is earlier then it will be better received.

Q5) Pride season is coming up and Birmingham Pride was moved from May to September however could this now be too soon?

Early September does seem optimistic, mass gatherings will be one of the last things to be relaxed, so we will be reliant on the numbers dropping the next two weeks. 

Q6) Do you have indication how this might affect the Common Wealth games, due to be held in Birmingham 2022?

Construction was paused as the lockdown happened, but is slowly opening up in line with national guidelines.  The current situation is that we expect the dates to only move by a week or so, as the games are not reliant on the Olympics and associated championships in the run up. 

Q7)  Any advice for stay at home carers?

For these groups of people, it is important to stay healthy and also to ensure there is “me time”. 

Q8) On the news we have seen cases of domestic volumes go up, how is the Midlands faring?

We are not at the moment seeing this go up across Birmingham and the West Midlands in terms of the police data, but we are helping promote the “No Excuses” national campaign and working with the government on this to provide clear statements that people should not stay in abusive situations because of lockdown, support is available. This is for all and is regardless of genders or sexual orientation.

Summary

Justin gave a clear overview of the current situation of Coronavirus in Birmingham and the West Midlands and answered our questions openly and honestly, it was a great opportunity for Alliance members to ask direct questions of someone who is closely involved in responding to the pandemic in our region.