The pandemic has exposed and exacerbated the deep rooted differences in health and opportunity across society.
Levelling up is an issue of social justice.
But it affects everyone *not* just the most vulnerable:
- it will help tackle the pandemic
- it will accelerate the economic recovery
- it will improve national resilience against the next major health or economic shock
People who are healthier feel better, they are more productive, they play a greater role in their communities.
People living in deprived areas and from minority ethnic communities have not only been more likely to get COVID, but they have had worse outcomes once infected.
Around 1 in 3 social care staff are on the national living minimum wage, 1 in 4 are on zero-hours contracts.
Insecure jobs and casual work can mean the appalling choice of staying at home to protect colleagues and limit spread, or going to work to be able to pay the rent.
Even at home, cramped housing often means people can't effectively isolate from family members/housemates, further increasing risk of transmission.
Until the underlying factors driving ongoing high case rates - like housing and employment - are addressed, we will keep experiencing outbreaks with the potential for new and more virulent viral variants to emerge.
And further local lockdowns will simply mean that those places most in need of economic recovery suffer yet further.
And this is why separating health protection from the rest of public health is a false dichotomy.
The reforms have the potential to create a more, rather than less, fragmented public health system.
Some bits are welcome, like a new ministerial board to co-ordinate cross-government action on prevention, but there's still no independent scrutiny of gov actions on health and inequals.
There's also recognition of the importance of local gov & Directors of Public Health
But the public health grant – for local services on obesity, smoking, alcohol, sexual health etc – has had a real terms cut of 24% per head over the last five years
Any organisational upheaval also leads to workforce attrition.
Over the past 12 months, public health professionals across the country have worked night and day to keep the nation safe.
They’ve tracked how the virus spreads & led research; managed cases/outbreaks in the most complex settings; they lead the ID of new potentially dangerous viral variants to limit their spread.
They have done this & more+++ with huge dedication & often little recognition.
They are physically and mentally exhausted, and there is a risk that many highly skilled professionals will leave during the transition unless staff wellbeing and workforce planning are taken seriously.
As health secretary Matt Hancock said in his announcement, “levelling up health is the most important levelling up of all”.
To do this, the government needs a public health system that can work more closely across health security, health promotion, and inequalities.
The new structures may threaten this close working, but as with any new system bedding in, there is still the opportunity to shape things for the better.
Including respond to the current consultation, closing 26th April.
Further drop in cases in the most recent week following a bit of a flattening off in previous weeks - with some of this due to school holidays and fewer LFD tests.
Worth noting that for March, both REACT and ONS surveys suggest that case rates are generally static.
Big drop in LFD use, which is mainly due to a drop in test use by secondary schools (see T&T data).
The drop off has accelerated with the school holidays, but the move from testing in school to at home may have contributed over the past few weeks.
Looks 11-30 March (schools fully reopened on 8th March).
- Suggests infection rates fell by around 60% between Feb and March to 0.2%
- Big differences by age, region, and deprivation
- R now estimated at approx 1.
PHE latest COVID surveillance report now out, as is ONS.
Covers 22nd-28th March 🧵
tl,dr:
-cases down all ages except 10-19yrs.
-Significant geographical variation.
-Vax still motoring.
Fall in case rates in all age gps (incl 5-9y/o) *except* for 10-19y/o where they've increased by 7% to 110 cases/100,000.
Lowest cases rates are among 70-79y/o at just 11/100,000, and generally there's a step decrease in case rates for ages 60yrs+ compared to those <60yrs.
And among 10-19y/o, case rates seem to be rising mainly among 10-16y/os.
Nearly one in four reception age children and one in three children at year 6 are overweight or obese.
And there are stark inequalities - children in yr 6 are *more than twice* as likely to be obese if living in the most deprived areas compared to the least.
The government is aiming to halve childhood obesity by 2030 and reduce inequalities.
You can't do this with one or two policies here and there. Obesity is complex and multifaceted. To make any kind of dent, you need a multifaceted solution.