Health

Why is Kent's coronavirus outbreak spiking?


Kent has suddenly become England’s Covid hotspot and cases are rising in East Sussex, as the country prepares to emerge from lockdown into a revamped three-tier restriction system next week.

While the north faced the brunt of the second wave of coronavirus, infections surged across the South East during lockdown. 

Kent’s seaside boroughs of Swale and Thanet have endured the worst of the autumn surge, with infection rates of 646 and 516 positive tests per 100,000 people in the week ending November 18, respectively. It makes them the top and third worst in the country. Only Hull in the North East has a comparable outbreak, with most areas in the North seeing cases plummet during the national shutdown.

Medway and Gravesham – two other districts in Kent — also saw spikes of 40 to 50 per cent in cases over the most recent week, while the neighbouring county of East Sussex also experienced a 60 per cent rise from 70 cases per 100,000 people to 111 during the first half of November.

Scientists have blamed a lack of curbs in the South East in October for coronavirus infections continuing to climb, despite being three weeks into the national shutdown. Other areas across England that were placed in Tier Two or Three benefited from two weeks of tightened local measures before the full lockdown drove cases down further.  

Experts said a lack of tiered lockdown rules may have meant infections were spreading rapidly up until the point that lockdown was declared. 

Local officials say members of the public ‘disregarding’ social distancing rules and lax restrictions in supermarkets could be to blame. And one academic speculated many people in the South East may have felt hard done by with the blanket intervention, which could have led to complacency in sticking to the rules.

Other officials say prison and care home outbreaks may be contributing to the spread of the disease, along with the outbreaks being hard to stop in deprived areas.

While the numbers of tests being carried out has increased in the counties in the South East – between 20 and 69 per cent more tests were done in the second week of November than in the first, compared to a growth of 18 per cent nationally – the increase in cases has outstripped this, with positive results more than doubling in some areas.

Cases are now starting to fall in many parts of the South East as the effects of England’s national lockdown trickle through into official data — but if rates cannot be brought down far enough the areas could face tough local rules over the Christmas period.

Boris Johnson is expected to announce which areas of the country will have to follow tougher social distancing rules on Thursday, with England’s nationwide restrictions being lifted next week.

Swale and Thanet, highlighted in deep purple, have the highest infection rates in the South East – a region which was left relatively untouched during the early stages of England's second wave

Swale and Thanet, highlighted in deep purple, have the highest infection rates in the South East – a region which was left relatively untouched during the early stages of England’s second wave

Covid-19 cases have fallen across most of the North of England since lockdown was imposed, but they are rising in a corner of the South East. The percentage change is based on comparing data from the week ending November 15 to the week ending November 8. It comes as the Government prepares to unveil its tier system

Covid-19 cases have fallen across most of the North of England since lockdown was imposed, but they are rising in a corner of the South East. The percentage change is based on comparing data from the week ending November 15 to the week ending November 8. It comes as the Government prepares to unveil its tier system

Official Government data shows Swale now has the highest infection rate in England at 647 cases per 100,000 people per week, as of November 18 – the most recent reliable data.

The rate had surged from 426 per 100,000 a week earlier, on November 11, and from 241 the week before that.

Kent as a whole, according to separate weekly data collected by Public Health England, saw its rate of infection rise by 44 per cent in the most recent week, up to November 15. 

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It was the fourth fastest increase in the country and put the county at a rate of 267 cases per 100,000. Although the increase was rapid, the rate remains relatively low – it ranked around 66th out of 149 local authorities.

Local areas within Kent have seen sharp rises in cases, with the seven-day average number of new cases more than doubling in Canterbury, Folkestone, Medway and Swale at the start of this month.

The number of infections in Medway surged from 402 in the last week of October to 1,110 in the week that ended November 19. In Swale it rose from 304 to a peak of 983 in the seven days up to November 16, but has since started to fall.

While the number of tests carried out in Swale rose by 49 per cent from 2,854 to 4,252 between the week ending November 4 and the one ending November 11, cases surged by 77 per cent in the same time.

And in Thanet test numbers increased by 68 per cent from 3,526 to 5,939 in the same time, accompanied by a 95 per cent rise in cases. This suggests a boost to the number of positive cases may have contributed to a rise in the infection rate but that there was a real increase, too.

Council officials in Kent met on Friday and Monday to discuss the county’s outbreak.  

Some of the driving factors behind rising case numbers included outbreaks in two care homes on the Isle of Sheppey and more than 90 inmates testing positive at Elmley prison on the island, Kent Live reported, but these only make up around 12 per cent of the area’s cases. 

The leader of Swale’s council, Roger Truelove, warned people last week the area would face tougher restrictions in December if people did not try harder to get the virus under control.

He accused some members of the public of ‘wilful disregard’ of social distancing rules.

In a meeting on Monday Mr Truelove said: ‘I know most people and businesses are doing what they should, but it is frustrating to still see people not wearing face coverings or keeping their distance when they should.

‘This kind of wilful disregard of the rules means we are more likely to have further restrictions imposed on us in December, which is hugely unfair for people and businesses who have been doing the right thing since March,’ he said, the BBC reported. 

In a statement after the meeting Mr Truelove said: ‘Whilst we do seem to be starting to see a fall in cases locally, they are clearly still too high.’

He added: ‘The overwhelming majority of cases are through community transmission. It’s spreading in residential settings, and through social activity and it only takes a small number of people to create the clusters of cases that are driving up our figures…

‘We will be getting in touch with local supermarkets to ask for them to be as vigilant as possible, and we will be carrying out work to make sure everyone involved understands the reasons why people might not feel able to follow the rules.

‘Parents seen with in supermarkets with children who should be isolating may not have any other childcare and can’t afford the minimum spend for a home delivery. 

‘People may be unwilling to get a test as they can’t afford to have time off work. These are issues we need to be able to identify so the relevant agencies can step in with the right support.

‘Everyone is committed to making sure people understand the seriousness of the situation to people, and if we don’t follow the rules in place, we face a winter of further restrictions.’

Andy Booth, a Conservative councillor for the Isle of Sheppey, which forms part of the Swale district, said he had seen residents disobeying social distancing rules.

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He told MailOnline that beach parties during the summer may have kept the virus circulating and an unwillingness to obey rules now meant it was taking longer for cases to fall.

‘There are certain areas of the island where there is complete disregard for authority, for guidance, advice and rules,’ he said.

‘To the point where people refuse to wear face masks, they refuse to socially distance – they just want to be anti-establishment.’ 

He also pointed the finger at supermarkets and added: ‘In large stores there are many incidents where people working refuse to wear face masks, and many people entering those stores refuse to wear face masks.’ 

Above are infections before winter in September (right) and those on November 18 (left) after the second lockdown

Scientists were more reluctant to say that people in the county were any worse at following the rules than in other parts of England.

But the fact the county was in Tier One until this month may have meant that the virus spread more widely before lockdown was announced and that residents may have been angrier about being thrust into a complete shutdown because of what was happening in other parts of England.

Professor Martin Michaelis, a virologist at the University of Kent, told MailOnline: ‘In the places in the North that went into Tier Three and then went into the lockdown, you see [in falling infection rates] the combination of Tier Three and then lockdown, whereas we were in Tier One in Kent – as we know, Tier One wasn’t successful in keeping the virus down… 

‘If people were in Tier One they may think “we’re being punished by the lockdown” and there might have been a bit of complacency compared to if you’d been in high numbers for a long time.’

But he said it was too much of a stretch to suggest people in Kent were any worse at following rules than the rest of the country.

‘It’s not as easy as to say that because it’s spread somewhere that it’s down to people not behaving appropriately,’ he added.

‘In every area you see people are more or less stringent in following rules and in other areas you think “oh, the virus is going to spread here”.

‘You see not everybody is not as thorough as they should be but you’d need to have clear evidence that this is why it’s worse in one area than another – it’s a very difficult question.’ 

Professor Paul Hunter, an epidemiologist at the University of East Anglia, told MailOnline: ‘I think the simple answer is that they [Swale, Thanet, Medway and Elmbridge] were all in Tier One.

‘And we know both from my own work and indeed Public Health England’s that Tier One doesn’t work [in bringing down infections].

‘Overall, pretty much every authority in Tier One — not quite all but virtually all — were still showing quite strong growth in [their] epidemic before lockdown.’ 

While people’s behaviour might not make the spread of the virus more likely in one area than another, their living conditions can contribute to how fast and wide the virus can spread in a short period of time.

Kent’s public health director, Andrew Scott-Clark, said high levels of deprivation in the hard-hit areas were making it more difficult to keep outbreaks under control.

Poorer areas are known to be worse affected by coronavirus because more people do jobs that can’t be done from home so they have to keep going to work, and families often live in larger households, so are at risk of spreading the virus to more people when they catch it.

Mr Scott-Clark said: ‘We can see from some of the postcode data that residential settings and whole families are being affected on the island.

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‘Of course those areas where people can work at home are probably less affected and you can see that pattern across Kent.’ 

He said: ‘They are effectively some of our care workers and key workers who have to go out and are more likely to be exposed by the virus.

‘Particularly those communities where there are multi-generational homes or [where people] are really challenged in their ability to self-isolate.

‘As we know [this causes] Covid clusters, which means the whole family is likely to come down with the virus.’

WHERE IN ENGLAND ARE COVID-19 CASES RISING FASTEST? 

Public Health England data for the week ending November 15. Positive coronavirus tests per 100,000 people. 

Infection rate (Cases per 100k)

East Sussex

Herefordshire

Milton Keynes

Kent

Greenwich

Medway

Southend-on-Sea

Enfield

Slough

N. Lincolnshire

Merton

Croydon

Havering

Camden

Hammersmith 

Bedford

Bromley

Kingston

Hackney

Cornwall 

111.8

183.1

188.5

267.2

176.1

299

174.7

210.3

338.4

469

168

156.5

357.2

133.3

208

166.2

155

184.2

163.7

84.3

+58.81%

+56.90%

+50.32%

+44.98%

+44.46%

+39.26%

+33.26%

+32.93%

+32.14%

+31.59%

+29.43%

+28.49%

+28.40%

+27.68%

+26.67%

+26.29%

+26.22%

+25.31%

+25.25%

+24.52%

WHERE IN ENGLAND ARE CASES FALLING FASTEST? 

Public Health England data for the week ending November 15. Positive coronavirus tests per 100,000 people. 

Infection rate (Cases per 100k)

Warrington

Oldham

Wigan

Blackburn 

Knowsley

Nottingham

Sheffield

Salford

Bury

Torbay

NE Lincolnshire

Doncaster

Trafford

Rochdale

Wirral

Tameside

Barnsley

Manchester

Derby

St. Helens

259.5

519.2

403.2

509.7

247.9

245.7

266.2

413

433

202.6

495.1

336

307.1

478.8

166.7

369.1

372.7

352

382.4

268.6

-32.54%

-30.68%

-30.29%

-29.75%

-28.62%

-26.17%

-24.97%

-24.57%

-24.06%

-23.32%

-23.30%

-23.29%

-22.45%

-22.10%

-21.85%

-19.85%

-19.78%

-19.45%

-19.09%

-18.06%

Similar patterns, of the virus spreading more among people in less well-off areas, were seen in the North of the country and the Midlands – during the summer in Leicester and later in Greater Manchester and Liverpool.

Throughout the pandemic urban areas – mainly cities – have been worse affected than rural places where people are better able to stay apart, use less public transport and come into contact with fewer strangers. 

Professor Michaelis said: ‘It is clearly the case that when you look at the three regions in the north of Kent – Medway, Swale and Thanet – that these are relatively deprived areas where people do manual labour a lot, so there is clearly an element of that. 

‘Whether that is responsible for what we see now is difficult to say – the scientist in me says it makes it more likely that such an area is more badly affected, but you will find other areas that are similar but rates are lower and the difference is just by chance.’         

The concerns about Kent come as England gets set to enter a new period of three-tier local lockdown rules when the national shutdown lifts next Thursday, December 2.

Boris Johnson yesterday unveiled his winter Covid-19 road map to curb the spread of the virus, which includes a toughened up tiers system. 

Under the new scheme, pubs and restaurants in areas in the highest category will only be able to offer takeaway and delivery services, while cinemas, bowling alleys and hotels must close.

Residents in Tier Two will have to follow rules that were previously in place in the highest Covid level – meaning pubs will only be able to serve alcohol with a ‘substantial meal’.   

Exactly which areas are being allocated into different tiers won’t be announced until Thursday, but the PHE weekly infection rate data is normally one of the measurements used by officials.



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