CMO statement 21 Day COVID-19 review: 28 October 2021

Chief Medical Officer for Wales statement on 21 Day COVID-19 review: 28 October 2021.

Cases of COVID-19 and test positivity rates have continued to increase and Wales is experiencing an exceptionally high rate of community transmission that is not falling in line with modelling expectations. The issuing of false negative PCR test results for welsh residents may be contributing to this uncertain epidemiological position but other factors including a possible impact of increased transmissibility of the Delta sub-lineage AY.4.2 requires further investigation. I have asked Public Health Wales and the Joint Biosecurity Centre to undertake further assessment as to why the community rate in Wales is higher than in other UK nations and why it is not falling as predicted. 

I note with concern the rise in case rate in the over 60s age group and rises in hospital admissions. This is likely to reflect both transmission from younger to older age cohorts and an effect of waning vaccine immunity. 

The NHS has been under sustained pressure for an extended period.  Although the COVID-19 contribution is much less than was seen in previous waves, COVID-19 bed occupancy rates are rising by around 10% per week so we can expect further direct COVID-19 pressures to accrue as long as community rates remain high. 

It is timely to consider further restrictions aimed at reducing prevalence and protecting the vulnerable. In particular, I support increasing vaccine uptake (including boosters) as the most important measure in mitigating the health impacts of COVID-19.  Discussions have been held with the JCVI on the best interval between the second dose of the vaccine and the booster.
I also support any reinforcement of the range of measures that can be used to encourage and support working from home as a way of reducing transmission of the virus. 

Our better understanding of high secondary attack rates within households brings into question the current policy of non-isolation of household contacts. There would be risks in reversal of this policy including loss of essential staff, reduced public confidence, and undermining of the centrality of vaccination as a protective measure. I therefore support the modification of this policy to require vaccinated household contacts and 5 to 17 year old household contacts of a positive case to self-isolate pending receipt of a negative PCR test result and to remove the requirement for a day 8 PCR test.

The UK Alert Level remains at UK Level 3 but is trending towards UK Level 4. We should watch the evolving public health picture carefully over the coming weeks and Ministers may need to consider a move towards a more comprehensive set of Welsh Alert Level 1 restrictions during the next 21 day review cycle.

Dr Frank Atherton
CMO Wales