A top north-east doctor has recommended “more severe” Covid restrictions for Grampian in the run-up to Christmas, amid a rapid surge in cases.
NHS Grampian public health consultant Derek Cox says areas like Aberdeen and Moray are experiencing higher case numbers than many other parts of Scotland.
While the north-east accounts for around 10% of the national population, its share of coronavirus cases is far higher.
A number of potential explanations are being considered but health chiefs admit they’re still “hunting around” for the full answers.
People behaving ‘as if Covid’s gone away’
Across Scotland’s council areas, the steepest rise is in Moray followed by Aberdeen.
By comparison, case numbers in the central belt appear to have stabilised after larger outbreaks in recent months.
Dr Cox said: “It might be that they’ve got a population that has a greater degree of immunity because of [those outbreaks], than we’ve got up here.
“But we can’t get away from the fact that the other possible explanation is that people are behaving as if this problem has gone away, which it clearly hasn’t.”
He says misconceptions that double-jabbed people can ignore Covid measures – like social distancing, wearing face coverings and washing our hands – are running rife.
Jabs may be wearing off
Another reason why numbers might be on the rise, particularly in Moray, is because of the outbreak the authority tackled in April and May.
In an effort to fight the spread of infection, NHS Grampian pushed a major vaccination drive to get residents protected against Covid-19.
Dr Cox believes one explanation might be the jabs’ immunity falling off around the six-month mark.
“For example, the AstraZeneca vaccine’s efficiency at stopping you from getting the infection is down to about 44%,” he said.
Another reason could be pockets where vaccine uptake and testing are both low.
“Again, we really need to be urging people to be aware that this problem has not gone away,” Dr Cox added.
“All the precautions that we were advocating a year ago, we continue to advocate them today.”
Surge not limited to schools
Some believe the surge in cases is largely being fuelled by schools.
It comes amid news of Covid-19 related school absences rising, with the latest figures showing the number of pupils staying home sick this week almost doubled in Aberdeen.
Dr Cox emphasised that, while it’s certainly the case that Covid is being detected in schoolchildren, it doesn’t necessarily mean that the transmission is only taking place in the classroom.
Instead, this might just be a “barometer of what is happening in the widespread community”.
He added: “If you have got contacts that are not associated with a school, that doesn’t mean you don’t have to worry.
“You still have to take the precautions just as before.
“It’s the relaxing of vigilance about these precautions that may very well be the most important driver of the increase here.”
Just five more patients could send hospitals over the edge
Compounding the crisis, NHS Grampian’s hospital occupancy is almost at full capacity—in other words: the wards are full.
Dr Cox says this is largely because of the other illnesses that spread in winter like flu and RSV, which can be particularly harmful to children.
Additionally, more people need to be seen at A&E for slips and falls, heart attacks, strokes and other respiratory infections.
“But the number of hospital admissions from Covid adding to this are like the straw that’s breaking the camel’s back,” he added.
Dr Cox warns, if coronavirus admissions rise any further, they could be entering an “untenable” situation at Aberdeen Royal Infirmary.
“The idea that we don’t need to worry about Covid because we’re not seeing as many hospital admissions as we did a year ago – we’ve got to get that idea out of people’s heads,” he said.
“An extra five admissions to hospital will make the hospital over-capacity.”
Should we be cracking down on Covid now?
In The Netherlands, early curfews have been imposed on supermarkets, restaurants and bars, while Austria has started locking down the unvaccinated.
Earlier this week First Minister Nicola Sturgeon confirmed there will be no immediate changes to Covid restrictions in Scotland.
She said the vaccine certification scheme could be extended to cover the likes of cinemas and theatres from early December, however.
Dr Cox said issues arise as the matter requires a balance to be struck between politics and public health.
“From the political side of things, people are anxious to try to get children, in particular, continuing their education,” he said.
“And so that that’s perhaps regarded as more important than some of the public health considerations.
“Ditto there are economic considerations about people continuing to be at work.”
“If I was to view this from a purely public health point of view, rather than having to look at it in the wider context, I would be saying we should be moving to some kind of more severe measures sooner rather than later.”
‘Too early’ to say if more boosters needed
This week the chief executive of NHS England said staff south of the border are preparing contingency plans for a long-term Covid booster scheme.
Dr Cox says it’s “perfectly feasible” we could reach a stage where everyone has to top up with a coronavirus jab every six or 12 months.
At the moment, however, he feels more evidence is needed to back up any decision, and scientists will likely want to see the situation once the current booster roll-out is complete.
“It’s certainly conceivable if the immunity levels start to fall off and we continue to have community spread of Covid… we could get into a six-monthly or annual round of immunisations
“But I think it’s too early to predict that at the moment.”