By Dominic Harrison, Blackburn with Darwen Council public health director

AS of Tuesday 21st September, Blackburn with Darwen's Covid case rate fell again to 231 per 100,000 - a 29 per cent drop over the last seven days.

The North-West rate was 311, a 17 per cent reduction, and the England rate was 259 - a fall of 22 per cent.

Despite the predicted rise in case rates for school aged children, it seems that many areas have seen overall Covid case rates fall in the last week. For now at least, the overall picture across the country is remaining relatively stable compared to other periods in the pandemic. This is really good news.

Many schools across Lancashire have seen rising rates in education settings and in a few cases, school outbreaks. These are being well managed by the schools themselves with support from parents and the local authority education services, supported by local public health advice. It is difficult to predict how the rate of schools based outbreaks will develop. On the one hand we will shortly be vaccinating 12 to 15 year olds, which should start to have a rapid suppression effect on overall transmission and infection rates in schools settings.

However, this effect will take quite a few weeks to register at the whole population level. We started rather late compared to other European and north American countries. Until then, we will just need to manage the risks in school settings as best we can, within the overall Department for Education guidance framework.

Many of our most important local public services are now in the middle of ‘Winter Planning’.

Looking back at last autumn and winter we can see that although Covid case rates rose significantly from the first week of September last year in Pennine Lancashire we did not see a hospitalisation admission surge starting until October 2. This peaked on December 2 and rates fell slightly over Christmas only to rise again more sharply from early January, due the Alpha Variant spread.

It is simply not possible to predict whether similar patterns will emerge this autumn. We may get a steady state of ‘endemicity’, where slowly rising cases and hospitalisations over the autumn and winter are matched by rising protection from increased vaccination immunity.

Alternatively, we may get a surge in cases and hospitalisations in mid-late autumn amongst the ‘as yet unvaccinated’ coupled with a four to seven per cent vaccine waning effect per month among those not yet ‘boosted’ with a third dose.

Either way an increasingly important ‘early alert indicator’ will be ‘Covid hospitalisation doubling times’. At the moment East Lancashire Hospitals Trust seems steady with 41 Covid hospitalisations. It is running on a ‘Hospitalisation Doubling Rate’ for Covid of 80 days – so whilst the hospital is definitely under pressure (along with GPs), we are managing OK for now.

If things do go ‘pear shaped’ over the autumn and winter due to a significant Covid surge, and we do need to move to a national Covid Plan B approach, we think we may get seven days’ notice. Across Pennine Lancashire we have good local collaboration so should pick up any risks very early on.

The ‘top tip for personal winter planning’ is clear: As soon as you are eligible, and invited get your flu jab, both your Covid jabs, and your Covid Booster jab. All ASAP!