IT is now around a month since Boris Johnson announced a series of stringent measures that have transformed our way of life.
On Thursday we were told by foreign secretary Dominic Raab that the UK would remain in lockdown for “at least” another three weeks.
The former Brexit secretary, who is standing in for Boris Johnson while he recovers from his own battle with coronavirus, told journalists in the daily No 10 briefing that a review had concluded relaxing the measures now would risk harming public health and the economy.
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As of 9am on Saturday, 114,217 people have tested positive for coronavirus in the UK, according to the Department of Health and Social Care.
More than 15,000 of those hospitalised by the disease have died.
About a month ago, Stephen Powis, the medical director of National Health Service England, said that if the total death toll fell below 20,000, that would be a “good result”.
Given the current trajectory, surpassing 20,000 appears inevitable, and will likely be done by next week.
The UK may have even surpassed that number already when deaths in the community are factored in, such as in care homes, although the data is somewhat unclear at this moment in time.
It was revealed on Friday that only 12 out of all the care homes in St Helens have reported no cases of people showing symptoms of coronavirus.
St Helens Council also confirmed that, in the week leading up to April 16, 34 people had died in the borough’s care homes, with eight of those “definitely” related to COVID-19.
Here in St Helens, another grim milestone was reached on Saturday.
NHS England confirmed that 103 people who contracted coronavirus have died at St Helens and Knowsley Teaching Hospitals NHS Trust.
This is significantly higher compared to Warrington and Halton Teaching Hospitals NHS Foundation Trust, which has registered 52 deaths.
Wrightington, Wigan and Leigh NHS Foundation Trust has registered 84 deaths.
The infection rate too has been higher in St Helens and Knowsley than all of these areas.
At one point, the infection rate in St Helens was the second highest in the North West, per 100,000 population, but has fallen to third after being-leapfrogged by Knowsley.
Why this is, remains unclear at the moment, although there are some speculative theories.
What are the MPs saying about the current situation?
Marie Rimmer, Labour MP for St Helens South and Whiston said: “Coronavirus is putting our community spirit at test in a way that it hasn’t been for a generation. Along with many of you, I have been following the numbers of deaths being reported at St Helens and Whiston hospitals.
“It is important to remember that they are not just numbers, each one of these losses is tragic. Each death leaves behind loved ones that will carry on in their memory.
“At the current time it is difficult to draw conclusions about why certain areas of the country seem to be affected more.
“The leading medical and scientific experts across the world are increasing our understanding of the virus more and more each day, but currently we do not know enough about it to discover why certain town and cities are showing more cases in hospitals.
“For now, all our efforts need to be on following the official advice to stay at home. We all have a part to play to protect lives.”
Conor McGinn, Labour MP for St Helens North said: “It’s clearly a cause for concern that our figures appear to be elevated, and I have asked Public Health England if they have identified any patterns or causes for this.
“Having spoken to the Chief Constable, he is clear that there is no evidence that people in St Helens are not following rules about social distancing and instructions to stay at home; quite the opposite, in fact.
“I also know that Whiston Hospital has been carrying out significant levels of testing since the outset of this crisis.
“I’d urge people not to speculate about the figures, or share unverified information online, which will only cause undue anxiety to an already worried community.
“The best thing everyone can do to keep safe and protect our NHS is stay at home.”
One reason that has been suggested for the high death rate is the health inequalities that features so prominently in many of St Helens’ communities.
According to the government’s English Indices of Deprivation 2019, which was published last September, St Helens is ranked as the 26th most deprived local authority in England out of 317.
The document is published every four years and brings together data – such as health, education, housing, and living environment – to compare the relative deprivation of small areas in England.
St Helens’ relative position has deteriorated since 2015 when St Helens was ranked as the 36th most deprived area out of then 326 authorities.
The two areas where St Helens demonstrates the highest levels of relative deprivation relate to health and employment.
St Helens ranks as the 8th most deprived authority in terms of relative health deprivation and disability.
The borough also ranks as the 9th most deprived authority in terms of employment deprivation.
Life expectancy – which is closely related to people’s socio-economic circumstances – is also lower in St Helens than North West and England averages.
According to the Office for National Statistics, men in St Helens currently live on average 77.5 years and women live on average 81 years.
For men, 19 of those years will be spent in poorer health, while women will spend even longer on average, spending 21.6 years in poorer health.
St Helens as a whole also has an older population than North West and England averages, with 20 per cent being over 65.
It has been widely reported that COVID-19 disproportionally affects people over 70 and those with underlying health conditions.
According to the last census in 2011, 40,262 people in St Helens – 23 per cent of the population – were living with limiting long-term illness.
In addition, 14,507 people (8 per cent) were not in good health.
Again, both are higher than North West and national averages.
The two leading causes of death in St Helens is cancer and cardiovascular diseases, according to the public health annual report 2017-18.
In 2017, cancer was the underlying cause of death for one person in four people (25 per cent).
When grouped together, cardiovascular diseases were responsible for 24 per cent of deaths in 2017.
Smoking is a major cause of cardiovascular disease and a leading cause of cancer. Historically, the proportion of smokers in St Helens has been higher than North West and England averages.
In 2018, there were 22,651 smokers in St Helens, 16 per cent of the population, according to the Annual Population Survey (APS).
This is the lowest on record for St Helens, despite being slightly higher than North West and England averages.
In 2017, just 1.7 of deaths in St Helens were due to infectious diseases.
The relatively high number of deaths in St Helens could simply be, in part, down to the high infection rates in the two main areas Whiston Hospital serves.
Currently, according to data from Public Health England, there have been 431 confirmed cases in St Helens and 362 in Knowsley.
But these figures do not take into consideration those people who have shown symptoms and self-isolated but have not been tested.
Testing has largely been carried out in hospitals, with a limited capacity in the community. It is unclear how much testing has been carried out in the borough’s care homes.
In reality, the true infection rate is likely much higher than the official figures, but this applies to other areas, not just St Helens.
Testing for frontline NHS staff and social care staff, as well as any of their family members showing symptoms, is now increasing, with a mass testing centre now set up at Haydock Park Racecourse as part of a wider UK network.
This means the number of confirmed cases in the coming weeks may increase even further.
“Like all other residents, I find the high infection rate in St Helens compared to other boroughs extremely concerning,” Cllr David Baines, leader of St Helens Council.
“Local intelligence is being collated from Whiston Hospital where most of our tests have been undertaken to date, and we’re also gathering information from our local registrars on deaths in the community to help us fully understand the local impact of COVID-19.
“While that research is ongoing, at this stage it isn’t possible to know for certain why our rates appear to be higher than similar areas.
“It is possible that the already high rates of COPD and other respiratory illness in St Helens are having an impact.
“A history of mining and industrial work has no doubt taken its toll on many in our local population.
“Additionally, we have significant poverty and deprivation in parts of the borough, and this too may be having an impact.
“However, these factors alone can’t be the reasons, given that we share that industrial heritage and current poverty with other towns who aren’t seeing such high rates.”
St Helens Council said drawing any conclusions that the high infection rates are due to health inequalities would be “speculative at the current time”.
And it warned that, as COVID-19 is a new and novel virus, anyone in the community is at risk of contracting it.
“Many in our community and other areas of the country may have symptoms but have not been tested,” a council spokesman said.
“Our public health and NHS teams are trying to determine the reasons why rates are high.
“The high infection rates are hard to understand without a picture of testing rates, infection rates and indeed death rates at a local level.
“Therefore, drawing the conclusion that high infection rates are due to health inequalities would be speculative at the current time.”
Much of the blame for the high infection rate in St Helens – often coming from members of the public – has been laid at people who are not adhering to the strict social distancing rules.
The difficulty with this argument is that the vast majority of examples are anecdotal.
Merseyside Police has issued a relatively small number of fixed penalty notices to people breaching the lockdown, but it has not given any indication that St Helens is a particular area of concern
Meanwhile, the government is coming in for growing criticism in its handling of the coronavirus pandemic, with critics saying they took too long to lock down to slow the spread of the virus.
There are also being questions asked about a lack of testing throughout the crisis – even if this is being ramped up – and the government’s handling of personal protective equipment (PPE), and if this has ultimately led to greater losses of life in both the front-line and within the general public.
Critics also point to messaging around social distancing being muddled at times, with confusion even arising just this week when national police guidance to officers about how to enforce regulations appeared to contradict the government’s own instructions.
Perhaps it is only when the dust has settled on this catastrophic event, that clear answers will be given to some of the questions no-one can seem to answer right now.
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“After the crisis is over the prevalence of the COVID-19 in certain communities – and in my view particularly whether health or income inequality is a factor – should be a focus of the local and national reviews that will take place,” St Helens Council leader David Baines said.
“What remains most important right now is that we all continue to follow the guidelines – please stay home, protect the NHS, save lives.
“It really is that simple.”
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