Health Matters – October 2021

Four Issues in this month’s Health Matters
• Covid Update
• Herd Immunity
• Covid & Flu
• Hospital Backlog Figures

1. Covid Update – the numbers are still rising in St Albans and are now much higher than the Hertfordshire Average. There are currently 2,399 active cases in St Albans which is up 40 on last week. That’s over 600 per 100,000 whilst the Hertfordshire average is closer to 400! 48% of those cases are among the under 18s and 27% are among the 35 -55. But people in hospital remains relatively low (28 in Watford and 25 in Lister) which is down on last month. So, does that suggest we have herd immunity in St Albans?

2. Herd Immunity – The fact that our daily numbers of new infections are so high suggests it isn’t but the fact that hospital numbers are so low suggest it is! So let’s try and unpick it! The key metric is what percentage of the population need to be immune in order to give herd immunity a chance? At first, it was thought to be around 65% based on experience of other viruses but the belief now is that it needs to be over 85% given the way that Covid is so infectious. There are several reasons for this:-
• The effectiveness of the vaccines wanes over time and at different rates in different people; for some people it slips down after a few months whilst in others protection can last a year!
• You may not have had a good antibody response in the first place – 5-10% of people don’t get a good antibody response
• You may have had a high viral load – if for example an infected person coughs in your face the viral load is too high for the antibodies; and
• You may be exposed to a new variant – and for example people who have built their resistance from a previous bout of Covid will have less resistance to variants than those whose immunity comes from the vaccine

So the killer question right now is do 85% of the people in St Albans have immunity? The level of non vaccinated in St Albans at the moment is around 8% and of course we don’t know where we are in that 5-10% of poor antibody response so it’s very marginal! And that’s a strong reason to continue to be cautious and remember wash hands, social distance, and wear a mask indoors!

3. Covid & Flu – There are two problems ……. First we have less immunity to flu than usual and second the symptoms of coughs and colds are very similar to Covid – especially if you’re young or if you’ve been double vaccinated! And there’s a simple way to get at least a first indication – that is loss of smell or taste! We’ll come to that in a moment.

We have much less immunity to coughs, colds and flu than we did last year – because we were in lockdown for most of last winter few of us caught them and therefore we have less protection than usual It’s as if we lived on an island in the middle of the ocean for twelve months – there are no colds or flu in Tristan da Cuehna. So again, keep up that hand washing and social distancing!!!!!

Back to the symptoms; if you do experience loss of taste or smell then there’s a high probability that it’s Covid and not a cold. You can tell this simply by going to the kitchen and smelling or tasting something strong. Of course, herbs and spices generally have strong smells but are not necessarily good to taste on their own! Possibly try some fruit that has a strong smell – an orange for example!

If you have Covid or flu like symptoms it’s best to take a Lateral Flow Test (you can get these free from the Pharmacy) and that’ll give you a strong indication – if you test positive that’s over 90% accurate but if you test negative it’s closer to 60-70% accurate so you should consider a PCR test to confirm it. The main symptoms of Covid vary depending on whether you have been vaccinated or not.

The most common symptoms of Covid are:-
• Runny Nose – it’s also very common symptom of colds; don’t read too much into it if this is the only symptom.
• Persistent Headache – also a symptom of multiple possibilities (e.g. too much time on a screen, or whatever we drank the night before!); but if it lasts for three days, runs across both sides of the head and features a stabbing pain it’s quite likely to be Covid!
• Sneezing – if you find you’re sneezing more than usual (more likely in the double jabbed rather than the un-vaccinated
• Cough – this is typically the first sign of Covid (it occurs within the first or second day of infection but it tends to morph into other symptoms within 2-3 days); if it persists longer it’s more likely to be a common cold rather than Covid
• Loss of smell or taste – remember it’s not just Loss of Smell or taste – many people report that their taste or smell has changed rather than gone!

These five are the classic symptoms; others include Tiredness or Fatigue, changes in the mouth or tongue (“Covid Tongue)”, loss of appetite, muscle pains and (esp in older people) delirium.

But the key point – remember to smell and taste those oranges!

4. Tackling the NHS Backlog – We know from a recent Kings Fund report that it’s very high. But what does that really mean?

One way of measuring it is to assess how much higher the waiting list is at the moment compared to April 2020. The figures are staggering; whilst the national average is 42%, the figure for the Lister is 16% and the figure for Watford is 73%. That’s the fourth worst in the country!

Although these figures are very high there is a fear that the list could double or even treble over the next few months as more people come forward. It should be an interesting session next month!
A couple of weeks ago I attended our local Commissioning Group’s AGM and asked the question about just how big was the backlog and what they are doing about it. I’ve been promised an answer before next month’s podcast!

Alan Bellinger
20th October 2021