Why Covid-19 is ‘endemic’ in Greater Manchester

A month ago people in Bolton were queueing outside pubs and restaurants for government-backed discount meal deals. Now the longest line is outside an emergency coronavirus testing centre, set up in a market car park after the town in northern England recorded the highest level of infections in the UK.

The surge in the former cotton spinning hub has left the local authorities with two conclusions: ending the full national lockdown in July was premature and the disease is now endemic in poorer communities.

Andy Burnham, the elected mayor of Greater Manchester — which includes Bolton, said the lockdown was lifted when it suited London, which had shaken off the first wave of the pandemic.

“We were left with a higher level of underlying virus,” he said. Once summer came and people started to mix again — especially those in their 20s and 30s who generally do not display symptoms of the disease — the virus spread. Quoting a confidential report from Public Health England, Mr Burnham said: “The virus has become endemic in parts of Greater Manchester.”

People queue at a testing centre in Oldham © Jon Super/FT

Local lockdowns were imposed across the region on July 31; households were banned from mixing indoors or in private gardens and outdoor gatherings were limited to six people. But individuals could still meet in pubs, cafés or restaurants.

After initial success in combating the virus’s spread, people’s willingness to obey restrictions waned. Case numbers are now rising in nine of Greater Manchester’s 10 boroughs and all have rates higher than the national average.

In Bolton, where the virus is spreading fastest, the government on Tuesday imposed tighter restrictions, including limiting all hospitality premises to takeaway meals and ordering a 10pm closing time.

Mr Burnham welcomed the government announcement that from Monday people across England will only be able to meet socially in groups of six or less and a renewed effort to explain the rules. “We have got to try to live with Covid-19,” he said.

Nadia Gebelli, 25, queueing in Bolton for a test after developing a temperature, said some people would ignore the new rules as they did the old. She blamed pub goers and the government’s “eat out to help out” meal discount scheme that ran on Mondays to Wednesdays in August. “We are running our economy on drink,” she said. “I saw a group of 16 saying they were in the same household. No one does anything. You never see the police.”

Nadia Gebelli: ‘I saw a group of 16 saying they were in the same household. No one does anything’ © Jon Super/FT

David Greenhalgh, leader of Bolton council, agreed that the surge from less than 20 cases per 100,000 people to more than 160 in a fortnight, was driven by young adults flouting the rules. Police fined a 23-year-old local man £1,000 after he returned from the Spanish island of Ibiza and instead of going into quarantine, held a house party and went out several times.

Another who went on a pub crawl while contagious has infected at least 17 others, Mr Greenhalgh said. “It is connected to a group of 18 to 42-year-olds, white British in the overwhelming majority of cases. We are a warning to other areas of the country.”

Chart showing that cases have continued to rise across much of Greater Manchester despite local measures

But there is another story too. In many parts of Greater Manchester, home to 2.8m people, the disease has ripped through more deprived communities where many people work in jobs that cannot be done from home: taxi drivers, shopkeepers, nurses and warehouse workers. They may not be eligible for sick pay so cannot afford to self isolate it they develop symptoms.

The majority are of South Asian heritage, packed into terraced houses in extended families so young people going to school and work bring the virus back to elderly relatives.

Community swabber Patrick Holden tests Katrina Szymnska in Oldham © Jon Super/FT

That is also true of neighbouring areas such as Blackburn, Preston, Calderdale and Bradford, which are under local lockdowns. Infection rates are climbing in all of them.

While rates have begun rising in almost all lockdown areas — and indeed across England — in one Greater Manchester borough they are bucking the trend: Oldham, another former mill town with similar demographics to Bolton. In the week ending September 7 the rate of infection per 100,000 people was 73 — down from 108 in the seven days to August 11.

The main reason is an army deployed by the council. They explain guidance, clarifying that households cannot mix at all and offer immediate coronavirus tests.

Members include council staff who cannot do their normal jobs. Andrew Bailey, a redeployed librarian, led the team on to the streets on Thursday afternoon armed with a map, mask and hi viz vest.

Community swabbers Patrick Holden, centre, with engagement team members Andrew Bailey, right, and Nadia Arif in Oldham © Jon Super/FT

As soon as the testers appeared in their protective gear people approached. The national testing system is overwhelmed and many wait days for a slot.

Dorothy Randall, who was out for a walk when the swabbers pulled up, said: “It is such a relief to get it done. I have been trying to get a test but the phone keeps ringing off.”

In less than an hour they had tested 13 more people, around three-quarters of those who answered the door, including one man who thought he had serious symptoms.

Cyclist Hugh Kane is tested by Lisa Schora in Oldham © Jon Super/FT

The swabbing team are Lisa Schora, a former payroll administrator, and Patrick Holden, a DJ and entertainer, who was recruited after posting a Facebook video saying he needed a job. “It feels great to be able to get out of the house helping people,” said Ms Schora, who was unemployed.

Arooj Shah, deputy leader of Oldham council, said that community engagement had been crucial, especially in the Asian population. The 80 volunteers have visited 5,500 homes since the scheme began in mid-August.

“Boots on the floor work. We will continue to do this with community organisations and charities to push out the message.”

But with people returning to school and work, “it will continue to be challenging”, she acknowledged. Council budgets, reduced by austerity in the last 10 years, have come under further pressure from coronavirus costs. “We need more resources from government,” Ms Shah said.

Bolton on Thursday began a similar scheme and Mr Burnham has proposed to ministers that the whole of Greater Manchester adopts the model as the best way to suppress the virus, taking over the bulk of the nationally organised test and trace operation and receive its funding. “The national system is not working for Greater Manchester,” he said.

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