Abstract
Background: Social distancing policies aimed to limit Covid-19 across the UK were gradually relaxed between May and August 2020, as peak incidences passed. Population density is an important driver of national incidence rates; however peak incidences in rural regions may lag national figures by several weeks. We aimed to forecast the timing of peak Covid-19 mortality rate in rural North Wales.Methods: Covid-19 related mortality data up to 7/5/2020 were obtained from Public Health Wales and the UK Government. Sigmoidal growth functions were fitted by non-linear least squares and model averaging used to extrapolate mortality to 24/8/2020. The dates of peak mortality incidences for North Wales, Wales and the UK; and the percentage of predicted mortality at 24/8/2020 were calculated.Results: The peak daily death rates in Wales and the UK were estimated to have occurred on the 14/04/2020 and 15/04/2020, respectively. For North Wales, this occurred on the 07/05/2020, corresponding to the date of analysis. The number of deaths reported in North Wales on 07/05/2020 represents 33% of the number predicted to occur by 24/08/2020, compared with 74 and 62% for Wales and the UK, respectively.Conclusion: Policies governing the movement of people in the gradual release from lockdown are likely to impact significantly on areas–principally rural in nature–where cases of Covid-19, deaths and immunity are likely to be much lower than in populated areas. This is particularly difficult to manage across jurisdictions, such as between England and Wales, and in popular holiday destinations.
Highlights
The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has resulted in 20.7 m cases of Covid-19 worldwide [1]
Differences in policies between countries within the United Kingdom (UK) reflect geographical differences in disease incidence, prevalence and the reproduction number, Rt, which was estimated on the 10th May 2020 to be between 0.5 and 0.9 across the UK, but nearer to 1 in Scotland, and 0.8 in Wales [2]
Mortality figures for people with a positive test for Covid-19 were obtained from Public Health Wales [3] and the UK Government [7]
Summary
The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has resulted in 20.7 m cases of Covid-19 worldwide (as of 14th August 2020) [1]. Declared a pandemic by the World Health Organization on February the 11th 2020, measures to contain the spread of SARS-CoV-2 has seen most countries impose social distancing measures including restrictions on travel, work and closure of non-essential services. Lockdown measures were aimed to suppress viral transmission, maintain a functioning health service, and reduce mortality. With devolved powers to enforce measures to control movement of people in response to Covid, the governments of Wales and Scotland retained their social distancing measures until 1st June 2020. Social distancing policies aimed to limit Covid-19 across the UK were gradually relaxed between May and August 2020, as peak incidences passed. We aimed to forecast the timing of peak Covid-19 mortality rate in rural North Wales
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