It is hard to believe that only a month ago the North East had the lowest Covid-19 infection rates in the country.
After weeks of skyrocketing case numbers that have now seen four of our areas placed on a government watchlist, that has become a distant memory.
So how did it all come to this, and is there still hope of the region avoiding what would be a devastating second lockdown?
In early August, Newcastle public health director Eugene Milne cautioned that the North East was just a small step away from a major outbreak despite its low infection rates – a warning that has proved sadly prophetic.
By the end of last month, South Tyneside was top of a list of predicted new virus hotspots – before it was added to Public Health England’s list of areas of concern on September 4.
Then came the worrying news of an outbreak linked to a charity football match on the border of Sunderland and County Durham, which has now led to more than 60 positives tests.
And throughout this week case numbers and infection rates have continued to shoot up rapidly, to the point where South Tyneside, Sunderland, Gateshead, and Newcastle are now classed as areas needing ‘enhanced support’.
Prof Milne says that the rapid rise in infections has been caused by a combination of severe, localised outbreaks such as the one at the Burnside Working Men’s Club football match and a wider “rising tide” across the area – two phenomena that will feed into each other and exacerbate the risk of contracting coronavirus.
He said: “The virus never went away, it was always circulating at low levels and we knew that. What has happened is those cases have begun to escalate, as we knew they were likely to, once people began to mix.
“Some of that is to do with the breakdown of social distancing and people starting to feel like we are out of the woods on this, whereas we knew it was a continuing problem and we were going to have to sustain the preventative measures over a long period.”
He added: “The things that have proved my point have been what has happened in Sunderland and Stanley and Middlesbrough. At the time my fear was of a sudden large outbreak of the type that they have seen.
“But we were also warning of the potential rising tide problem that we would see an increase gradually in circulation of the virus.
“In Newcastle we seem to have avoided big focal outbreaks so far, but inevitably we are seeing that rise which is also reflected in other northern cities and in Scotland.
“And the risk of those big outbreaks increases as the circulation of the virus increases as well.
“There are more and more opportunities for one of those larger outbreaks to happen.”
Newcastle has reported that 60% of its new cases in the past two weeks are from the 18 to 30 age group.
Prof Milne says that is partly down to the fact that younger people are now more likely to be tested, as opposed to earlier in the pandemic when tests were reserved for those with severe symptoms and in hospital – generally more elderly and vulnerable people who have now been “cocooned”.
But the expert believes that greater social mixing post-lockdown is a clear cause of the spike in local cases – a major worry with 50,000 students set to descend on Newcastle in the coming weeks.
He said: “This is a volatile time because we have schools going back, university students coming back.
“I am also very aware that we have been doing this for more than half a year now – in Newcastle it kicked off really early with the first cases in the country coming to the RVI.
“I think a lot of people are very tired by it all, both in services and in the community.
“It is a long time for people to shield and isolate, people have stuck to the rules for a long time and it becomes progressively more difficult.
“What then worries me after the influx of people and the resumption of schools and so on is going to be heading towards winter and the additional risks usually associated with that – we fear a second wave of Covid combined with those other things happening. We are very keen to get our flu immunisation programme thoroughly taken up to get that projection in place.”
Is the return of lockdown a foregone conclusion then, or can we still rescue the situation before it is too late?
Prof Milne believes that if tougher restrictions were to come into force then it would be preferable to do it on a regional scale – to avoid, for example, the danger of people from a locked down area crossing borders to find an open pub.
A new lockdown, he added, is not inevitable – but it will be “difficult” to reverse this trend of rising cases.
And the way infection rates have taken off in the past fortnight has made him wary of predicting where the North East will be in even another week’s time.
It is hoped that the government’s new ‘rule of six’ will simplify people’s understanding of how to act and what is acceptable – on top of the need to continue with social distancing, hand washing, and the wearing of face coverings to stop the virus getting out of control.
Prof Milne said: “It depends on the behaviour of a lot of people choosing to do the right thing.
“We have seen, particularly around the more focal outbreaks, areas go up on the risk register and then come down again. That is still possible, but I don’t want to predict which way we are going to go.
“But we need to get the message across to the public that we need to try our best to do this – if we do our best, we can’t do anymore.”