Chief Medical Officer advice on 21 day review

I have reviewed the proposed amendments to the Health Protection (Coronavirus Restrictions) (No. 2) (Wales) Regulations 2020 which include to allow: 

• up to four households to form an extended household to signal expanding the scope of extended households: to include up to four households as part of a single exclusive extended household from 22 August
• indoor celebrations for up to 30 people for a wedding, civil partnership, or funeral in premises, subject to reasonable measures set out in guidance from 22 August
• for pilot outdoor events for up to 100 people, subject to agreement of, and conditions set by, Welsh Ministers

I have also reviewed the signalling of proposed amendments to the same principal Regulations to:

• allow indoor visits to care home to recommence on 29 August
• allow casinos to reopen on 29 August
• consider during the period of this review how more activity indoors might take place, focussing on services provided in homes and regulated settings

I support these proposals as being in keeping with the prudent approach to easement which we have adopted in Wales. 

The proposals are modest and present a low risk of increasing community transmission; this is important given our imminent plans to reopen schools; a move which should be a very high priority for Wales.

Viral transmission appears to remain low and stable in Wales but I remain concerned about the increase in cases in other UK nations, in Europe and in other parts of the world. Our recent re-opening of the hospitality sector together with further evidence of transmission within households lead me to believe that we have very little headroom for further easement at the present time. I am also concerned that, despite quarantine arrangements, we are seeing a number of cases in returned travellers and I have asked for this issue to be discussed at our Health Protection Advisory Group with a view to formulating recommendations for improved control. In the weeks ahead I anticipate that we are likely to see further outbreaks and clusters of infection which will need to be identified and managed in line with our recently published Coronavirus Control Plan. 

Whilst the overall public health conditions remain stable the expansion of the extended households to enable a greater number to meet at one another’s houses is acceptable subject to the continued requirements that:

• no person can be part of more than one extended household, with the exception of children who live in two homes (for example because their parents have separated and have joint custody)
• all individuals in one home must belong to the same extended household
• all of the adult members of each household must agree to join the same extended household
• once an extended household has formed nobody can leave the extended household to form a new one

I also consider it reasonable and low risk that restricted ceremonies to celebrate weddings, civil partnership or funerals of up to 30 people can take place subject to conditions on the conduct of an indoor celebration is limited to a meal (with certain additions such as speeches).

Whilst I agree that it is not yet appropriate to permit the reopening of large outdoor events generally, providing for a limited number of events with up to 100 spectators with express agreement of the Welsh Government and with appropriate mitigations agreed with the Welsh Government will provide opportunity to learn from and reflect on how mitigations can work effectively in the future.

I acknowledge that it is important for the well-being of care home residents to be able to receive visits from loved ones from Saturday 29 August providing conditions in Wales remain stable.  Indoor visits should only take place subject to the stringent considerations by care home providers which is being set out in guidance. These include the restriction of indoor visits to a designated visitor to reduce footfall into the home, continuing to encourage outdoor visits where feasible and the resumption of indoor visits being dependant on local transmission rates.

Dr Frank Atherton
Chief Medical Officer
21 August 2020