Covid-19 could be endemic in poorer parts of the UK, according to a leaked Public Health England report.

The report suggests that in areas with poor housing quality, high levels of deprivation and large BAME communities the months-long UK-wide lockdown was ineffective.

The study, seen by the Observer, reportedly investigates in-depth the links between housing, poverty, ethnicity and high levels of Covid-19 in areas in the north-west, and looks to take lessons from the region to be applied throughout the UK.


“The overall analysis suggests Bolton, Manchester, Oldham and Rochdale never really left the epidemic phase – and that nine of the 10 boroughs [of Greater Manchester] are currently experiencing an epidemic phase,” the report reads.

A mobile advertising vehicle displays a Covid-19 high risk area warning in Oldham, Greater Manchester (PA)

The areas of the UK with the highest levels of coronavirus – Bolton, Bradford, Blackburn and Darwen, Oldham and Salford – are all in the North West.

With more than 98 cases per 100,000 people last week, Bolton had around five times as many cases as some of the least-affected areas, like Milton Keynes, Kent and Southampton.

The study goes on: “Each region has experienced its own epidemic journey with the north peaking later and the NW [north-west], Y&H [Yorkshire and Humber] and EM [East Midlands] failing to return to a near zero Covid status even during lockdown, unlike the other regions which have been able to return to a near pre-Covid state.”

The report questions whether local lockdowns are effective in these areas, given the claims that national lockdown had less impact than in other parts of the country.

Shoppers in Oldham (AFP via Getty Images)

“If we accept the premise that in some areas the infection is now endemic – how does this change our strategy?,” it says.

“If these areas were not able to attain near zero-Covid status during full lockdown, how realistic is it that we can expect current restriction escalations to work?”

Gabriel Scally, public health professor at Bristol University, said the “extremely alarming” findings show better contact tracing and improving housing conditions is vital for tackling the virus.

“The only way forward is to build a system which provides much better, more locally tailored responses,” he told the Observer.

“There is no integrated find, test, trace, isolate and support system at the moment. The data on housing is extraordinarily important. Overcrowded households are part of public health history. Housing conditions are so important and always have been, whether it was for cholera or tuberculosis or Covid-19.

Shoppers in Greater Manchester (Getty Images)

“Doing something about housing conditions for someone who has an active infection is extremely important and it is not something that can be handled by a call centre run by a commercial company hundreds of miles away.”

The leaked report comes as the Labour Party and former Labour Prime Minister Tony Blair pile pressure on the Government to ramp up testing to help prop up struggling businesses.

Public Health England has been contacted for comment.

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