As lockdown and social distancing measures started to relax, cases of coronavirus unsurprisingly crept up again across the country.

In recent weeks, we have seen spikes in cases in Richmond, but why did it happen, who's been affected and what can we do to prevent a second wave?

We spoke with Richmond and Wandsworth's director for public health, Shannon Katiyo, to find out more.

A couple of weeks ago Richmond saw a sudden spike in the rate of new infections before they fell again.

"What happened is, over the summer months, particularly from July 31 when social distancing measures were relaxed quite considerably, we did see the number of cases start to rise," said Mr Katiyo.

"Not just in Richmond and Wandsworth, but nationally we started to see that rise, and it was quite discernible compared to, for example, where we had been in the peak of lockdown around June, when the number of cases in Richmond on any day had gone down to zeros and ones.

"This was an indication that something had changed in the summer months. I think it was expected that as social distancing was relaxed we might expect to see some changes happening in the number of cases.

"For Richmond, interestingly, we did have a couple of occasions within the month of August where our numbers rose to higher levels than before.

"Around August 12 we had a peak of about 10 cases on a single day, which for Richmond is relatively high compared to what we've been used to throughout the pandemic. Then again around August 27 towards the latter end of the month.

"In terms of what we know about potential reasons for that, the relaxing of social distancing is possibly one that has had an impact nationally. But we also found out that we did have a few cases that were potentially travel-related because the cases occurred in people who had recently returned from holiday abroad."

With different social distancing rules in place in different countries, it is possible that some people may have let their guard down when catching some late summer sun.

Mr Katiyo also explained that most recent cases in Richmond and Wandsworth have been among younger people.

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[h3]Which age groups are being affected?

This contrasts to the beginning of the pandemic where public health officials noticed more cases among older people, who were more likely to be hospitalised and therefore tested.

Now testing is widely available for people who have even mild symptoms.

"What we're seeing now is quite different. We've got a marked increase in cases in the 20 to 39 age group," said Mr Katiyo.

This is reflective of the wider picture, both in London and nationally, where we are seeing more cases among younger adults.

"In Wandsworth our population is generally a younger one with an average age in the 30s, and so if we see a wider epidemic in the country that's affecting younger people, then you would expect to see an impact on that in Wandsworth, just because of our demographic," he said.

Are there any virus hotspots?

However, across Richmond and Wandsworth the increase in cases has not been linked to any specific clusters or locations.

"In the general community we are not seeing a very consistent pattern now in terms of where cases are happening," said Mr Katiyo.

"Obviously we have got areas where the cumulative number of cases from the beginning of the outbreak is higher, but from week to week it is a varying picture of where we are seeing high numbers of cases. They tend now to be dotted all over the borough.

"In a way that makes it slightly more challenging in terms of targeting interventions on a geographical basis. What we are tending to focus on now is particular age groups, and also looking at the ethnicity and other data to see what messages we need to target to those groups."

Effect on different ethnic groups

In both boroughs, young people from a white ethnic background are seeing the higher number of coronavirus cases at the moment.

But the reasons behind this are unclear.

"I would say, though, as we have known throughout the whole pandemic, complex and multiple factors have determined why some groups are more likely to test positive, and why some ethnic groups are more likely to end up having a more serious illness or being admitted into hospital.

"But in terms of who is testing positive at the moment, I don't think we have that explanation of why it is predominantly young people from a white ethnic background," he said.

"We are seeing much lower numbers of people being admitted into hospital or into intensive care units than at the peak of the pandemic. This may be due to younger people potentially having mild symptoms or not having any symptoms at all. So they are less likely to end up in hospital and needing treatment."

Preparations for a possible winter spike

We are preparing for potentially more cases in the winter months.

"Because Covid-19 is a respiratory illness, and we know that in the winter months we tend to see an increase in the transmission of other respiratory illnesses such as flu, there is a concern that we could end up with several things going on, an increase in the incidence of Covid in the winter time, and circulation of flu.

"I think there will be a concern there that our healthcare services could become overwhelmed by those two things happening at the same time.

"So the main conversations that we're having right now with our partners is around our winter effort, particularly around flu vaccinations.

"In terms of preparing for a potential second wave, obviously we have already started to see the number of cases rise in August, so this is very much on the cards in terms of strengthening our existing outbreak control plans.

"I think on a positive note, because we have been through the first wave of the pandemic, that's already given us an opportunity to galvanise ourselves as a system and how we work collaboratively to try and manage outbreaks."

What you should do to keep safe

His key piece of advice for residents in the coming months is to keep washing hads, as well as wearing face coverings in enclosed spaces and maintaining at least a one-metre distance from people not in your household.

"This was the main message right from the outset of the pandemic and remains as an important message, we can't relax, we can't take it for granted," said Mr Katiyo.

"Washing hands is not just good for Covid, it's good for flu, and it's good for other infectious diseases so please, please keep doing that."

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