The remote Cumbrian town with the UK's highest Covid-19 infection rate

It is one of the remotest towns in England, situated on a windy peninsula a 45-minute drive from the nearest motorway and receives a fraction of the visitors of the nearby Lake District. Yet Barrow-in-Furness in Cumbria has the highest coronavirus infection rate in the UK.

According to the latest government figures, 552 people in Barrow have so far been infected with Covid-19, a rate of 882.2 for every 100,000 people. To put that into context, the English average is 244.5 for every 100,000; Scotland’s is 250.6; Wales’ is 365.4 and Northern Ireland’s 220.5.

Sixty-one Barrowvians had died from Covid-19 by 1 May, including Simon Guest, a much-loved radiographer at Furness general hospital. It is a lot in a town of 67,000 people, giving it a death rate of 91 for every 100,000, one of the worst outside of London.

“It is a big worry, especially with the lockdown being released on Wednesday,” said Lee Roberts, deputy leader of Barrow borough council, who complains he has not seen any data analysis looking into the figures.

The first person to die from Covid-19 in Barrow attended a house party in the town where at least five other people were infected, according to one expert familiar with the local infection pattern. The party took place before lockdown on 23 March and there is no suggestion the host or any guests were being reckless.

Quite how everyone else in Barrow got infected is not yet clear, according to Colin Cox, the director of public health for Cumbria. He said the high infection rate could in part be explained by the fact more people in Barrow have been tested than in other places.

“The rate of testing in Barrow has been two to three times higher than in many other parts of the north-west, so that will explain a fair chunk of it, but I don’t think it will explain all of it,” said Cox.

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Barrow is part of the University Hospitals of Morecambe Bay NHS foundation trust (UHMBT), which covers three hospitals treating coronavirus patients: the Furness general in Barrow, the Royal Lancaster Infirmary and the Westmorland general in Kendal in South Lakeland. After Barrow, Lancaster and South Lakeland have the second and third highest rates of coronavirus infection, which corresponds with much higher than average testing rates, said Cox.

The trust started testing healthcare workers and their families at the end of February, three weeks before other testing pioneers such as Sheffield, according to David Wilkinson, the trust’s director of people and organisational development.

“We started swabbing our employees and household members who were symptomatic of coronavirus at the end of February 2020. Since then, we have swabbed 9,617 individuals, made up of UHMBT employees and household members, hospital inpatients, care home residents and staff, and key workers from other organisations and their households,” he said.

According to doctors in the region, the hospitals have not been overwhelmed with Covid-19 patients at any point in the crisis, with up to 100 beds free some days thanks to a combination of routine procedures being cancelled and people avoiding hospitals.

But the high rate of infection in Barrow continues to cause concern locally. “What I would hope for is some sort of deeper analysis, which we have been pushing for,” said Roberts. He has his own theories, such as high levels of deprivation among the densely packed terraces: “Most of Barrow is very compact: 40 to 50% of Barrow is terraced housing and we’ve got a lot of flats, we’ve got a lot of deprivation, a lot of health inequalities.”

The constituency of Barrow in Furness has higher than average levels of asthma, chronic obstructive pulmonary disease, diabetes, high blood pressure and obesity, all of which are known to be risk factors for Covid-19. “We have quite a lot of historic respiratory problems from people who worked in old industry, in the ship yards,” said Roberts.

Figures from the Office for National Statistics (ONS) this month showed that those living in the poorest parts of England and Wales were dying at twice the rate of those in the richest areas.

Barrow’s population is also older than average, with 22.7% of residents aged 65 to 90, compared with the England average of 18.3%.

Roberts said he would like to see data on who was being infected.

He added: “You would hope some sort of spike would attract some sort of resource to come in and help. You’d want someone to say: ‘We better look at that to see if we can learn from it.’ But so far we haven’t had any detailed information.”

Q&A

Coronavirus: should everyone be wearing face masks?

The World Health Organization (WHO) guidance on face masks has remained consistent during the coronavirus pandemic. It has stuck to the line that masks are for healthcare workers – not the public.

“Wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral diseases, including Covid-19. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted,” the WHO has stated.

Nevertheless, as some countries have eased lockdown conditions, they have been making it mandatory to wear face coverings outside, as a way of trying to inhibit spread of the virus. This is in the belief that the face covering will prevent people who cough and sneeze ejecting the virus any great distance.

There is no robust scientific evidence – in the form of trials – that ordinary masks block the virus from infecting people who wear them. There is also concerns the public will not understand how to use a mask properly, and may get infected if they come into contact with the virus when they take it off and then touch their faces.

Also underlying the WHO’s concerns is the shortage of high-quality protective masks for frontline healthcare workers.

Nevertheless, masks do have a role when used by people who are already infected. It is accepted that they can block transmission to other people. Given that many people with Covid-19 do not show any symptoms for the first days after they are infected, masks clearly have a potential role to play if everyone wears them.

Sarah Boseley Health editor