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A vaccine for coronavirus by the start of 2021 is becoming a distinct probability, with the interim results from the Pfizer/BioNTech trials giving some much-needed light at the end of the tunnel.

The NHS still has the second covid wave to cope with, of course, but there are some increasingly positive signs coming through on this front as well.

Several indicators are suggesting the North West region – the hardest hit by the second wave to date – has peaked.

On cases, the raw numbers of people testing positive increased rapidly in September and most of October, but the latest weekly government data shows a clear reduction.

Reinforcing this, the latest Office for National Statistics’ prevalence survey — considered a better measure as it uses random testing — also suggests a dip in positivity in the latest data.

New cases in hospital had surged ahead of the rest of the country during September and October, but have now started to decline, while the total number of beds occupied by covid-positive patients has flattened.

The impact on critical care is a few days behind, so a flattening of the curve is not yet clear. But the trust that was at the sharp end of the second wave, Liverpool University Hospitals, saw a clear reduction last week.

At the end of the line, covid deaths in hospital will be the last metric to stabilise, and there is certainly no obvious flattening in this data so far. The numbers are still surging in some Greater Manchester trusts such as Pennine Acute Hospitals.

Again though, a clear flattening of covid deaths at LUH over the last fortnight will be encouraging for everyone else.

None of this means people can relax, of course, as transmission rates in the community are still high, and the high covid bed occupancy greatly increases the risk of outbreaks on the wards.

But it does suggest the new lockdown measures are making an impact (some had feared new measures would be ineffective after a gradual loosening over the summer) and can again stop the taps from pouring water into what was feeling like a sinking ship.

A testing mission

There has been another change at the top of NHS Test and Trace as the agency again shuffles the interim appointments and secondments that make up its executive team.

Haroona Franklin was brought in to run the contact tracing component of NHS Test and Trace on a temporary basis from HM Revenue and Customs. But at the weekend HSJ revealed she has made way for Steve McManus, chief executive of Royal Berkshire Foundation Trust.

Mr McManus is well thought of on his local patch in the South East and is now part-way through a six-month secondment at NHSTT, where he has been working in the “contain” part of the programme.

His ascension will reunite him with Raghuv Bhasin, currently chief of staff to Baroness Dido Harding but formerly director of operations at Royal Berkshire. It also means NHSTT’s top team again includes an NHS trust chief executive after Sarah-Jane Marsh, boss of Birmingham Women’s and Children’s FT, went back to her day job, having been testing divisional director since mid-May.

Ms Marsh was replaced by Mike Coupe, the retired head of Sainsburys, who will fill the role on a voluntary basis until Christmas.

NHSTT has been thrown together at pace to deal with the covid crisis and has lurched from one crisis to the next, as one might expect for a nascent organisation. It has rather come to define the term beleaguered in its efforts to create huge covid testing capacity from next to nothing while stitching together an England-wide contact tracing service.

The testing element of NHSTT seems to have recovered some of its composure, reaching the government target for capacity for 500,000 covid tests a day at the end of October, after faltering badly in the late summer when it saw capacity plateau perilously.

Much government PR has been focused on the successes at meeting this target, to some extent sweeping the continuing challenges contact tracing behind the curtain. Contact tracers were set the target by the government experts at SAGE of reaching at least 80 per cent of close contacts of people who tested positive for covid.

They have yet to meet this and a key task for Mr McManus will be somehow finding a way to shift this vital metric, which is stubbornly stuck around the 60 to 65 per cent mark.