Lockdown & Licensed Premises: COVID-19 Lessons for Alcohol Policy | ICARA-led webinar | August 2021

Lockdown & Licensed Premises: COVID-19 Lessons for Alcohol Policy | ICARA-led webinar | August 2021

okay so i’m going to move on to our final speaker which is professor knee fitzgerald from the university of stirling thank you neve thank you hopefully you can see my full slide now thank you very much really interesting presentations so far which have really set the scene for what i’m talking about but i’ll just give you a little bit of background on the situation in scotland and england where our studies are based so both had a full lockdown with closures of on trade but not off trade premises from late march 2020 but the reopening dates and the restrictions on the operations that existed after that time so from around may june were very varied both within and between scotland and england so just as an example nightclubs have been closed throughout the pandemic period in scotland but in summer 2020 when on trade premises were permitted to reopen nightclubs were still closed but late bars were permitted to open in some cities but in other cities there were voluntary agreements to close at midnight and as another example a curfew in autumn applied in england around 10 30 p.m that would have varied uh but shops were still allowed to sell alcohol in 20 for 24 hours and whereas in scotland both pre and during the pandemic off trade sales stop at 10 pm so where there were curfews in scotland there wasn’t the opportunity to immediately go to a shop and buy alcohol after you left the pub if there was a curfew and what we’re also seeing which is one of the motivations for our paper is a pressure to liberalize opening hours as part of a narrative around recovery of on trade premises and the suffering of on trade premises and the need to therefore liberalize in order to help those businesses to recover and we’re already seeing um significant developments in liberalization of opening hours in the republic of ireland and in northern ireland uh and uh discussions along the same lines in the rest of of these islands just going to present today on three research questions from three studies i’d like to just acknowledge the team of people who’ve worked on these studies and our founders the scottish government chief founders office and the national institute for health research in the uk we’re going to look at how the pandemic might have shaped regulation of alcohol sales through the licensing system we’re going to look at how ambulance clinicians experiences and views of alcohol-related call outs and how they felt call-outs had changed during the pandemic in scotland and then specifically looking at quantitative data on alcor-related ambulances collides during that first national lockdown from march onwards so this is opportunistic data that we’re analyzing from studies that were already underway and i’ll mention very briefly some of the limitations from that the three studies that we’re drawing on are a study that’s looking at alcohol premises licensing drawing on the overall study draws on data from 40 diverse local authorities across england and scotland and the pandemic relevant interviews are 16 interviews with diverse stakeholders within our alcohol premises licensing system the second study is also qualitative it is set up to look at the impact of alcohol and minimum pricing of alcohol on ambulance call-outs in scotland and again we conducted during the pandemic 15 in-depth semi-structured interviews this time with ambulance clinicians paramedics and paramedic technicians and the third study was a study specifically set up funded by the chief scientist office also to look at alcor-related ambulance call-outs during that first lockdown period and that is based on a descriptive analysis that i’ll show you um but we identify alcor related calls through a button that paramedics can select on the patient records when they’re recording their callouts but also with an algorithm-based search of free text entries that is more uh much more sensitive in picking up all core related call-outs and you can read more about that in our paper so firstly just to present some of the qualitative data from our licensing stakeholders so the stakeholders felt that the liberalization in local licensing and other changes in alcohol licensing policy favored some businesses over others so they talk about where reopening was permitted initially in outside areas only in outdoor areas and indoor areas were either not permitted to open or later not permitted to serve alcohol then you see the premises expanding their outdoor areas so the quote here saying everybody needs to turn everything into a beer garden car parks the street outside everything and so you see this expansion in outdoor areas you also saw particularly in england a national decision to permit all on trade premises to sell takeaway alcohol and and in and this combined with a lack of restrictions on drinking in public which we have in some parts of scotland meant that people could wander around the streets with pints of alcohol in in plastic pots which was not permitted previously and overall the licensees the licensing stakeholders felt that there were businesses that were that benefited from this clearly off trade sales increased in the uk during the lockdown but there were also some that they felt really suffered so small corner pubs live music venues and nightclubs were particularly felt to be affected when we look at the qualitative data from the ambulance clinicians it’s striking that they note this huge reduction in alcohol-related call-outs that they experienced as not being replicated by home drinking call outs for alcohol and what we see here is their descriptions of kind of the pre-pandemic being just such a huge level of public intoxication and mass intoxication and they just didn’t see this when pubs and nightclubs were closed and this report seeing much less in the way of assaults that involve alcohol you see here falls and all of these things they talk about this massive drop and they describe this as being really welcome and i think it’s quite striking here and picking up on some of charles points from earlier just the kind of uh level of um pressure on ambulance collets that they that you can see in this next quote here that was in place prior to the pandemic so they say it’s just so nice to go to work on a friday night and know that you don’t have to go into pubs and clubs it’s made this huge difference and they do describe some occasions still where you get parties or elicit parties during lockdown where people are still drinking but not this war or battlefield environment and really welcoming that i think quite stark comments there about how it was previously but they did raise fears echoing sarah’s comments that home drinking habits might persist they were particularly concerned about some subgroups those with alcohol problems or those living in difficult or abusive relationships so i think they talk about people might get used to being in the house drinking so why get dressed and go out when i can just sit here and watch tv and do what i’ve been doing for the last seven months and the sense that all of these people can’t stay at home drinking without a consequence at some point uh so quite qualitative uh reflections from the paramedics but they’re going into people’s homes and i think seeing what’s happening in people’s homes so it’s quite interesting to see their views so the the third study is quantitative data so what i’m showing you here is not alcohol specific callouts this is all call outs and what we see when people are staying at home and also with a fear of attending hospital being a real feature of the kind of public discussion during the first lockdown you see a drop in the total number of ambulance callouts for any reason between march and june 2020 so particularly in april may and june just over 10 reductions in all ambulance call-outs during that first lockdown but what we see when we look at the alcohol related callouts is a much bigger reduction especially in april so we see particular falls in alcor related call outs driven by a fall at weekends so when you look specifically at friday to sunday call outs you see a 31 reduction in the alcohol related call outs whereas the reduction in other weekend callouts is only under 10 percent so for non you know the ones that are not deemed to be alcohol related and this is even greater still when we restricted to 8 p.m friday to 6 a.m saturday and 8 p.m saturday to 6 p.m sunday uh it’s not shown on this graph but you see almost 50 percent reduction in alcohol-related ambulance call lights and if you’re wondering um what’s on the graph here so what we see here is the red dots are the total daily callouts on a on each weekday so every dot is a daily as a day total of call outs and the blue dots are weekdays there are some outliers here those are when new year’s eve fell on a weekday so if you’re just looking back through the time series that’s what those are [Music] so just very briefly discussion points on this um what we see is that outdoor drinking is on the rise and actually as we you know even since i’ve written this originally i’ve updated this to say that this is probably difficult to reverse once uh spaces are granted licenses and once outdoor spaces are licensed it’s quite difficult within our licensing system to revoke those changes and that carries risks and but particularly i suppose just an overall potential increase in availability once the restrictions on capacities within premises are also lifted uh what we also see here is that a large proportion of alcohol-related ambulance callouts are linked to the nighttime economy so this is perhaps not surprising uh to those of us working in the field but i think it’s important to acknowledge that prior to this we weren’t particularly with the qualitative data we weren’t really sure what the balance was in terms of how many elk related callouts are linked to home drinking which we have you know eighty percent of our drinking in scotland is home drinking but actually uh that’s the balance is not the same in terms of all correlated ambulance callouts looking at this data and i think it echoes charles points about what what do we want to return to post covet is this the kind of level of harm that we’re comfortable with home drinking habits may persist and may have long-term consequences it looks from our data that there are probably lower net short-term harms during lockdowns arising from alcohol and but risks of course for the subgroups and risks in longer term plus we are have seen although it’s not in our data and bounce backs in terms of overall consumption potentially rising after lockdowns which would have some of those consequences and finally i think just thinking of the how the on trade sector has potentially been reshaped as a result of of the pandemic and this is still continuing we’re seeing that where smaller operators are struggling they’re being bought up by chain retailers chain pubs and we are also i think more aware than previously of the interest groups being i suppose mixed in that those that might be advocating for measures uh that would protect potentially on trade venues or at least not harm on trade venues like a rise in price and off trade where on trade venues are owned by producers and trade associations are representing on and off trade together you’re perhaps losing allies in the on trade for some of these policies that might be those sort of sweet spot policies that might both protect public health and support on trade recovery and we’re looking into that some more very quickly limitations uh the data are limited to interviews conducted after the pandemic had started and it’s also of course possible that in our call out data and our paramedics reflections they may not be recognizing alcohol as a factor where they’re visiting homes quite so easily as it might be recognizable where they are going to call outs and bars pubs and streets and so just to conclude then i guess our suggestion is and we’re looking into this further in another study looking at originally set up to look at opening hours in the nighttime economy called elephant and we’re wondering if when policymakers are reluctant to be seen to hurt sort of this suffering hospitality sector and but they also want to protect health services are there policies that we can find that we could agree on that would both reduce all correlated harm overall but not necessarily further um further effect on trade premises where they might be struggling and so more more to plenty more to report here and we’ll be looking into it further the paper um for this study is under review at the moment but we’ll share it with you when we can thank you okay if anyone wants to ask a question of need if they could raise their hand or type a question need there is one question here in the chat box from alyssa elsa sorry um need you have any thoughts on the scottish death data increase of 17 17 could this partly be explained by people presenting too late with symptoms during the pandemic and health services not picking up on things much earlier as not seeing the people yeah i think that’s quite possible as one explanation i think the other possibility is that that data i haven’t seen it but i’m assuming it’s annual data and so i guess what we’re reporting largely is for subs small parts of the year where we were in lockdown but it looks like drinking may have gone up even further after lockdown than it was so i think it’s it’s not just what’s happening in lockdown that may be explaining the deaths data but what happens when place premises are reopened as well um and i think there’s also you know a sense of kind of is there a sort of celebratory or kind of uh post-pandemic party atmosphere that that exists that might explain some of it but i think um the delay in in people presenting with symptoms may also be i think others who deal with people um in sort of end stage liver failure and so that would be better place to comment on that than than i am as to whether that sort of delay is likely to be fatal for people but i suspect that maybe i’ll be the case there’s a second question there also is could it be also related to increases in home drinking and are we able to unpack yeah i think it could do and there are other studies that have been published so i know colin angus and others have published on um some of the sales data during the pandemic in the uk and so that’s some of the data that i was referring to but yeah so i guess i think our study is probably not best uh placed to look at the debts because it doesn’t look at consumption levels directly it’s this indirect kind of pressure on services but yeah there’s there’s lots to there’s lots to take in i think okay
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Lockdown & Licensed Premises: COVID-19 Lessons for Alcohol Policy | ICARA-led webinar | August 2021

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