Agenda item

(a)     Local Outbreak Control Plan - Progress Update: Presentation of        Director of Public Health, Durham County Council, including   questions from members of the public and stakeholders

The Board received a report of the Director of Public Health which provided details of the updated COVID-19 Local Outbreak Control Plan and a progress update of the work.

 

The Director of Public Health gave a presentation which provided an update on the work of the Health Protection Assurance Board (HPAB), key communication activity, statistics with regards to confirmed Covid 19 cases in County Durham, COVID-19 Contain Framework and Local Lockdown Plans, and the Community Champions Programme (for copy see file of minutes).

 

Public Health England would be undergoing major organisational change and the Chair had written to the Secretary of State to raise concerns and ask for engagement in the design of the new National Institute of Health Protection and in addition the Chair has raised concerns about the issues around testing.

 

Councillor Gunn referred to the changes to Public Health England and thanked the Chair for writing to the Secretary of State as it was an issue that made the Board anxious, especially during a pandemic.  Councillor Gunn also praised the Public Health Team as the amount of work was extraordinary, the response to Covid 19 by the Public Health Team had kept the confidence of the residents.

 

Councillor Gunn also expressed gratitude to the Education Team who had worked extremely hard to inform schools around safety issues and what they should do in order to ensure children were able to go back to school in September, to an environment which was as safe and risk free as it could possibly be.   

 

The Chair referred to the letter she had written which had been written in conjunction with the Chief Clinical Officer of the County Durham Clinical Commissioning Group and circulated to the Board.  She advised that it was important to make representations and praised the Public Health Team for their expertise and what they had achieved however this had not been an easy task and they had worked extremely hard.  There had been changing guidelines and this was an area of deprivation and poverty, a population with health risks and people were having to travel miles to get a test, finding it extremely difficult.  The Chair advised that she would make representations and if organisations had any similar problems or concerns she was happy to get involved and use her platform as Chair of the Board to do so.

 

F Jassat, County Durham CCG expressed his gratitude to system leaders and for the leadership of the Director of Public Health, during this generational challenge. He asked for information with regards to a vaccine and the Director of Public Health responded that the team could only work with others alongside and had received a positive response from partners and communities, however with regards to a vaccine, there was a National Development Programme but no recent update.  She added that there was a developing framework for the potential delivery of a vaccine but no clear date.  She confirmed that the update would be circulated to the Board as soon as it was received.

 

A number of questions had been submitted by members of the public and answered as follows;

 

Question 1:

 

The Track and Trace System was in place to reduce the spread of the Coronavirus. What was happening to encourage local businesses to collect this information for people who used their services?

 

The Director of Public Health confirmed that the Council had been working with businesses throughout the pandemic, firstly to help them access funding to protect them and their staff from economic effects of coronavirus and then to provide advice, support and resources to help them re-open safely.

All business had to take steps to keep workers and visitors safe, by following the 5 steps for working safely, along with sector-specific guidance laid down in the government guidance. This ensured businesses were ‘covid secure’ and the risks of transmission were as low as possible.

 

For the hospitality and service sectors the collection and safe storage of contact details was a key element of their ‘covid secure’ measures. The Council continued to engage with all businesses on a countywide basis to provide advice and guidance, but also on a one to one basis where asked for help or advised of poor practice.  The Council’s approach was always one of engagement, education and if necessary, enforcement.

 

The Director of Public Health took the opportunity to remind everyone that if contacted by NHS Test and Trace, by following instructions to self-isolate, people who had been in close recent contact with someone with coronavirus would be protecting their family, friends, colleagues and other people around them, and would play a direct role in stopping the spread of the virus.

 

Question 2:

 

How could people be encouraged to follow social distancing guidelines in venues, for example, restaurants, pubs and clubs?

 

The Clinical Chair, County Durham Clinical Commissioning Group advised that everyone had a vital role to play in protecting themselves and their loved ones from coronavirus. In restaurants, pubs and clubs there had been changes to make sure that people were socially distanced, such as limiting the number of people allowed into a venue at any given time; tables spaced apart; monitoring of both indoor and any outdoor space; lots of signs reminding people about social distancing, queueing and hygiene practices.

 

The Clinical Chair advised people that they needed to play their own part; it was about adjusting to a new normal; the coronavirus had not gone away and it was vital that people did not let their guard down.   He advised to continue to follow government guidance and be responsible if people were going out. They were going to be with friends or family, so needed to help each other. If they forgot to keep their distance, he advised to give them a friendly reminder and ask them to do the same. It was about protecting each other.

 

Finally, the Clinical Chair confirmed that it was important people trusted their instincts. If they felt uncomfortable by how many people were in one venue, don’t take the risk and go somewhere else. It was the same if someone else felt uncomfortable. 

 

Question 3:

 

The national guidance on operating indoor performances was unclear.  Could clarity be provided on whether a karaoke show in a local public house was allowed to take place?

 

The Deputy Chief Fire Officer, County Durham and Darlington Fire and Rescue Service confirmed that there was no specific government COVID-19 guidance related to karaoke performances in public houses.  Activities such as karaoke were to be conducted in line with COVID secure guidance as there was a high risk of transmission due to the sharing of microphones and potential increased volume.

 

The advice given was that if a karaoke performance did take place, the microphone was to be stationary and remain in a microphone stand at all times.  Performers were asked not to touch the microphone or stand.  The microphone and stand was to be cleaned and disinfected after every use.  In the government guidance, ‘Guidance for people who work in performing arts, including arts organisations, venue operators and participants’, it stated that if equipment had to be shared, regularly disinfecting it (including any packing cases, handles, props, chairs, microphones and music stands) always between users, following UK Government guidance.

 

Therefore, if a decision was taken to hold a karaoke event in addition to the regular disinfection of the microphone and stand, numbers in the public house should be limited, the volume of the speakers should be low with no background music.  The aforementioned guidance stated to consider alternatives to using live music.

 

Question 4:

 

What jurisdiction did the Council have for events taking place on both their own land and also private land?

 

The Corporate Director of Adult and Health Services confirmed that up until the 14th September 2020, the guidance from the Government was that outdoor events should go ahead where they could do so safely.  Many outdoor events were already permitted provided that they had carried out a thorough risk assessment and taken all reasonable steps to mitigate the risk of transmission. Where those steps had been taken, outdoor events that were organised by businesses, charitable organisations, and public bodies, were not restricted to 30 attendees.

 

However new government guidance released on the 9th September 2020 on ‘Meeting with others safely’ would be fully reviewed to understand the implications on future events going ahead both on private and DCC land after the 14th September 2020.

 

Event organisers were encouraged to speak to local authorities as soon as possible to discuss plans for their events and how they could be managed safely. Councils could advise on safe working practices, support events to comply with relevant requirements, and help address any concerns.

 

This council had a well-established Safety Advisory Group which brought together representatives from the local authority, emergency services and other relevant bodies to help advise event organisers on the safety of large events taking place in the area.  An Events Licensing Group had also been set up to look at events in County Durham during COVID.  The group decided collectively if events should be permitted to take place and decisions were fed back to the Council’s Corporate Management Team.

 

She reiterated that with the exception of large sporting events, current government guidelines allowed for outdoor events that were organised by businesses, charitable organisations, and public bodies to take place provided they had carried out a thorough risk assessment and taken all reasonable steps to mitigate the risk of viral transmission, in line with COVID-19 secure guidance.

 

The COVID-19 Secure guidance itself was not legally enforceable, however the Health and Safety at Work Act 1974, provided a framework for considering the steps businesses were to take to ensure they were operating in a way that was safe and could help to prevent the spread of COVID-19.

 

The Director of Adult and Health Services confirmed that large outdoor events were able to apply for, or may already have had an existing licence, under the Licensing Act 2003. In the absence of a health objective councils’ powers to refuse or revoke a premises licence on the basis of concerns about COVID-19 could be limited, as the refusal would need to relate to one of the Act’s licensing objectives, as followed:  

 

·        the prevention of crime and disorder

·        public safety

·        the prevention of public nuisance and

·        the protection of children from harm

 

In some cases, event organisers had applied for Temporary Event Notices which gave councils the opportunity to review an application for an event, although, objections would still need to relate to the four licensing objectives.

 

There were limited circumstances where a council could clearly refuse permission for, or request organisers to cancel an event, however the newly introduced Health Protection (Coronavirus, Restrictions) Regulations 2020 gave county, unitary and metropolitan councils powers to restrict access/close individual premises or public outdoor places as well as prohibit certain events from taking place where there was a serious or imminent threat of transmission of coronavirus, for example a local spike where a large event would risk further transmission of the virus.

 

Regulations needed to be met before the directions could be issued, therefore they were only to be issued where councils could successfully demonstrate it had met relevant criteria, to resist any challenge. When considering whether this power could be applied in relation to a planned event, councils would need to discuss with public health leads, and potentially the police.

 

The local authority as landowner was able to determine whether or not it would grant permission for an event to take place on its land, and could refuse permission to allow the use of the land for an event without the need to issue a direction.  

 

Beyond this, however the intention was that outdoor events should take place where it was safe to do so with the focus on these being supported to operate safely.

 

Question 5:

 

To help people in this area to know the nature and extent of the local risk, could the postcode level information on current reported infections be made public?

 

The Operational Director- Children's & Countywide Community Care Services, Harrogate and District NHS Foundation Trust advised that the COVID19 dashboard on Durham Insight was updated weekly using Public Health England, NHS England and ONS statistics and contained publicly available Middle Layer Super Output Areas (MSOA) data based on counts of cases.

 

A link to the dashboard had recently been circulated to HWB members.  The dashboard showed the number of positive COVID-19 cases in a week by MSOAs which were a standard statistical geography of approximately 7,200 people.  Some MSOAs had the same name as local electoral wards and figures within the map should not be compared with ward data that may be published elsewhere.  Cases from pillar 1 and pillar 2 of the Government's testing programme were included.  There was more up to date data available to us, however this was not in the public domain so could not be shared publicly.