Agenda item

The Corporate Director of Public Health presented the Adults Wellbeing and Health Overview and Scrutiny Committee with a progress update on the Covid-19 local outbreak control plan (for copy see file of minutes).

The Chair gave a warm welcome to Amanda Healy, Director of Public Health and he thanked her, on behalf of the Committee, for the personal commitment she was making to the position, at this unprecedented time. 

The Director of Public Health explained that when government relaxed the lockdown rules, it requested all local authorities to develop and publish a local outbreak control plan, with a public facing board being used to communicate openly with the public on the plan.  It was agreed that the Health and Wellbeing Board, chaired by Councillor L Hovvels would fulfil this role. The current plan was presented to the Health and Wellbeing Board on 11 September 2020 and it builds upon the existing health protection arrangements in place to protect residents’ health from Covid-19, and, to reduce onward transmission. 

The Director of Public Health outlined the governance arrangements and the key objectives of the plan which identify seven control settings including care homes, schools and high risk communities and within these setting smaller, focus teams are in place to develop more in-depth plans. The Director of Public Health provided an overview of the work within each of the settings. 

With testing and tracing being a key aspect of the plan, the Director of Public Health informed the Committee that work is being undertaken to set up longer term, local testing sites and she acknowledged the challenge some residents have faced when having to travel outside of the county to access testing facilities.  In addition, work is being carried out with colleagues in the Contain Team to improve contact tracing rates which currently stand at approximately 60% of people being contacted within a 24 hour period.

In terms of the current position, the Committee noted a rapid rise in the rate of infection since the beginning of September.  The Director of Public Heath then provided information on the number of cases at the time which stood at 95.3 per 100,000, with 372 cases being reported within the previous 7 days. She explained cases were being observed across communities, with small clusters spread throughout the county, within households, schools and workplaces. 

Members were advised that up-to-date statistics are available on the Durham Insight website and a link to the website would be circulated to members of the Committee.  The Committee noted specific outbreaks in parts of the county had taken place including outbreaks at Stanley, Burnside and Consett.  The Director of Public Health informed the Committee that County Durham had joined the LA7 group of local authorities, and the group is looking into additional prevention measures and seeking intervention from government to ensure swift action to slow the spread of the disease. With further restrictions in place from 18 September, a support package had been requested from government, for resources to support these measures, with discussions ongoing.

The Chair thanked the Director of Public Health England for the update and he sought clarification of the role of local members in the local prevention control plan.  The Director of Public Health commented on the importance of their role, being the direct link to the community and she encouraged suggestions from members on how they could play a more active role.  She added the service aims to keep local members updated through regular briefings and the provision of information with regard to specific outbreaks and widespread community transmission, and, she encouraged members to access the data which is available on the members’ dashboard.  In addition,  a ‘Community Champions’ initiative is being looked into, which will include volunteers from the Community Hub, AAPs, and, it is hoped local members will also have input.  The Director of Public Health then responded to comments and questions from the Committee as follows.

Councillor R Bell, local member for Barnard Castle West, commented that he had been unable to find positive case data at ward level on the Durham Insight website and he requested that granular level data be included. The Director of Public Health agreed to circulate a direct link to the data and to look to provide refined data at ward level but she cautioned that this type of data changed very rapidly. She emphasised the importance of interventions within the community and the continuation of the public messages with regard to hygiene, protection and social distancing.

With respect to funding, Councillor Bell referred to the ongoing discussions on additional funding to resource the recent local restrictions and he asked what funding has been made available, what funding the service would like to see made available, and, what the funding to date, had been used for. 

The Director of Public Health replied that a grant of £4.5million had been received initially for the local outbreak control plan, overseen by the Health Protection Assurance Board and the funding had been used to support matters such as additional capacity for a dedicated outbreak control team, enhanced support for environmental health, and, additional capacity in respect of prevention and control for special education. The additional government funding requested would be used to resource test and trace, compliance, enforcement, communication, and, to provide support for businesses and the community sector.

Councillor O Temple, local member for Consett North, expressed concern that with regard to a local outbreak in Consett, he was first made aware of the situation by reading a notice on a community centre door.  The Director of Public Health apologised to Councillor Temple for the oversight, adding that community organisations have been a useful tool in enabling messages to be communicated speedily within localities and she assured Councillor Temple that local members will be informed of any further local outbreaks as soon as possible, in the future.

Speaking in relation to care homes, and, recognising that it is essential to control the virus, Councillor Temple said he had received many appeals from local residents who had been unable to visit their relatives in care homes.  He  requested that the Committee consider how to balance control of the virus with the importance of the basic need for human contact, at the Special Meeting in November.  The Corporate Director of Adult and Health Services acknowledged these concerns and suggested that it would be helpful to do a broad presentation around the framework the Council works within, in terms of social care.  She said that this question from Councillor Temple would be taken to that meeting and she requested further questions from members to be sent to her, by Friday 9 October, for inclusion in the presentation.  The  Chair requested that hospital settings also be included, having received similar concerns from those who had been unable to visit relatives in hospitals.

Councillor P Jopling asked what safeguards are in place to ensure that only those who are in need of tests, receive them.  The Director of Public Health commented that when the schools returned in September many worried parents whose children had minor illnesses telephoned their GPs fearing they had symptoms of Covid-19.  To address this, a flow-chart was developed with colleagues from the NHS, which was circulated to schools to inform parents about symptoms of Covid-19.  The service had also responded to intelligence within communities, such as taking steps to raise awareness when it was reported that entire football teams were being encouraged to be tested as a precautionary measure. 

The Director of Public Heath responded that the service continues to send a clear message to the community that only those with symptoms should be tested.

Councillor Tucker commended the work of the Public Health team adding she hoped staff were looking after themselves, whilst they were busy keeping the people of County Durham safe.  She raised concern about the capacity of testing, saying she was aware of a number of people who had been unable to access tests and, as a result, were isolating as a precaution.  She asked if more tests could be made available, and, she enquired as to how accurate the self-tests are.  The Director of Public Health encouraged members to inform her of instances when people have been unable to access tests, as the service will continue to press for increased and easier access to testing.  She added that an advantage of being part of the LA7 group is to maximise Durham’s capacity for testing.  With regard to self-tests, the Director of Public Health undertook to provide information on the failure rate of self-testing to a future meeting of the Committee.

Councillor L Brown, extended her thanks to the Public Health Team and commented that, as the local member for Neville’s Cross, she had been approached by concerned residents who were apprehensive about going into Durham city and the risk posed by the return of the University students.  The Director of Public Health reassured members that the University is going to great lengths to prevent the spread of the virus and that it is taking the return of students very seriously.  It is part of a north east group looking at wider plans and it has liaised with local residents and community groups to explore their concerns and to balance those concerns with ensuring the city is welcoming for the students.  In addition, Cabinet had visited the University to investigate the plans and to offer support in the event of an outbreak.  The Director of Public Health added that she would pass the comments on to the University, at an their up-coming meeting.

Councillor J Stephenson commented, as a school governor, she had been heartened by the support provided to schools to assist them to manage outbreaks effectively.  Councillor Stephenson asked whether there had been an increase in non-compliance following the recent additional local measures, and, for information as to how enforcement is dealt with.  The Director of Public Health replied that the Licensing Team had carried out approximately 200 visits during the previous weekend and they had reported many good examples of businesses which were Covid-secure.  Under the Local Resilience Forum, a compliance cell had been established, with the police and licensing officers, to look at enforcement measures.

Thanking the Director of Public Health for the work, Councillor C Wilson referred to the use of plastic visors and asked if they are safe to use without a mask or should a visor be worn together with a mask.  Councillor Wilson also asked if staff in shops are encouraged to challenge customers who are not wearing masks.  The Director of Public Health responded that face coverings are slightly more effective, however, the use of a visor provides a physical barrier.  Shop mangers are encouraged to request proof of exemption, if customers refuse to wear face coverings.  The Director of Public Health stressed the responsibility for every individual to recognise their social duty and comply with the protective and social distancing measures.  

Councillor S Quinn spoke from her experience of working in a care home and agreed with Councillor Temple’s concerns regarding the lack of human contact and the impact of this whilst patients are unable to receive visits from relatives. She assured members that care home staff are endeavour to do all they can to provide patients with comfort and support at this time. Speaking as the local member for Shildon, which had recently been identified as a Covid hot-spot, she expressed concern that as more and more pubs close, this may be leading to people travelling from house to house, or, to other towns with fewer restrictions, in order to socialise and she asked if work was being done to dissuade people from this. The Director of Public Health said that the increased rate in Shildon was being actioned, in terms of communication and community engagement, and she would provide an update to Councillor Quinn in due course.

Councillor Bell echoed other members in thanking the Director of Public Health and her team.  He commented that having recently checked national statistics, he agreed with Councillor Jopling’s comment that the worried-well are accessing tests unnecessarily, as the national statistics indicated that only 1.5% of those tested are testing positive. He commented that if it is the case that most people are asymptomatic, control measures are vitally important.  The Director of Public Health advised that the percentage of positive tests locally is higher than the national figure with approximately 6% of those tested being positive.

Councillor Bell then observed that although reports suggest that the hospitality industry is working hard to put measures in place to be compliant, he had observed supermarkets and shops seemed to have relaxed their procedures since the lockdown measures had eased.  He also raised concern that as more and more of the hospitality sector is forced to close, an increasing number of people will gather in households to socialise.  In acknowledging that the variation of restrictions between locations and settings may be confusing, the Director of Public Health commented that, at present, the rise in transmission is more prevalent in indoor spaces and between households.  She remarked on a difficult balancing act to be achieved in keeping the economy going whilst ensuring public safety and she emphasised that it is very much a case of collective responsibility, for all individuals to be as stringent as possible. 

Councillor A Reed referred to a public protest planned to take place in Crook and asked what measures would be put in place to protect protestors and members of the public and she asked if local members could assist in any way.  The Director of Public Health commented that the planned lawful protest would be managed safely with the police and that she will brief local members to inform them of the plans and liaise on any action they could assist with.

In concluding the discussion, the Chair commented that two themes could be observed throughout, firstly that members would like more information and involvement with regard to their own wards.  Secondly the great deal of appreciation members expressed for the Director of Public Health and the Corporate Director of Adults, Wellbeing and Health, and their respective teams, for their ongoing work.  The Director of Public Health thanked the Committee for their kind words of support and paid tribute to all the staff within the teams, and, partners, who were working together, across the county.

The Chair then asked Councillor Hovvels to address the Committee on the plans to replace Public Health England with a new organisation.  Councillor Hovvels referred to her campaign saying any support from members would be very welcome.  She informed members that a joint letter from Health and Wellbeing Chairs was sent to the Health Secretary, however no response had been received.  She expressed concerned and disappointed that there had been no communication or consultation with Public Health teams prior to the government announcement.  Councillor Hovvels stressed the proposals will have a direct impact and the importance of having an opportunity to shape and influence the new arrangements.  The Chair agreed to discuss the matter with Councillor Hovvels and the Principal Overview and Scrutiny Officer in order to look into what support the Adults, Wellbeing and Health Overview and Scrutiny Committee could provide.

Resolved:

That the report be received.