Agenda item

The Committee received the report of the Director of Public Health that provided Members with an update on the COVID-19 response and the transition from the COVID-19 Local Outbreak Control Plan to Local Outbreak Management Plan (for copy of report, see file of minutes).

The Director of Public Health was in attendance to present the report and deliver a presentation that provided Members with a summary of County Durham Cases; Local COVID-19 Update; COVID-19 Vaccination Programme and the route out of lockdown (for copy of presentation, see file of minutes).

The Director of Public Health indicated that the COVID work was built on strong relationships that they had both across County Durham but in particular with partners at Public Health England and the Health Protection Team who were going through some significant changes in the forthcoming year as Public Health moves into different directions. Members were advised that the Health Protection Assurance Board was chaired by the Corporate Director of Adults and Health Services that was multi-agency in nature that had been meeting on a weekly basis. This board reported directly into the Health and Well-being Board who were recently updated and one of the community champions attended that meeting.

The Director of Public Health updated Members on the County Durham 7-day rate that was currently 23 per 100,000 that was lower than the England average. There were around 106 to 110 cases per week that was a big reduction from the previous week. They had also seen a reduction in the over 60s and older and also a reduction in hospital admissions and deaths.

She advised Members that there was also now a vaccination dashboard that added to the transparency of the work they were doing in County Durham. All the data was monitored and updated on a daily basis.

Members were updated on the Local COVID-19 operational planning arrangements and that they were starting to review the local outbreak control plan that was published in July 2020 and updating that at the request of government to turn that into a local outbreak management plan. This had given them a chance to stop and reflect on the last nine months and look at the lessons learned from outbreaks.

The new UK variant and variants of concern was something they were monitoring very closely with national and regional partners and learning any lessons where there had been a variant of concern or interest in another part of the country. An in depth piece of work had been carried out with the local resilience forum to ensure that they had some surge testing arrangements in place if they had to move to test a wider section of the local population, if there was a variant of concern that required that response.

A lot of innovative work had been carried out bringing a number of the arrangements for tracing cases and following up on cases locally and they had launched the Local Tracing Partnership and Local Zero where the council would receive any cases that had been tested positive immediately rather than being dealt with by the national team. They also had a spike detector tool that had been recognised regionally and presented regionally as an example of good practice.

The Community Champions had been in place since November and they now had over 100 champions and were looking to develop community champions within a school with a young person setting as a development.

From a County Durham perspective the vaccination programme was progressing really well through the NHS priority list and were carrying out some specific work in relation to health and inequalities to reach some of the more difficult to reach communities and ensuring that they had a high uptake in those priority groups. Some people had now been called for their second dose and they wanted as many people as possible to take up that second dose and were doing some insight work for those who had concerns about the confidence in the vaccination and some communication to counteract that.

The Director of Public Health reported that there was a slight difference in how people were being called for their second vaccination and was the difference between the mass vaccination centres that were run through the national portal then the local vaccinations through GPs and primary care networks and this difference was due to the supply of the vaccine. GPs only know a couple of weeks in advance what their supply was going to look like.

A huge amount of work had been carried out in terms of testing and the government had rolled out testing and the offer locally they wanted people to come forward for the gold standard PCR testing if they had symptoms but had lateral flow device testing in place as well and were ensuring that uptake was people carrying out the test twice per week.

The lateral flow tests were in place within care homes and had seen a really high uptake of Lateral Flow testing in teaching staff when they’ve returned to school and the community testing was trying to target those who aren’t able to work from home and encouraged that twice weekly testing.

Members were advised of the work that had been carried out in the Education, University, Care Homes, Prisons, Workplaces and Healthcare settings.

Funding had been confirmed for the forthcoming year and Durham would receive just over £4 million and they were looking at a budget prioritisation process.

There were ongoing arrangements for outbreak management, and they continued to work with regional colleagues and the Chief Executive was the regional lead for regional oversight group and they worked very closely with LA7. There had been a very successful beat COVID North East campaign and underpinning this was evidence led work with communication with local residents.

The Director of Public Health then referred to the COVID-19 Vaccination Programme dashboard that was positive. The dashboard showed a high uptake of over 80s and over 75s right through to over 55s with 81.6% and were still taking up their vaccine. They had being doing some dedicated work to increase the uptake with carers and ongoing work in terms of vaccine hesitancy.

Members were then provided with details of the routes out of lockdown and advised that they were monitoring figures very closely but the changes to the figures from the opening up on the 12^th April would not be seen for another two weeks.

The Chair thanked the Director of Public Health for a very comprehensive report and presentation.

Councillor R Bell conveyed his thanks to the Director of Public Health for all her hard work. He referred to the case rate and the interactive map for the county and indicated that Shildon was relatively high at a rolling rate of 140 and asked if there was a reason for this. He then referred to the lateral flow tests and the NHS website indicated who was eligible for these tests that stated that anyone in England who did not have symptoms could now get regular tests that was very wide and gave an example of a friend who lived in the middle of nowhere had lateral flow tests and asked if there was a danger that the system was going to get overwhelmed.

Councillor Temple thanked the Director of Public Health for all her work as she was clearly working around the clock. He indicated that he was a user of the ZOE App and raised concerns as their estimated numbers for County Durham had been increasing quite rapidly, so there was a conflict with the Council’s dashboard. He asked the Director of Public Health if this could be investigated to ascertain if they had any basis for that as it showed the county’s numbers up quite considerably to almost mid-March levels, the app had 4.5 million users so was quite a significant sample size.

The Director of Public Health responded that it was the residents that had made the difference in terms of rates by supporting a very difficult lockdown period during winter. She then referred to Shildon and advised that a small outbreak was increasing the case rate in those areas and they have had an outbreak in one of the primary schools within Shildon that they were actively managing. They had not had any further cases and were working really closely with the school and the local community and moved additional testing there and a meeting was to be held later this morning in relation to the outbreak and this should settle very soon. In response to the question on the lateral flow tests and the shift to more of a universal offer the Director of Public Health indicated that the overall approach to testing was to think about the purpose of testing that was to identify and if people had symptoms could be tested and identify if they had COVID 19. The lateral flow tests were for people who did not have any symptoms and the authority had sought to use this locally for those people who were in high risk settings where they were more likely to come into contact with COVID-19 and had this in place within care home settings and had been introduced in schools and council employees who weren’t able to work from home. Some of the broader workplaces had done similar such as the Fire Service and Northumbrian Water, as it was the ability to detect the infection when people were asymptomatic. The shift towards universal testing was the government’s strategy and what the council had done locally was to support that strategy but ensure that they did not widen inequalities while that strategy was being implemented. They now had pharmacies collect who were coming on board and local pharmacies were key members of the local communities to engage with people to ensure good access and were encouraging twice weekly testing where appropriate. She referred to the information for testing for children under 12 as it was not recommended that primary school children be tested, and they had raised this nationally. They were in active dialogue with colleagues at a regional and national level and were trying to make the testing programme proportional and not widen inequalities. They would be looking at how testing had been utilised with events and hospitality as they opened up.

The Director Public Health advised Councillor Temple in terms of the ZOE App she would take that away and come back to the committee with a response. She indicated that there was a wide range of different apps with people uploading different results which was why they were focused on using the council’s dashboard and the intelligence that they received that was complimented with some soft intelligence that might come through other routes.

Councillor Stephenson indicated that she was a community champion herself in her local area and a lateral flow testing champion and volunteered at Annfield Plain library. She commented from a community perspective the lateral flow testing was something that the community had found reassuring particularly people who worked in community centres who were on the front line doing food banks. She had been asked to put the community centre forward as a place that could have the lateral flow devices delivered to the centre. She then referred to the vaccination slide that was reassuring in the numbers for the older generation and asked if the under 55s numbers were lower as they had not completed the programme yet or was it due to hesitancy.

Councillor Quinn thanked Councillor Bell for raising Shildon where they did have a spike and commented that they were kept fully informed as local Councillors and everything that could possibly be done was done. The school was closed, and the locomotion became an outlet for testing and the community were encouraged to get tested. The outbreak was manged well and thankfully it was the week before the easter break and the school closed early but this did not have a massive effect. She indicated that she worked in a nursing home and assured members that care staff got tested three times a week, two lateral flow tests and a third test that was sent away. She was also a community champion that was a great honour and was a good programme and she believed there was a place for community champions in the future to continue good work and hoped their work would continue.

The Director of Public Health responded that they had raised the issue nationally of community centres becoming distribution points for lateral flow devices. In response to the uptake of the vaccination for over 55s they were still encouraging people to come forward and were working on the vaccine hesitancy and confidence. Going down the age groups they needed to be more flexible in their approach to reaching people and thanked community champions as they needed to understand what was happening at a local level to ensure that the messages were been provided and they hoped to keep the community champion programme going.

Resolved: That the updated report and the progress to date on the development of and transition to the COVID-19 Local Outbreak Management Plan be noted.