Update on the Epidemiology of COVID 19 and on the Northumberland COVID 19 Outbreak Prevention and Control Plan
An update will be provided at the meeting on the epidemiology of COVID 19 in Northumberland and developments with the Council’s COVID 19 Outbreak Prevention and Control Plan.
Minutes:
Liz Morgan, Director of Public Health, gave a presentation to update the board on the Covid 19 epidemiology. It included the latest key data and developments of Covid in the area and showed the statistics of Covid in England compared to Scotland for the past several months. It was noted that Scotland had an increase in cases since restrictions were relaxed which had been exacerbated by the return of schools. Rates across the country were variable with some areas having significantly higher rates than others. Data from the national statistics suggested that up to 1 in 70 people were infected at any one time using data up until the end of August.
From a regional perspective across the LA7 it was highlighted there was a general upward trend for infections. Cases per day in Northumberland had increased by just under 20% in the last 7 days. There had been an increase in rates in 10-19 year olds which was expected. Cases in over 80’s are decreasing and mainly stable in older age groups.
Data from Northumbria Trust suggested that cases in hospital were stable and there was no significant change. The rate of patient deaths had increased from July and August. It was highlighted that double vaccinated people are still being admitted to hospital and are still dying from Covid and it was noted that although the vaccine provides protection from serious illness and death, it does not necessarily prevent the transmission of infection. Therefore it was expected that there will be more cases of double vaccinated people being admitted.
The presentation gave an oversight about how we will live with Covid in the future. It gave an overview of the Government’s summer roadmap and recent Government guidance which included an updated control plan:
· Reinforce the country’s vaccine wall of defence.
· Enable the public to make informed decisions through guidance, rather than laws
· Retain proportionate test, trace and isolate plans
· Manage risks at the border to reduce the risk of variants emerging
· Retain contingency measures while learning to live with COVID-19
It outlined the priorities moving forward for the LA7 region which were:
· Equitable and rapid deployment of covid and flu vaccination progammes
· Encouraging good infection prevention and control measures including hand washing, respiratory hygiene, good ventilation and face coverings where appropriate ?
· Coordinated Test, Trace and Isolate programme and management of outbreaks via Local Outbreak Management Plans?
· Taking our communities with us via Beat covid NE using behavioural insights, consistent messages and community champions?
· Protection of vulnerable individuals in the community;?
· Continued monitoring and surveillance ?
· To re-focus our work on health inequalities
The presentation gave an overview of schools and how DfE and PHE will assist with children returning to schools safely:
· Revised DfE guidance for management of covid in schools and FE
· Close working between schools, education teams, public health and PHE
· Prevention – hand and respiratory hygiene, environmental cleaning
· Schools are continuing to test
· Regional documents to support outbreak management and measures
· Still asking schools to report cases
· Other infections
· Likely increase in cases – Scotland
· Agreed NE arrangements
· 12 – 15 yr old vaccination
The Local Tracing Partnership (local contact tracing) was ongoing to ensure people engage with NHS Test & Trace. Modelling was underway to inform planning for moving to 'Local 4', where NCC would receive all or a proportion of cases from the national team after 4 hours. There were reported benefits from other LAs using this model which included better customer experience and engagement, linking into the local support offer and intelligence gathering. There was only one supervised asymptomatic testing site in Northumberland as demand had fallen due to the multiple channels where people could pick up tests including pharmacies and home direct.
It gave a progress report on outbreak prevention and control plan implementation. The key messages were;
· The only certainty is uncertainty?
- The covid vaccination programme?
- Case rates?
- Flu and other respiratory illness?
- Multiple variables - easing restrictions, how people change their behaviour around social distancing, use of face-coverings and testing, the duration of immunity from vaccination or past infection and the effect of schools returning.?
· Acceptable levels of infection would be influenced by NHS ability to cope?
· Continue to be cautious to get through the winter
Richard Hay, Head of Planning and Operations (NHS Northumberland CCG) gave an update on vaccine uptake figures in Northumberland. Statistics on vaccination uptake were provided and compared the region to the rest of the country. It showed that Northumberland had the highest percentage uptake of 16+ first doses and second dose of any Upper Tier Local Authority in England. The statistics also showed that the North East is above the national average and Northumberland was again largely above the North East average for vaccine uptake for both 1st and 2nd doses. It highlighted that the younger age bracket (16-39) had the highest difference which was a credit to the region.
The latest JCVI guidance was that all 16-17 year olds would receive one dose of the vaccine and eligible 12-15 year olds (with eligible health conditions) would receive both doses. JCVI had not recommended that 12-15 year olds without underlying health conditions be vaccinated. However Health Ministers were looking at the other benefits of vaccination for this cohort. Therefore plans were ready in the background should the go ahead be given.
JCVI advised Government in July that any potential booster programme should be rolled out by September to maximise protection to those most vulnerable. It should be offered in two stages:
· Stage 1: all those over 70 inc. Care Homes and all those over 16 who are Clinically Extremely Vulnerable, frontline H&SC workers
· Stage 2: all those over 50 and all those 16-49 in a flu or COVID-19 ‘at-risk’ group
It outlined the next steps for the vaccine rollout:
· Continue to provide 2nd doses to all eligible patients at 8 weeks and maintain an evergreen offer of vaccination into the Autumn/Winter?
· Promote importance of second dose uptake to provide greater protection to patients and reduce opportunities for transmission?
· Prioritise vaccination of eligible Children and Young People?
· Deliver 3rd doses to those eligible immunosuppressed individuals?
· Collaborate and co-operate across delivery models (PCN, Community Pharmacy, Hospital Hub) to complete Phase 2 and standby to deliver Phase 3, subject to JCVI guidance?
· Deliver seasonal flu vaccinations as normal & without delay?
· Increase activity and promotion of the benefits of vaccination in our most deprived communities to tackle inequity of uptake?
· Communicate proactively and effectively with our patients and public
The following comments were made in response to questions:
· Several members expressed their pride at how well Northumberland were performing with the vaccine uptake. Especially the younger age brackets.
· From November it was to be mandatory for Care home staff to be vaccinated and the same regulations were being looked at for wider people who enter care homes but not necessarily visitors.
· Sometimes the death rate was higher than expected throughout the year and sometimes it was lower than expected
· It was agreed that Liz Morgan would do a deep dive on death statistics and share with members information regarding average death rate and non-covid deaths to help understand the impact of Covid in our region.
· Consent for younger people to be vaccinated (12-15 yr olds) could be more complex if parents disagreed or there was a disagreement between parents and children. Guidance may be needed to agree an approach to these issues when they arise. This would be addressed as part of the planning process but most.
· There was always going to be a proportion of the population who would not be vaccinated because they had a clinical condition that precluded it but in general, vaccine hesitancy could be attributed to complacency, a lack of convenience or lack of confidence. The health service has proactively worked to reach out to groups to promote the benefits of vaccination and many people had valid concerns which must be taken seriously
· Communications was a key factor in informing the public of the benefits of vaccination. Communication is being directed to different cohort groups for example expectant mothers.