To receive a presentation from the Director of Public Health (Cumbria County Council (copy to follow).
Members received a detailed presentation from the Director of Public Health (Cumbria County Council) which gave an update on COVID 19 setting out the national and local picture.
The Board was informed there had been a substantial rise in cases nationally since September but this was beginning to plateau. It was explained that the number of patients admitted to hospital was also rising nationally but this was more gradual than during the first peak of the pandemic. Members noted the North West had the largest figures for hospitalisation and that mortality was increasing nationally but slower than during the first wave.
The Board was informed that all local areas had seen a rise in cases but they were now stabilising and beginning to decrease, with approximately 200-220 cases per 100,000 population, which was less than the average in England. It was explained that hospitalisation continued to increase creating significant challenges for the local Trusts and that mortality rates were still increasing but were lower than during the first wave of the pandemic.
The Board drew attention to the statistics regarding the number of excess deaths from all causes in comparison to a five year average which showed that the excess death figures were approximately twice the level of deaths solely attributed to COVID. Members asked if any work was being undertaken as to the extent to which that represented either an under reporting on the deaths caused by COVID or if it was largely due to deaths which were non COVID attributable.
It was explained that the number of excess deaths overall had not been investigated in Cumbria but considered nationally. Officers felt that in the initial phase a number of the excess deaths that were not recorded COVID-related could actually have been as a result of COVID because of the relative immaturity of the testing regime. However as the outbreak progressed, and the testing and attribution schemes became more established, it was more likely that the excess deaths were not as a direct result of COVID, but probably more likely due to the impact of the control measures that were put in place.
Members welcomed the evidence that lockdown measures had reduced the level of winter flu and, therefore, reduced the additional pressures on the system.
Members were informed that testing remained part of the mainstay to the strategic approach to reducing COVID 19. It was explained that future testing plans were being investigated with a view to establishing a number of more robust, permanent and more accessible local sites during the winter season in Barrow, Carlisle and other key towns in the county. The Board noted that local authorities had been invited to express an interest in a lateral flow testing system and that Cumbria was working at pace to put plans in place. It was explained the final strand of the testing strategy was to establish a rapid deployable outbreak response with a hyper mobile unit being pursued for that purpose.
A discussion took place regarding support for domiciliary care and members were informed that lateral flow testing would be controlled locally and that this cohort of people, and possibly school staff, would be at the top of the list for weekly tests.
The Board then received an update on contact tracing which it was felt was working exceptionally well in Cumbria. Officers explained this was set up in the middle of May, ahead of the national contact tracing system, and approaches were being formalised with the Department of Health, through a local Contact Tracing Partnership, to reduce duplication and ensure there was data consistency. Officers emphasised how critical access to the national system was to enable local contact tracers to have the ability to provide individuals with an identification number which would allow them to access the national support grants if they were isolating and on a low income.
Members were informed this was a substantial piece of work and following an initial meeting every effort was being made with the Department of Health to quickly gain access to the appropriate system. It was explained that in order to undertake this local contact, training was being increased with support being provided to district council teams along with the provision of a central team to follow up contacts and advise on self-isolation.
The Board received an update on the vaccination planning and was informed that preparation work was underway for when the vaccines in development could be delivered. It was explained the intention was for primary care to primarily lead on this programme with an initial focus being on care home residents and staff together with NHS staff and that discussions were taking place at national level regarding other prioritised groups.
A concern was raised regarding the lack of inclusion of care support workers who worked in the community supporting people in their own homes, reablement and supported living and asked when vaccine capacity would be available to them.
Officers explained that to?date no vaccines had received regulatory approval but assured members that the NHS was fully prepared for the vaccine when it was available, highlighting the enormous logistical challenge this would bring. It was explained that prioritisation was being led nationally by the Joint Committee on Vaccination and Immunisation with every endeavour being made to make the best local interpretation to offer support to a range of frontline staff. It was agreed that further information would be circulated separately to the Board.
A discussion took place regarding the disproportionate effect of COVID on people with learning disabilities and how Cumbria dealt with this. Officers acknowledged concerns drawing attention to the challenges of access to testing but explained that when lateral flow testing was in place this would be applied to that group of people. It was explained that discussions were ongoing with the Department of Health to ensure all centres were accessible for everyone.
A concern was raised regarding the lack of reference to the availability of the COVID vaccine for all school staff. It was explained that the prioritisation had been determined nationally and, although schools did not appear at present, this had not yet been finalised.
During the course of discussion an issue was raised regarding the lack of contact with schools regarding the flu vaccination this year. Officers explained there had been challenges regarding the national supply of the vaccine but confirmed that vouchers for the vaccination would be made available to all schools in the forthcoming week.
In conclusion, the Board was informed that following the end of the current lockdown on 2 December there would be more national dictation of tiers, including any relaxations for the Christmas period. It was felt if a vaccination was available early in the new year there may be improvements in the Spring but highlighted vaccinations may take a long time to administer, therefore, there may need to be ongoing controls for the next 8-12 months.
The Chair, on behalf of the Board, expressed thanks and appreciation to everyone involved.