Agenda item

COVID-19 Local Outbreak Management Plans

To consider a verbal report by the Director of Public Health

Minutes:

The Director of Public Health took the opportunity to inform the Board of what had been done by Public Health Dorset (PHD) - in partnership with other heath bodies GP’s; Dorset Clinical Commissioning Group; the NHS, emergency services; and Dorset and BCP Councils - to address and manage the Coronavirus pandemic within Dorset over recent months.

 

The Board were given a presentation illustrating the local outbreak management plan, how it was being applied and managed and what was being done in practice, along with other associated information pertaining to the pandemic, to put what PHD was doing – and had done - in some context, this being:-

 

National context

        Northern metropolitan areas and cities hit hardest

        Low number of cases in BCP Council area and Dorset Council area

        Impact of COVID-19 bigger in areas with higher multiple deprivation

        BAME groups more at risk of poor outcomes, obesity, diabetes, age, male gender and occupation also key risks, as is poverty

        Enhanced surveillance is key over the next few weeks

        Planning for winter, and return of COVID-19 with potential for seasonal influenza also hitting hard

        Care homes continue to be setting of highest concern nationally

 

Outbreak management

        Local outbreak plans will be our first line of defence against going back to national lockdown

        Developing key actions for high risk settings through COVID-19 Health Protection Board

        Health and Wellbeing Board in each Council functions as Local outbreak Engagement Board

        Relationships built during crisis and first wave will stand us in good stead if we need to respond quickly

        Capacity planning, scaling testing quickly, good, clear communications and engagement all key actions for an effective plan

        Supported by Test and Trace Grant in each council, worth £1.28M and £1.8M

 

Outbreak Management Plans

  1. Level 1 (BAU) – day to day outbreak response in specific settings – plus preventive and preparatory activities, training, action cards, communications
  2. Level 2 – where local outbreaks have potential for wider spread into the community requiring additional community engagement, possible LRF involvement and extra resources
  3. Level 3 – local outbreak with national significance – most likely to be sustained rise in community cases that exceeds a number of triggers, including testing positivity rate >5%, 7-day case incidence rate of >50 per 100,000 pop

 

 

 

 

 

Next Steps

        Regional and local assurance on readiness of plans – exercising, action cards, resourcing and capacity plan

        Re-shaping Public Health Dorset business plan and re-prioritising into two workstreams – recovery (BAU) and response (outbreak preparedness and response)

        Capacity and resourcing within team feels about right – short term investments in modelling capability, backfill for Environmental Health Officer support, community and voluntary sector response to support self-isolating, IPC training, testing

 

Given the unprecedented circumstances in having to deal with such a pandemic, it was a seen to be a credit to PHD in how this ad been managed and as a consequence how relatively successful it had proven to be. Relatively low contagion and transmission rates had meant that the success seen in suppressing such an infectious and contagious virus was seen to be largely attributable to how PHD managed it, what had been done in practice to do this; and the preparations they had made to do so. The acts of social distancing, hand washing and isolation - which had been generally well observed in Dorset - had meant that containment of the virus had been relatively successful, compared to if this had not been the case.

 

Moreover the ability to maintain what PHD services offered and could do throughout this outbreak was to the benefit of Dorset, its residents and visitors in being assured that continuity as far as practicable. Considerable emphasis was placed on what partnership arrangements had achieved in addressing the outbreak, with those organisations identified above - as well as the voluntary sector and individuals – all playing their significant part in contributing to ensuring, firstly, that the ability to maintain satisfactory critical care in the NHS was not compromised or overwhelmed as well as how the prevention of the transmission of the virus might be mitigated and the arrangements put in place to be able to do this.

 

Having understood all that was explained, the Board took the opportunity to ask a series of questions about other aspects of the pandemic including the coronavirus itself; social isolation; individual personal hygiene measures; transmission rates and dynamics; ethnicity disparity; tracking tracing and testing; PPE; and vaccination prospects to clarify what PHD had done to address those issues and how this had been achieved and what success it had.

 

In answer to one particular question the Director explained that the virus was likely to be seen to be more virulent during wintertime - when there was more chance people would be indoors for longer periods, with more people - so there was potentially more opportunity for it being able to be transmitted, as well as coinciding with the period that other viruses were apparent, the cumulative effect of this being that this could prove to be a challenging time for the NHS. Conversely, time being spent outdoors when the weather was warmer and there was greater opportunity to socially distance, meant that this transmission opportunity was lessened.

 

The Director was confident that lockdown had contributed significantly to breaking the chain of transmission along with the observations of social distancing and individual hand hygiene being applied, observed and complied with had gone a long way to Covid-19 being dissipated as it had.

 

The Board appreciated what PHD had done in addressing the Covid-19 pandemic and how this had been achieved, being seen to be a credit to how important PHD preventative work was, which demonstrably demonstrated how Dorset and its residents benefitted from it.  They hoped this positive response could be maintained and looked forward to receiving a further, positive update at their November meeting.

 

Resolved

That the Outbreak Management Plans and how these were being applied be welcomed and endorsed and should be maintained and improved, as practicable.

 

Reason for Decision

To ensure cases of Covid-19 remained as low as they possibly could be in Dorset.