Agenda and minutes

The Board had no interests to declare.

There were no matters arising from the previous minutes. The Board agreed the minutes as an accurate record of the meeting held on 30 September 2020.

The Board noted the updates in the action log.

Fiona Phillips, Assistant Director of Public Health, City of York Council, presented an overview of the local available data. The positivity rate of York had increased to 18% which was significantly higher than the national rates.  This was an indicator that was closely monitored daily.  A high positivity rate showed that community transmission was high and usually called for more testing to be considered by the local authority. As stipulated by the World Health Organisation (WHO) at the start of the pandemic, a healthy positivity rate was below 5%.

The areas that had been the most affected with the highest rates were Fulford, Heslington and the University of York.  The paper also outlined the age profile from both before and after the restrictions were relaxed in July.  In the first two weeks of the lockdown the spread of positive cases had been mostly within the 20-60 age group, making up three quarters of all cases, with the rest being in the 10-19 cohort.  Now however the 10-19 age group made up 40% of all positive cases in York.  Data gathered from the National Track and Trace service showed that 70% of positive cases had been successfully contacted by the system, which was good.  This would hopefully increase with the recent implementation of the localised contact tracing system.

Councillor Aspden asked whether there had been any learning shared with other local authorities who had moved into Tier 3, in case it happened in York.  Sharon Stoltz, Director of Public Health for the City of York, assured the Board that she met with the Chief Medical Officer and Directors of Public Health from other areas across England regularly and they had found that a whole host of different measures could have an impact. If we managed to keep the positivity rate in older people stable and address the community transmission rate to protect the NHS and care homes, she would expect that York would stay in Tier 2.

As seen in the presented data, the majority of cases were aged under 30.  Alison Semmence, Chief Executive of York CVS, asked how long the time lag was before the older cohort became infected.  Sharon Stoltz assured the Board that this wasn’t inevitable and that trends were monitored over a 7/14 day period.

Julia Mulligan, North Yorkshire Police, Fire and Crime Commissioner, asked whether there had been any insights learnt from the behaviours of different age groups.  She stated that the 60+ age group were well aware of the risks and therefore were being cautious.  Sharon reported that people of all ages had been found to break the guidance.

Marc Bichtemann, Managing Director of First York, asked whether people weren’t following the rules because they didn’t understand them, rather than actively not following them.  Siân Balsom, Manager at Healthwatch York, thought it could be attributed to people suffering from quarantine fatigue; especially since people had been following the rules and cases had still continued to rise. The Board discussed how  ...  view the full minutes text for item 55.

Claire Foale, Head of Communications at City of York Council, gave a presentation on the continued messages and engagement that the Council carried out.  Facebook Live Q&A sessions had continued to be used to engage with the local community.  The last Q&A held was on 14 October and had been focused on the return of students to the city.  A daily tweet had also been introduced last week which showed the daily cases.  This was also shared with Jorvik Radio, who had a daily thirty minute segment around covid. Local media had been very helpful in supporting the council in disseminating local messages.  There had been a shift over to more positive messaging recently, to be more supportive and encourage the public to adhere to the guidance more. 

The Board noted the presentation.

Charlie Jeffery, Vice Chancellor and President of the University of York, gave an update from the Universities and Higher Education Establishments Sub-Group.  He stated that we continued to see a significant amount of cases but these were starting to decline. A clear pattern of the cases had been identified after working closely with the City of York Council’s Public Health Team.

The Sub-Group had had a good experience in requesting and receiving tests in a timely manner.  The walk-in testing site was in full operation and had been a very helpful resource to draw upon. Charlie informed the Board that a large number of students were currently self-isolating but this had decreased significantly over the last week.  Charlie noted the great work the Student Societies had been doing to build the morale of students.  Due to the regular contact, access to online resources and the recreational activities that had been created, students were showing quite a high level of compliance.

There were different challenges that faced universities and colleges as they both had big accommodation buildings and a large amount of commuters who travelled.  This made these settings much more prone to outbreaks and would require whole site asymptomatic testing to stop widespread transmission.  This had already been carried out on two student accommodation buildings with relative success.

Charlie informed the Board of the close collaborative work with the City of York Council, Clinical Commissioning Group (CCG), York Hospital and colleagues in Hull to see whether any joint working could help increase testing capacity.  Charlie had found that the working relationships in York were much stronger than those of his education colleagues elsewhere in the country.  Siân Balsom asked whether there had been any lessons learnt from other universities as they were expected to be the first hit by the second wave.  The University of York had the fortune of having a later start date to that of other parts of the country, which Charlie explained had given them a degree of foresight that had informed their preparatory work.  Charlie added that they were currently working out the logistics of students going home for the holidays as well as their eventual return in January 2021.

The Board noted the update from the Sub-Group.

Fiona Phillips updated the Board on the work that had been progressed regarding contact tracing in complex settings.  If it was a complex scenario, the Public Health England (PHE) Public Protection Team would pick it up and would potentially work with the local Public Health Team if any local work needed to be carried out.  Three visits to premises with concerning outbreaks in York had been carried out by a representative from both the Public Protection Team and the Public Health Team.

A lot of work had be completed with schools to trace the contacts of cases.  However, Fiona noted that the head teachers within the schools and the respective role in universities had done a lot of work on this, almost becoming experts themselves.

The first preparatory meeting with PHE had taken place on 1 October and in just three weeks the local contact tracing system had been fully set up.  Existing staff members from the Health Trainer Team had been used in the interim while Health Promotion Officers were being recruited and trained.  After they were fully trained, the Health Trainers would only be used in a surge capacity if they were needed.  Fiona stated that this was important as the service needed to be reactive and able to be scaled up when appropriate.

Currently, the National Track and Trace Service attempted to contact cases/contacts for 48 hours and if this hadn’t been achieved it would be passed over to us.  Our local system  would then try to contact the person for a 24 hour period.  If contact could not be made, a visit to their home address would be organised to offer support in person.

Councillor Myers asked about the consistency of funding regarding the local test and trace system.  Sharon stated that all local authorities received a share of the one-off grant of £300m that was allocated to local authorities’ Public Health Teams.  York’s share of that was £173,000, which had been used to support the communications work as well as to boost the capacity of both the Public Protection Team and Business Intelligence Team.  Money from the existing Public Health grant had also been used to supplement the funding.  Through being prudent, the funds were expected to allow the service to run up until December 2021.  If the pandemic continued further funding would have to be requested. The Chair added that a letter had been sent to the Health Secretary which called for additional funding and support for the test and trace system as well as for a second walk-in testing site.  Ian Floyd, Interim Head of Paid Service at City of York Council, stated that we shouldn’t forget that other funding was still being received with all other local authorities suffering from the same financial pressures.  However it clearly made sense that the return of investment in covid will be massive for businesses and residents.

The Board noted the report and expressed their thanks to the Public Health Team for establishing the local contact  ...  view the full minutes text for item 58.

The Board discussed the new three-tiered covid alert system and how being moved into Tier 2 affected York.  Sharon Stoltz asked the Board if any further work could be identified to mitigate some of the potential impacts of moving higher up in the Tiers.  Sharon asked for feedback to be sent to herself and Claire Foale.

The Board noted the verbal update.

Sharon Stoltz thought it would be useful for the Board to have sight of the risk log that the Outbreak Management Group (OMG) used. The OMG brought representatives from all teams across the council to work on the Outbreak Control Plan.  Sharon explained the different themes and named the Public Health Practitioner who led on each of them.

Theme 1 had been separated into Schools and Care Homes.  Care Homes were managing to control the spread of infection well with the risk level RAG rated at Green.  Leigh Bell was the Practitioner who led on Care Homes.  Schools was led by Anita Dobson with support from Maxine Squire.  Schools had been coping well throughout the pandemic with no whole school closures having to take place.  Head Teachers and their staff had done a great job with disseminating public health messages to their students and families as well as carrying out a lot of their own contact tracing before even being asked.  The only concern, Fiona stated, was that should there be a massive influx of cases in schools, it could create a staff capacity issue if most had to self-isolate. If  guidance was followed however, it would dramatically reduce the risk of this happening.  This explained why the risk was currently RAG rated as Amber.

Theme 2: High Risk Settings and Vulnerable Populations had been split into Workplaces, Universities and other vulnerable populations.  Universities was led by Nick Sinclair and Peter Roderick.  This theme had been rated amber due to the amount of staff capacity required to support it.  Workplaces was led by Natalie McPhillips with support from the Public Protection Team and their Environmental Health Officers.  It was a very resource intensive work as we needed to react quickly to any clusters or outbreaks that were identified.  There had been no difficulties reported accessing businesses and they had been very compliant with the suggestions made at each site visit.  Working relationships with businesses had become a lot better throughout the pandemic but there was still some work to be progressed to help them understand the necessity to self-isolate if required to do so. Workplaces had been RAG rated as Amber. 

Themes 3 & 4 covered the local contact tracing and testing arrangements. Philippa Press led on this. Another application was currently being prepared for the second walk-in test site at the other side of the city, which was still being identified. Consultations with Deloitte and PHE had already started.  Fiona reported that access to testing had been improved but there were still issues around the timeliness of the results coming through to us.  This was a national issue that the government was aware of and was also why the risk level had been RAG rated as Amber.

Theme 5 was around data.  This theme had fostered a lot of cross agency work from across the CCG, CYC and the Hospital. Data sharing agreements had been developed to be able to look at the biggest, most complete current picture of York.  ...  view the full minutes text for item 60.

The Chair confirmed that there were three standing items for all future agendas:

·        Current Situation in York

·        Communications and engagement

·        Updates from Sub-Group/ Task and Finish Groups

A request had already been received from York CVS around the work they had progressed regarding covid and this would be added to the November agenda.  James Farrar had also suggested an agenda item on the economy and the furlough scheme to understand whether there were any knock-on effects for the future.  It was agreed that this be brought to the December meeting.

The agreed dates of future meetings were as follows:

·        18 November 2020

·        9 December 2020

·        13 January 2021

·        10 February 2021

·        17 March 2021

·        7 April 2021

·        19 May 2021

The Board had no other business to discuss.