Agenda item

The Director of Public Health commented that the NHS Test and Trace Programme was just one strand of an overall approach to managing Covid-19 outbreaks. There was still a role for local authorities and partners to work jointly together to support the overall programme and ensure successful outbreak prevention and management in local areas.

One of the requirements for each local authority area with public health responsibilities was to produce an Outbreak Control Plan.

York had been allocated £733,896 to support this work as its share of £300m Government funding distributed in line with the Public Health Grant.

The overall aim of the Outbreak Control Plan was to provide a framework for the City of York approach to preventing and controlling outbreaks of Covid-19 and reducing the spread of the virus across the city.

There were a number of objectives to help deliver this:-

the first of these was to have a proactive approach to prevent outbreaks by identifying and supporting high risk settings and cohorts. Part of this work was to identify where we may have high risk settings and where there are groups in the population that might be at higher risk from Covid-19. Examples of high risk settings might be care homes; schools; high risk businesses where it is difficult to put in social distancing measures. Examples of groups that are high risk are the BAME population; older people and people with existing long term conditions.

The second was to identify outbreaks early by using local intelligence and responding to the various alerts of suspected cases through the testing system.

York had been successful in its application for a satellite testing site in the city and this will give us capacity for 500 tests a day. This opened up an opportunity to look at wider testing.

There was a third objective around outbreak management, which could include localised closures.

Fourthly, there was continuing the successful work done in York already through the community hubs to support people who needed to self-isolate.

Finally, there was a role for this Board to ensure that we had the right governance arrangements in place so that there was oversight and assurance in relation to the plan.

The Outbreak Control Plan had seven themes:

     i. Care homes and schools

   ii. High risk places, locations and communities

  iii.Local testing capacity

  iv.Contact tracing in complex settings

   v.Data integration

  vi.Vulnerable people

vii.Local Boards.

The Director of Public Health went on to give an overview of the national framework of the 5 pillars of testing and how far these had progressed and were available. The five pillars were:

Pillar 1: NHS swab testing

Pillar 2: Commercial swab testing

Pillar 3: Antibody testing

Pillar 4: Surveillance testing

Pillar 5: Diagnostics: national effort

Finally the presentation covered local testing capacity and capability as well as management and governance structure, the links into different groups across the health and care system and flexibility in terms of response and how long they might need to be in place for.

The city’s Outbreak Management Plan would be published by the end of June but would need to remain a live document and be responsive to changing circumstances.

There was going to be a self-assessment at Humber, Coast and Vale level. The initial self-assessment for York, undertaken within the public health team, showed that we were broadly on track but the red risk area we had was was around confidence in data and systems needed for local surveillance.

There were some uncertainties going forward, including a lack of certainty around funding and whether there will be more funding in the future; Pillar 2 data not being available in a useful format; clarity on local lockdowns and information from the Department for Education in relation to schools.

There were a number of comments, questions and actions from board members as follows:

Action: The chair asked that the published Outbreak Control Plan be brought to the next meeting of this board.

Action for the Director of Public Health: That the issues in relation to the ‘uncertainties’ section of the presentation (in particular those around the amber and red risks concerning data; the governance around local and regional lockdowns and the earlier flagged issue around collecting ethnicity data be included in one representation from this board to the Local Resilience Forum and to Leeds City Council, who are the pilot Council in the region and also to the Department of Health.

The Police, Fire and Crime Commissioner mentioned the limited powers of the police around enforcement and also asked what constitutes a local lockdown. She raised some risks around the impact on critical service delivery and what would happen if one critical service was unable to function due to Covid-19 and the impact this would have. A local lockdown would also have implications for businesses; particularly in the hospitality sector on which York is reliant. She suggested that practical advice to businesses would be really useful.

In response the Director of Public Health said getting the local surveillance systems and data sharing mechanisms in place will be really important. Implementing a local lockdown should be a last resort and the prevention measures we have in place should be robust enough to give us early warning of a hotspot of infection emerging. The Outbreak Control Plan should enable us to respond very quickly to manage and contain the situation.

In terms of practical help and support for businesses one of our priorities is to use some of the monies from the Government to expand our capacity to enable us to do this. Some packs have been sent to retail businesses already but this will only go so far and some may need further help. In addition to this there will be packs for the hospitality sector available soon.

The Vice Chancellor at the University of York hoped that students would return to York universities later this year. The York Universities should surely be classed as a high risk location or community with the numbers of students being approximately 27, 000. Universities feature in the local Outbreak Control Plan and it is acknowledged that they will require special consideration not least when it come to the complexity of the setting and contact tracing. There will need to be a very swift testing capability so that contacts can be traced quickly otherwise there could be an extensive number of students in self-isolation not knowing whether they are infected or not. Is the testing capability we have through the various sources really up to coping with this bearing in mind there will be upwards of 20,000 people from various places being brought together. If not, what can the universities do, to supplement that testing capability?

In response the Director of Public Health said that we are going to need an individual outbreak plan for each of the universities in the city. For the University of York there are challenges around the campus itself and the number of students. We will need to work with you and involve Public Health England (PHE) to develop an outbreak plan for the university.

The Managing Director of First York commented that the York picture was better than national picture yet we were adhering to the same national interventions, such as not using public transport. It would be good to understand where there was scope in the Local Outbreak Plan to provide positive local interventions that may not be aligned to the national picture.

In response, the Director of Public Health said there was scope to do things differently in York, providing that, as a city, partners together said we were able to do something that other cities may not be able to do. As long as we adhered to the themes in the Outbreak Control Plan then how we implement that was very much up to us locally.

Cllr Myers asked for clarity around theme 1 in the Outbreak Control Plan; particularly on the risks of a universal approach to care homes and schools.

In terms of the element around care homes, this would be covered under the case scenarios in item 7 of this agenda. In terms of schools the Corporate Director, Children, Education and Communities said that the approach would be the same approach that had been taken right the way through. It was important to remember that schools had been open through lockdown for particular groups of children. We had worked very closely with York Schools and Academy Board to take a city wide approach to making sure that everything we did was based on risk assessments and on the most up to date information available. The approach to opening each school was different, and dependent on the physical building and the teaching staff available to them. We would continue to work with all of our schools to ensure they had individual plans. 

The Board noted progress towards the development of a local Outbreak Control Plan, the deadline for publication and that the Plan would come back to this Board.