To receive an update on Lancashire's response to the pandemic.
Minutes:
Dr Sakthi Karunanithi, Director of Public Health, Lancashire County Council gave an update on COVID-19 in Lancashire and highlighted the key issues/risks in the system and also provided an outlook for the next few weeks.
As can be seen across the world, there has been a resurgence of cases and what Lancashire is seeing is that the first wave has levelled off. However, there are flare-ups within care home settings and other establishments and there are also signs of infections within household settings in parts of Lancashire.
There are a couple of breakthroughs in the form of a vaccine which will possibly be available early next year and which further information is still awaited, and the other new development is drugs and medicines which keeps evolving. What is currently being seen across Lancashire, is that there has been a clear shift in the demographic of the pandemic from older people to the younger working aged groups.
Daily data is provided which is more precise and aids the actions taken from the results of the Test and Trace programme so that Local Authorities can make decisions from the data relevant to their areas and communities which are more localised than the national picture.
Two key themes that will help through the next phase of the virus are:
i) Messaging, more dynamic and aligned with local agendas and engage with the local public.
ii) The effectiveness of Test and Trace and support for self-isolation especially when the furlough scheme stops.
Mental health and wellbeing is a key theme across all age groups as an issue which needs to be addressed now. Longer term there are three fixed points that are a cause for concern:
i) As the lockdown lifts and new powers are given, what changes will happen to the pandemic curve is the immediate issue and there are starting to be localised outbreaks already.
ii) When more businesses, particularly schools, colleges, universities start to reopen, if the virus is contained and the outbreaks are controlled those settings will not become places of transmission.
iii) Winter - if the points above are not fully under control there will be significant winter pressures. If the situation with the virus changes for the worst or is not kept under control as it is now, this will cause huge additional pressures in the winter.
The situation in terms of the outbreaks in Pendle and Blackburn with Darwen are different, in that Pendle saw a recent two day spike in infections and Blackburn with Darwen have seen a sustained increased level of cases. Both of them are beyond the usual outbreak management situation so a broader plan has been activated and agreed by the Lancashire Outbreak Engagement Board, the Health Protection Board and the Lancashire Resilience Forum structures to look at that broader plan; and in essence involves community engagement and increased test and trace in areas which have seen outbreaks. The testing regimes have been broadened to include members of the public that may not be symptomatic in Pendle.
The rest of the areas within Lancashire are being assessed based on escalated risk which utilising five categories:
i) The pandemic is over
ii) Outbreaks/incidents are well managed, just follow national guidance (all areas excluding Pendle (and Blackburn with Darwen) are currently at this level)
iii) Requires additional testing, increased inspections, introduce some new powers, additional intervention and further restrictions on top of national guidelines ie introduction of face coverings, testing more people, enhancing support for shops including requiring them to display the maximum number of customers at any one time allowed inside the premises
iv) Further increase in widespread community/household transmission where further restrictions will need to be introduced. This will involve discussions with national colleagues
v) Maximum escalated risk which is where there would be a need to add national interventions with sectors/localities in lockdown
Fundamental to an effective response is public consent and the role of elected members and national politicians is crucial in getting that engagement as well as getting the intelligence from the local community. There are also fundamental issues regarding stigma and community cohesion.
A plan is being activated in every district with different levels of intervention based on the risk as explained above. Learning is happening from the areas that have had to introduce stricture measures locally, such as Blackburn with Darwen, Pendle as well as Leicester.
In summary, the first wave of the pandemic has levelled off, with a couple of flare-ups occurring in a few of areas in Lancashire, where additional measures have been introduced on top of the national measures. The forward planning phases are from now to September and September through to winter. There are specific risks that come with the planning and the requirements of community engagement and people following the advice, as well as an effective test and trace programme will help ease the pressures from now through to winter.
Dr Sakthi Karunanithi extended his thanks to all the public, agencies, colleagues, elected members for their involvement and support throughout this pandemic.
Following Dr Sakthi Karunanithi's overview, the Board discussed how they could support especially in terms of communicating and engaging with communities. The Board were informed that there was a Communications group which was taking a universal approach and going ultra-local with very specific insights into local businesses, ie barbers, food shops.
With regards those who have limited digital capabilities, different approaches were being made with regards encouraging people to get tested. At the moment there are local testing stations so people can just turn up for tests and also there is some good partnership working emerging with the community where staff are buddying up with local community. With regards tracing, it is proving that not everybody leaves their details and that is becoming a challenge in itself, however not everybody that gives their details engages as well. Again, more communication and engagement is needed to improve this.
There is a widespread flu vaccination plan which is expected to have a higher uptake than normal and if a vaccine is found for COVID-19, this cannot be given at the same time as the flu vaccination, so there is a huge logistical planning exercise underway if and when a vaccine for the virus is found.
The Voluntary, Community and Faith Sector (VCFS) reiterated that they can help communicate at different levels throughout Lancashire and keep repeating the messages being delivered centrally and reassure communities that there was a plan for each area. There was a request for a consistent message to be passed to the Voluntary, Community and Faith Sector (VCFS) groups to forward on to their communities and they requested to be kept updated when there was a change. It was noted that there needed to be a bridge built between the Local Resilience Forum and the Integrated Care System.
Resolved: That Dr Sakthi Karunanithi would speak to Communication and Engagement colleagues in the Lancashire Resilience Forum along with colleagues in the Integrated Care System and ensure that connections are made with colleagues in the Voluntary, Community and Faith Sector (VCFS) so they can actively engage and reiterate messages out to the communities of Lancashire.