Agenda and minutes

Steven Cooper - Assistant Chief Constable – Nottinghamshire Police

None

The minutes of the meeting held on the 23 July 2021 were agreed as a true record.

Lucy Hubber, Director of Public Health - Nottingham City Council, gave an update on Nottingham’s Outbreak Control Plan, highlighting the following information:

a)  Whilst the position with regards to the number of people with Covid in Nottingham was stabilising, it was disappointing that there had not been a continued decline in the number of cases.

b)  In last week, there has been a stabilisation of case rates in Nottingham City but figures indicate that there has been an uplift in the England case rates and Nottingham has largely followed the national trend and case rates in Nottingham remained relatively high. As such it was important for people to remember the message to wash hands, cover faces and get tested.

c)  Asymptomatic testing was still encouraged and there were a number of sites where people could collect a Lateral Flow Test (LFT). There is slight move to Local Authorities being the lead for more community targeted testing distribution.

d)  Changes to the self-isolation rules as a Covid close contact were highlighted:

·  New self-isolation rules as a Covid close contact will change for those who are double vaccinated and those under 18, as long as they don’t have any symptoms

·  NHS Test & Trace will be in contact to advise people take a PCR test

·  Those who are ‘double jabbed’ remain at risk of being infected and are advised to wear a face covering in enclosed spaces and limit contact with others, especially those who are clinically extremely vulnerable

·  Those not fully vaccinated will be required to isolate if they are a contact.

e)  However, some workplaces will be offering daily contact testing, meaning someone can go to their workplace in some situations. Those participating in this, will need to self-isolate when at home.

The roll-out of the daily contact testing is national programme and notification of any work places implementing the daily testing programme will be reported to the Director of Public Health, of which there are currently none in Nottingham.

The Board noted that the information from Government on this was confusing that and expressed their disappointment that the guidance was not clearer; as previously seen over the course of the pandemic, the clearer the instructions the more compliant people were and the confusion these changes may bring is concerning. It was noted that there was an indication that there would be a National Testing Strategy available in Autumn 2021 but this had yet to be confirmed.

·  NHS

·  Environmental Health

Amanda Sullivan, Nottingham and Nottinghamshire CCG updated the Board and highlighted the following:

a)  The levels of people in hospital with Covid was rising. There had been some fluctuations but there was a steady state of admissions to hospital for people with Covid. As a result, all services were being put under significant pressures, not exclusively relating to Covid but people were coming presenting with various other non-Covid issues. This affected GPs, Surgeries and Ambulance Services as well as community and social services.

b)  89 people admitted to hospital in the 7 days in run up to the 8 August 2021 compared to 92 the previous week. 131 people had been admitted with Covid week ending the 19 August, with 22 of those admitted requiring ventilation and 7 deaths in the week. Whilst there was a low level number of people dying with Covid the pandemic remained very much evident.

c)  The number of people who are becoming seriously ill and admitted to hospital had decreased since the first wave. Approximately 60% of those admitted to hospital had not received any vaccinations and 10% of those having only received one dose of the vaccination. Approximately 95% of Covid patients in Intensive Treatment Unit had not received any vaccination and it was evident that the vaccinations both reduced the changes of contracting the illness but also significantly reduced the severity of it.

d)  At the beginning of the pandemic, the demographics were very different and the majority of patients and those dying from Covid were the elderly. Since the vast majority of that age group had now been double vaccinated, the average age of those currently being admitted were unvaccinated people in their 30’s and 40’s

e)  Targeted communications was underway to continue to emphasise the importance of getting double vaccinated, with particular emphases being placed on getting the message to the younger generations.

f)  Additional work was being undertaken to also encourage pregnant women to have the vaccinations as there had been increased evidence that they were safe for birthing women. There was a joined up approach to getting the message across and the correct information was being provided to health care workers and mid-wives to ensure a consistent approach. It was noted that evidence suggested that pregnant women were more susceptible to the Delta variant of Covid and thus the need to educate pregnant women on their vaccination options was essential. Due to the length of the pandemic, it was reported that real time factual information was available to pregnant women and to health care workers/those coming into contact with pregnant women.

The Chair thanked Amanda for her update.

Matthew Daft - Environmental Health Officer, updated the Board and highlighted the following information:

a)  Since the withdrawal of the Covid regulations, Environmental Health had no enforceable powers to intervene on enforcement matters. However, there was a continued commitment to engage and influence where possible.

b)  The Environmental Health Team would align alongside the Health and Safety Executive  ...  view the full minutes text for item 276.

Sarah Carter gave an update on the Local Covid vaccination plan and highlighted the following information:

a)  16-17 year olds are now being offered vaccinations and these sites are operational from 13 August 2021 for walk- ins; there are 4 in total across the city, 2 at hospital hubs and 2 at local vaccination sites.

b)  Various communications team were working together to promote this in order to get as many 16 & 17 yr olds vaccinated as possible

c)  Work was ongoing in targeting certain areas and consideration was given to other behavioural insights to do more targeted work. With regards to pregnant women, a vaccination clinic in QMC maternity department had been trialled and take up was higher than expected. Work continued to be carried out with Community Midwives to ensure they too were able to inform women within the communities.

d)  With those individuals who have concerns about the vaccine clinicians and GPs are on site to answer any questions; you are not then obliged to have the test there are then but it was hoped that this may allay fear or any misinformation.

e)  Many people admitted to hospital have either only had 1 jab or none. By having 2 doses of the vaccines, protection against the delta variant was increased by up to 2.5 times.

f)  Planning was well underway for the roll-out of vaccination boosters, working with GP’s, public health colleagues and NHS providers which will mean those who had 2 vaccinations after 6 months they will get a further booster vaccination. There was also an expectation that there would be a significant increase in sites delivering the vaccine.

The Board were encouraged by the flexible approach that had been adapted in the vaccination of young people, specifically those aged 16 and 17. It had been necessary for a swift and adaptable approach to be utilised in order to encourage as many your people as possible to get vaccinated. Consideration would be given the plausibility of pop up sites, offering Covid vaccinations at Further Education at the start of the new term.

Lucy Hubber, Director of Public Health, gave an update of the impact of Covid on the local education system. The following information was highlighted:

a)  She had been very impressed by close working with schools, education and Public Health; the partnership working had been collaborative and meant that they had been able to act swiftly and effectively when outbreaks had been reported.

b)  Research had shown that schools had remained places of very low transmission rates when compared with the general population. This has been in part due to the swift action taken by schools and their effective outbreak management when cases had been reported.

c)  A number of changes would be in place for the start of the new term in September; from the 18 July 2021, close contacts identified by NHS track and trace and education settings will no longer be expected to undertake contact tracing. There was a peak in summer term and at the highest point the number of children and young people self-isolating was almost 3000 not attending education due to contact tracing. There was a far greater number of children being asked to isolate due to contact tracing compared to the actual number of cases of Covid reported.

d)  Where appropriate, should there be an outbreak, it may be necessary to re-introduce social distancing and request students wear face masks, but this will be undertaken on a much more individual outbreak response.

e)  All secondary school children will be required to take the 2 tests and home testing will be a significant feature of management control. There is an expectation that there will be a rise in other respiratory illness such as flu and plans for quite a large resurgence were underway with the flu vaccination being extended to more children this year

Nick Lee – Director of Education, gave an update and highlighted the following information:

a)  As a general overview the relationship between NCC and Public Health has been extremely beneficial and the expertise and recovery issues have been very valuable.

b)  8 different phases were identified in the response to Covid regarding schools – each phase needed to be risk assessed and it had been essential for flexibility in adapting to changing environments of learning. Tributes were payed to the staff, not just the teachers but the whole school support staff and the low transmission rate was testament to the work that has been done.

c)  Work had been ongoing with SEND children who make up 15% of students and any additional supported needed had been considered. There had been regular communication to ensure issues identified were managed and a huge range of work had been completed around re-aligning relationships around the Department for Education

d)  There had been a very large focus around free school meals for those entitled. There were considerable difficulties initially but managed and ensured that children and families were supported. Further to this, a holiday programme was introduced to enable children from low incomes or those  ...  view the full minutes text for item 278.

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