Agenda item

Nottingham's Outbreak Control Plan Update


David Johns, Consultant in Public Health, gave an update on Nottingham’s Outbreak Control Plan, highlighting the following information:


a)  There have been 304 cases in the last seven days, which is a rate of 91.3% per 100,000 population. 


b)  This is an improving position, with a 42% reduction in the rate compared with the rate for the preceding seven days which was 157.4%.


c)  The rate in Nottingham remains higher than the England average but the gap continues to narrow. 


d)  The number of cases amongst those aged 60 years or over has significantly reduced.


e)  Two additional asymptomatic testing sites have opened, at the Portland Leisure Centre and the Clifton Community Centre.  The opening days and times for these sites vary but booking is not required.  The sites are open to everyone but households/ bubbles with children at school and those who have to leave their home to work are particularly encouraged to attend.


f)  In accordance with the ‘roadmap’ set out by Government, schools reopened face to face to all pupils from 8 March but there is still a ‘stay at home’ instruction in place.  If Government tests are met, then non-essential retail outlets, outdoor attractions, indoor leisure facilities and personal care services will be able to reopen from 12 April.  It is important that as restrictions are eased, people continue to follow the guidance fully.  


Vanessa MacGregor, Consultant in Communicable Disease Control Public Health England - Midlands, spoke to the Board about issues relating to virus mutation.  She highlighted the following information:


g)  All viruses mutate over time and this is happening with the Covid-19 virus, and this can result in new variants that can be passed on.  Most changes are very small with little impact on the virus or the people who get the disease, and the prevention measures remain the same.  However, some changes can enable the virus to spread more easily and this can become a cause of concern.


h)  The Government is monitoring changes in the virus to identify any ‘variants of concern’.  The Covid-19 Genomics UK Consortium looks at a proportion of all Covid cases and this allows new variants to be picked up in the community.  Variants are also identified through targeted testing e.g. testing all those entering the UK from southern Africa.


i)  There are a number of variants currently in circulation and details of these can be found on the Gov.UK website.  Some are designated as ‘variants of concern’ and some are ‘variants under investigation’.  Variants of concern are subject to more intensive investigation.


j)  Variant VOC-202012/01, commonly known as the ‘Kent Variant’, is the most dominant variant present in the UK and accounts for 98% of all the samples that are sequenced.  There is a variant originating in South Africa that, as of 8 March, had 310 confirmed cases in the UK and all entrants to the UK from southern Africa are tested for that variant.  There are two variants originating in Brazil.  There are two other variants that have originated in the UK but most cases have remained clustered in their local area: one in the north-west and one around Bristol.


k)  Cases of variants are investigated and managed to help determine how they are spreading; understand if there is wider transmission of the variants; understand risk factors e.g. links to travel, hospital admission; and to inform decisions to control the spread of variants.


l)  Investigations start with the Genomics Cell identifying the variant and/ or notifications coming in from outbreak investigations and clinicians.  These are reported to the Public Health England National Incident Director, who informs the local Health Protection Team.  Once informed, the Health Protection Team establishes an incident team and decides how to investigate to gather as much information as possible.  Results of the investigation are fed back to the National Incident Director who considers the next steps e.g. further investigation and testing.  Work then takes place with the Communications Team to send out messages about measures that people with the variant should put in place. 


m)  People with a case of a variant of concern are currently not being advised to take any additional measures than for those with other cases.


In response to questions, Vanessa MacGregor confirmed that once the Health Protection Team is aware of a variant in the area, the Director for Public Health is notified of the case(s) and that an investigation is about to commence; the results of the investigation; and will be involved in discussions as to whether further investigation is needed.