Issue - meetings

To receive a report from the Director of Public Health on the current situation and up to date data.

The Director of Public Health shared the weekly update with the Board outlining the current position in term of managing the outbreak in Hampshire including data on current infection numbers, the position for care homes and death rates across the county.  

Members heard that Hampshire is in a good position with rates now lower and falling well.  This can be liked to local demographics, actions taken, and levels of compliance.  District rates continue to be monitored at the granular level and the overall R rate for the Southeast is between 0.6-0.8.  

In terms of the impact on population over the course of the pandemic, the number of cumulative cases has gone up but is now slowing down.  Seven-day case rate is now 35.2 per 100,000 bringing the total number of cases to 61,000 over the pandemic.  District rates continue to come down over time and while there are slight variations, they are falling overall across the patch with the pandemic under control.

With regards to infection rates by age, over 60s are more likely to face complications and hospitalization and this rate has now been falling. There has been a positive effect from vaccinations and age groups affected decreasing across all age bands.  Asymptomatic programmes in place for younger populations more likely to be out at work.  Hospitalization rates have been falling across all areas and hospitals, though there are still a significant number still in hospital.  Less people requiring intensive care and mechanical ventilation, a decline due to less cases of Covid.  As society opens up again, these areas will need continued monitoring alongside effects of vaccination.  Very sadly, there have been 2703 deaths since pandemic the pandemic started and 52 this week.  While there is a delay in data, rates are below the 5-year average for excess deaths.  

Based on the current data, across Hampshire about 37% of residents have now been vaccinated and there has been encouraging progress in local vaccination programmes.

In response to questions, Members heard:

With the opening up of economy, working populations not yet vaccinated and areas with younger population will be receiving key messages in preparation to encourage testing and prevent potential spread by those vaccinated to those not.  Similarly, safety in school but also outside of school including community testing for parents and clear understanding of guidance.  With more testing, there is likely to be more positive cases who are asymptomatic but will allow isolation to break the infection chain.  

The Hampshire Local Outbreak Engagement Board noted the current data and implications.

To receive a report from the Director of Public Health on the current situation and up to date data.

The Director of Public Health shared the weekly update with the Board outlining the current situation in term of managing the outbreak in Hampshire including data on current infection numbers, the position for care homes and death rates across the county.  

Members received an update on the national picture and revised scale which confirmed Hampshire rates as being in the lowest categories.  Rates were reviewed by ethnicity, age, and areas and overall going down.  Work around communications and marketing continues to target and support appropriate action.  With the steady fall in rates, the R rate in the Southeast is currently between 0.6 and 0.9 with a continued decrease for ceremonial Hampshire.  The all age 7-day case rate of 114 is currently lower than that of England and the Southeast and continuing to fall.

Outbreaks in care homes do affect the rate and the Public Health team look across all districts around the county on a daily basis to review and manage outbreaks in any settings and testing to pick up asymptomatic people to ensure rates continue to fall. 

The number of people in hospitals is falling but is still a lot of pressure on the NHS at this time.  Southampton continues to accept residents from various areas due to the services and expertise offered by the hospital.  Ventilator bed usage rates continue to fall, and hospitals are managing well in terms of critical care needs.  Unfortunately, there have been over two thousand deaths and some lag in the reporting.

The current Covid alert level guidance is being followed and a variety of factors have an impact such as the level of compliance with rules, vaccination levels, etc. and careful preparation continues for the easing of lockdown.

Community testing for those without symptoms, subject to approval, will commence from 22 February for front facing workers or those who must travel for work.  This will include County Council staff who may not qualify under other programmes.  The department is grateful to district colleagues in this partnership approach implemented at a fast pace to find the right venues and staff and currently waiting for approval.  Better understanding the asymptomatic condition will help break the infection chain.  One out of three people will have Covid without knowing it and everyone taking part in the lateral flow testing will be doing their part to help.

Testing for specific settings and developing bids for groups such as primary school teachers, companies of 50 or more, etc. continues.  This will allow for home tests to be used to meet needs of Hampshire population using government funding for the programme.

There has been news of single case of South African variant in the Bramley area, but the risk is low with national restrictions in place.  To enable the government and Public Health team to understand how this variant is spreading, surge testing is likely to commence tomorrow door to door with identified postcodes.  Tests are expected to arrive on 16 February and walking routes have been designed.  Members  ...  view the full minutes text for item 71

To receive a report from the Director of Public Health on the current situation and up to date data.

The Director of Public Health shared the weekly update with the Board outlining the current position in term of managing the outbreak in Hampshire including data on current infection numbers, the position for care homes, and death rates across the county.  Members heard that while vaccinations protect individuals, they do not prevent spreading it.

In response to the query raised by Councillor Jackie Porter, the confusion regarding the cancelled vaccinations organized by CCGs was due to an error in the cancellation process,  in the early part of the programme.  The incident has been reviewed and not expected to happen again.

Weekly case rates and changes in national scales were reviewed, confirming the current R rate of 1-1.2.  There has been a decline in the majority of age groups and data at the district level shows falling rates in most areas.  The over 60s rate is critical for due to the impact on hospitalization and is monitored alongside the high transmission in the younger population.  There were 126 deaths in the latest week.

The hospital data is not as up to date but is currently plateauing and mechanical ventilated beds and critical care needs, vital resources, are rising.  Key messages and factors continue to be a priority.

The Hampshire Local Outbreak Engagement Board noted the current data and implications. 

To receive a report from the Director of Public Health on the current situation and up to date data.

The Director of Public Health shared the weekly update with the Board outlining the current position in term of managing the outbreak in Hampshire including data on current infection numbers, the position for care homes and death rates across the county and updates to the published presentation.  

There has been a changing position and rise in cases over the weekend across the Southeast, though Hampshire remains in a good position.  Early part of December was lower but going up again though there are some unvalidated numbers.  Hampshire is currently at 89.7 and gone up slightly.  The region is a picture of concern with the highest rates with increases in Kent, Surrey, Buckingham, Oxford, while Hampshire and Isle of Wight is in a more favourable position, but rates are still rising.  

A similar picture for 60+ residents is emerging and the case rate change rising in all districts, though some are considerably higher and a concerning position across the county.  With regards to hospital pressures and in-patient diagnoses, there is a steady increasing trend with Portsmouth Hospital Trust is admitting the highest admissions.  Pressures on the NHS are a key concern in determining tiers.  Deaths are rising but the numbers lag behind infection rates and are currently under the 5-year rate.

Indicators for determining tier that are considered nationally were reviewed and local sight of them is helpful to be mindful of the current position.  There is a ripple impact from surrounding areas and Christmas period relaxation of rules will see rising rates.  

In response to questions, Members heard:

Direction of travel is very clear and silver lining may be that rates are not increasing in Hampshire quite as quickly as other areas and can be managed so hospitals are not overwhelmed.

Rates rising is disturbing and in terms of local compliance appears good and Hampshire messaging is important for the relaxation period and central action taken.  Well received messaging is critical and focused messaging for ahead of concern Gosport, Havant, and Rushmore, but across all of Hampshire as well.  Insight work to ensure we are meeting population needs has been a priority for working with the Communications team.  Work continues to prepare for the Tier that is announced on 16 December.

District councils continue to prioritize and maintain community spread of infection and have received government funding and deployed staff to support busy public areas and encourage visitors, residents, and retail businesses to comply and working alongside police colleagues.  

District and unitary leadership meetings are continuing to ensure consistency in messaging across the area.  Remaining in the same tier will help manage the spread and infection across the county.  

Substantial rises are often commuter belts into London and is it possible to discourage travel into London, with positive lifestyle messaging across LRF.  This messaging is emphasized and discouraging unnecessary travel in general.  Intercommuting for work or social and family connections does have an effect on spread.  Trends and connections are reviewed, and specific messaging targeted for those areas, in collaboration  ...  view the full minutes text for item 54

To receive a report from the Director of Public Health on the current situation and up to date data.

The Director of Public Health shared the weekly update with the Board outlining the current position in term of managing the outbreak in Hampshire including data on current infection numbers, the position for care homes and death rates across the county.  

An update and rationale on tiers were shared and a review of the 7-day rate across England, the Southeast, and other areas.  The 7-day case rate has been decreasing over the last few days. The case rate for over-60s, more likely to be hospitalized and have serious effects of Covid, is also coming down.  

NHS admissions were rapidly going up until mid-November but are now stabilizing.  An overview of ventilated beds, hospital admissions, and increasing death rate (still below the 5-year weekly average) were reviewed.  Maps depicted the spread of infection and the breakdown for Hampshire and surrounding areas.  It is best to remain cautious and review the impact of lockdown that ends 2 December 2020.

In response to questions Members heard:

·         There are five measurements for determining tiers and the next review is expected prior to 16 December

·         A sustained drop in figures over a significant amount of time is the goal, being mindful of the looser restrictions over Christmas and compliance in the New Year

·         While the rate of increase is dropping, it is a recent start but overall still an increase and thus Tier 2 will promote the appropriate restrictions

·         There has been a lag in the death rate and unfortunately, it will continue to rise following the cases increases we have seen recently

·         Research continues on the effect of Covid alongside winter and respiratory illnesses and there are worse outcomes for those with combined risks, such as Covid and influenza, or Covid and weight issues

·         While there have been pressures to exit into a lower tier, the concern is to move out too early and not have the correct restrictions in place, with the added risk of higher rates after Christmas

·         Now is the time to encourage people of all ages to stick to the rules

·         Promoting good messages of hand hygiene and social distancing across districts and county should continue to move safely through to Tier 1 when appropriate 

·         Additional messaging from Public Health, General Practitioners (GPs), and Primary Care Networks will encourage healthier actions to avoid increased risks

·         A weight management service is being funded next year to help people protect themselves from Covid, with a system wide approach for able people to exercise more and encouraging lifestyle changes to mitigate effects of Covid and weight 

·         GPs have been inviting in high risk patients to address any concerns and ensure right prescriptions and encourage healthy choices

·         It is hoped that there is a shift of resources towards prevention and Public Health

·         Shared messaging must continue to encourage both masks and social distancing  

·         The Hampshire Local Outbreak Engagement Board noted the current data and implications.

The Hampshire Local Outbreak Engagement Board noted the current data and implications.

To receive a report from the Director of Public Health on the current situation and up to date data.

The Director of Public Health shared the weekly update with the Board outlining the current position in term of managing the outbreak in Hampshire including data on current infection numbers, the position for care homes and death rates across the county.  It was noted that the presentation published is for Hampshire data only.  Members heard:

While cases testing and diagnosed in Hampshire has been rising with 1526 confirmed in the last 7 days. Rates across districts have become closer in value with no particular area standing out. Prior to national lockdown, priority data being reviewed included the 7-day rate, rate for over 60s, and positive testing rate. 

In response to questions, Members heard:

The Director of Public Health will share district rates following the meeting and consider changes to help the data be more accessible.

There have been 4 deaths from Covid in the past week and the death rate is lower than the 5 year average. The monitoring of excess deaths over the long-term continues.

The NHS continues to be open for any kind of business and residents need to continue to access healthcare the right way, in the right setting, at the right time.  Working together closely to promote this message will be part of the restoration and recovery process. People need to go to the hospital for heart attacks, urgent cancers, etc. and support should be provided to primary care services for preventative care with a focus on those more at risk such as BAME population, being overweight, etc. 

In supporting the NHS, 3 step-down units across the County are accepting patients who can legitimately move out of acute care facilities to release beds, though in many cases the pressure is not capacity, but rather staffing issues.  Acute hospitals have appreciated this quick piece of work and it is a great service for patients finding care in the right setting.  Adults’ Health and Care services will continue to prepare to provide services in a lockdown scenario, especially for those extremely clinically vulnerable, some 52,000 people in Hampshire. Coronavirus helpline and volunteer support will continue alongside a range of preventative action. 

All messaging has been joint working, clear and consistent since March, and aligned for across the county, NHS, and districts, in addition to promoting national messages.

The Hampshire Local Outbreak Engagement Board noted the current data and implications.

To receive a report from the Director of Public Health on the current situation and up to date data.

The Director of Public Health shared the weekly update with the Board outlining the current position in term of managing the outbreak in Hampshire including data on current infection numbers, the position for care homes and death rates across the county.  

The infection rates remain below that of the Southeast and England.   There has been an increase in cases week by week, which is being monitored carefully to take required actions.  Efforts are focused on managing and mitigating the increase in cases and moving forwards, in line with national guidance.

In response to questions, Members heard:

Proximity to London have impacted increased infection rates, as well as the ethnic diversity impact on disease, with continued preventative efforts and work in these areas.

There has been a slight increase in excess deaths from expected numbers at this time of year, possibly as a result of deaths brought earlier.  There has not yet been an impact of flu on deaths.  Deaths as a measure of infection is useful but requires longer term review and the consideration that those seriously ill are tested in the hospital setting rather than community testing of milder infections, as well as limits on testing capacity.

Local context remains critical and with spikes or rises in infection rate, communication must be adjusted and revise accordingly.  The general rise and community spread have been due to exposure to asymptomatic people, cases in education settings or among individuals and households.  The data is reviewed and mapped daily and while more younger people are impacted, the age is beginning to rise.  

If incidents of influenza are suppressed due to social distancing and handwashing, we should see a reduction in influenza cases.  Seasonal consideration of excess deaths is complex and will need longer term analysis.  Prevention work and campaigns continue for both illnesses, which are often difficult to tell apart.  Prevention will allow NHS to manage the level of respiratory illnesses in hospitals. Thresholds remain unchanged for hospital admissions and the public messaging remains encouraging for those who need to access hospital services to get better.

The number of cases amongst Hampshire schools are on the rise but have generally been single cases with bubbles or partial bubbles affected, rather than outbreaks, with one exception including more than 1 case.  The number of confirmed cases broken down by adults and children will be circulated after the meeting.

Public Health continues to work with Safety Advisory Groups (SAGs) in addressing Covid safety at events.  While the process is complicated, it advises on cleaning regime, number of people, entry and exit, queues, social distancing etc. though not all events are licensed and thus will not go through a SAG.  There is collaboration between the 11 SAGs, districts, and unitary colleagues, as well as environmental health colleagues, to ensure that clear, consistent local advice is provided, within the national guidance as well as that of guilds and sports associations.

To receive a report from the Director of Public Health on the current situation and up to date data.

The Director of Public Health shared the weekly update with the Board outlining the current position in term of managing the outbreak in Hampshire including data on current infection numbers, the position for care homes and death rates across the county.  Testing capacity has been stressed at the moment and while figures have been encouraging in the Southeast, there are some indications to proceed with caution.

In response to questions, Members heard: 

The rate of transmission is much slower in the younger population than in older people however due to existing health issues and underlying conditions older people are more likely to be impacted.

Capacity has been a priority in acute hospitals since July with the NHS moving towards recovery and restoration.  Measured and well-ordered preparations are in place should a Covid uptake be necessary in the future.  Covid-secure testing protocols are in place for discharge from hospitals and into care homes or discharge facilities with bed-based recovery, reablement, and independence.  Lab capacity for tests need to increase but positive progress has been made around care homes, though there can be local challenges.  Further funding has now been allocated for infection control and reducing staff working in multiple care settings and good compliance.

All excess deaths are included on the graph and NHS is considering Covid-related delays in provision of care (for cancer, heart disease, etc.) and deaths brought forward due to Covid.

Test availability and lab capacity is increasing but not keeping pace with the number of people presenting for tests.  Members noted concerns about people requesting tests without symptoms or having been sent long ways for testing.  Testing is a priority for only those showing one or more symptoms. 

The Hampshire Local Outbreak Engagement Board noted the current data and implications.