Agenda item

Coronavirus (Covid-19) Update

The Director of Public Health to report, followed by questions from Members of the Council, to be answered by the Director.

 

 

(NOTE: The above item of business is scheduled to commence no earlier than 4.00 p.m.).

 

 

Minutes:

9.1

Greg Fell, Director of Public Health, provided an update on the latest position in relation to the Coronavirus (Covid-19) pandemic. Following the presentation there was an opportunity for Members of the Council to ask questions.

 

 

9.2

He outlined what could be ascertained about the Coronavirus from the epidemiology, key messages and areas of concern and the response arrangements that were in place to manage the pandemic from a public health perspective, together with core messages.

 

 

9.3

With regards information from the weekly surveillance report as published by Public Health England, this showed that the weekly rate of Covid-19 cases was increasing and the position was changing quickly. In Sheffield up to 3 October, the positivity rate was 327 per 100,000 population. The most significant growth was in the 18-24 age band and this was a national pattern. There was concern that Covid-19 cases were beginning to increase in older age groups and which were at greater risk of a much more severe illness than was generally the case for young people, notwithstanding the effect on some younger individuals such as long-Covid.

 

 

9.4

Whilst there had been a growth in cases across the city, there was faster growth in more deprived communities, which may be because of types of employment and travel patterns. Growth was principally in household clusters and was generally more diffuse across the city and increasing in number.  The most opportunities to slow the spread of the virus related to household transmission. Ethnicity had also substantially shifted from South Asian communities in the East of Sheffield and was now largely representative of the city population. Mr Fell pointed out that this was an incredibly infectious and dangerous respiratory virus and not something that could be stopped.

 

 

9.5

There was probably no single cause or explanatory reason for the trend of increased cases in young people but it might include people returning to normal behaviours, the return of people from holiday and returning university students and other events such as house parties.

 

 

9.6

In relation to access to testing, the national and capacity problems were not quite such as they had been some weeks previously, but it was still a problem and one that had ramifications for the isolation of those with symptoms and the test and contact tracing that followed, together with the results which were the key metric for the epidemiology.

 

 

9.7

It was unlikely that cases would be contained within young age groups and cases were beginning to move to older age groups.  There was a sustained increase in related hospital activity and Covid-19 related deaths following a long period of having none.

 

 

9.8

Mr Fell said that in relation to the response, the existing plan was being intensified although the strategy remained fundamentally the same. The Covid-19 prevention and management board owned the strategy, which was essentially to minimise harm, both direct harm of the virus and the indirect social and economic harm of measures to control the virus, and aimed to keep people safe; protecting the vulnerable; reopen Sheffield and follow government guidance. There was also an operational plan which was implemented by a programme board.

 

 

9.9

He explained that at this time, Sheffield was in the enhanced support category and had been invited to set out what support it would like from the Government. It was a difficult balance to protect the vulnerable from the harm of the virus and from the social and economic harm of measures to control the spread of the virus. It was thought that the best way to protect the vulnerable was to minimise the spread of the virus and to focus upon behaviours and clear messaging and a consensus and a consent based approach.  Efforts were being intensified in relation to prevention, management of individual outbreaks, communications, contact tracing, enforcement and supporting isolation.

 

 

9.10

Consideration was being given to the management of upcoming events, such as Halloween. More effective contact tracing was needed and, whilst it was working, it needed to work better.  The Government would decide whether it changed its view of the region and as to whether further measures such as lockdown would be applied. There was also a need to focus on basic behaviours and consistency. Thought would also need to be given to adaption in the long term and taking into account that it would be some time before there was vaccination available in sufficient numbers and that issues relating to long term immunity were not yet known.

 

 

9.11

He said that the Council was asking the Government for clarity about support for the response after March 2021, localised contact tracing and in relation to support for isolation and economic support.

 

 

9.12

Mr Fell said that the things that would have most impact included prevention; a consistent push on people getting tested even if symptoms were mild; minimising testing delay; optimising testing and tracing coverage and speed; and optimising isolation.

 

 

9.13

He outlined communications activity which was about cutting through the confusion; collective responsibility; changing behaviours; and consistency and stability.

 

 

9.14

He acknowledged that the autumn would be difficult and that it was important to continue with the programme and to build consensus and trust and said that much of the level of compliance was down to people’s choices and their understanding and consent.

 

 

9.15

Mr Fell stated that other measures may be imposed by the Government, although the exact nature and timing of those was not possible to predict. The city would continue to seek a balance between protecting people from the virus and the economic impact of control measures. He said that the basics of the city’s approach remained important in supporting individuals and the economy.

 

 

9.16

He reaffirmed the core messages of the guidance which were constant and were; if you have a symptom get a test, stay at home and isolate; and give details of your contacts; seek help and advice; bubbles and social contact i.e. the more contact people had, the more opportunities there were for the virus to spread into new groups; stay home if identified as a contact; wash your hands; keep your distance and wear face coverings where recommended.

 

 

9.17

Members of the Council asked questions arising from the update from the Director of Public Health and responses were provided, as summarised below:

 

 

9.18

Questions were asked regarding how in the context of higher infection rates, the city had anticipated and prepared practical measures for addressing the situation in Sheffield under the new upper tier local authority powers within the Department for Health and Social Care contain framework. Further questions were asked about whether the city had considered applying to enact its own local shielding rules and with regard to the implication in local messaging that a future lockdown was inevitable and the city was waiting for government intervention.

 

 

9.19

Greg Fell responded that if and when the Government imposed more restrictions on local authorities, there would be a recommendation to recommence shielding, although it was likely that would be a much narrower, defined cohort than before as more was now known about who was at risk. He did not know the exact timing of when that might happen. A written response would be provided in relation to the other question above.

 

 

9.20

Questions were asked about testing capacity and test and trace and with regard to making sure people isolated appropriately; and whether the local management of testing should be explored, given problems with national testing. Further questions were asked as to whether people should be recommended to use the NHS test and trace mobile app; and with regards to whether the focus should be on protecting vulnerable citizens by allowing them to isolate and permitting those not as susceptible to go about a more normal existence and if such an approach should be adopted in Sheffield. A question was also raised as to whether immunisation should be made compulsory, when it was available.

 

 

9.21

Mr Fell responded to the questions and said that it was unlikely that a robust vaccine would be available until approximately mid-spring 2021 and it remained to be seen how effective and how long immunity from that might be. He said that he did not support making vaccination compulsory as it might have unintended consequences and erode trust in vaccination which may have ramifications elsewhere.

 

 

9.22

He said that with regards to comments relating to a strategy of herd immunity, he did not think that would be viable and it had never been successfully done anywhere in the world. If that strategy were to be pursued, it would allow the spread of the virus which had a 1 percent mortality rate which would lead to a number of deaths that would not be acceptable to people and it was not sensible for both clinical and epidemiological reasons.

 

 

9.23

Mr Fell said that with regard to the NHS app, it remained to be seen if the app would radically improve contact tracing. It was acknowledged that it was not a perfect solution, but it was improving, and he also recommended that people download and used the app, including the QR Codes as appropriate when visiting premises.

 

 

9.24

He said that in relation to local testing capacity, whilst this could be done in theory, the necessary resources would be needed and it could not be done within the local resources currently in place; and it would require an end to end solution from taking the test through to delivering the result and following interventions. Although both the teaching hospitals and universities had substantial laboratory capacity, the teaching hospital laboratory was at present either at or over capacity and the integrity of pillar one (the testing of NHS staff and patients) was essential.

 

 

9.25

Greg Fell explained that testing capacity was better than it had been previously, and the city had worked with the Government to manage that. It was still recommended that only people with symptoms got tested. The concern with regard to both testing and contact tracing was that it was not fast enough and this meant that some people were not being contacted quickly enough by the contact tracing system and there were particular concerns in relation to some communities. In relation to those communities, some local activity could be undertaken but not with regard to speeding up the test result process, which was not within local control.

 

 

9.26

A question was asked concerning work that was being done with schools to make sure children with symptoms relating to seasonal colds were not sent home, leading to families seeking Covid-19 tests in cases where children did not have Covid-19 symptoms.

 

 

9.27

Greg Fell stated that there was a written response to this matter which he could make sure was published and in summary, it was considered that schools had become quite adept at managing risks within guidelines and in conjunction with the Council’s Public Health team, the Department for Education and Public Health England. Schools were managing individual cases and contacts with the Department for Education and there was also a helpline. The Public Health team and Public Health England were contacted if there was a significant number of cases or an outbreak. Advice had been issued to all schools on a number of occasions about how to differentiate between common cold, flu and Covid-19, based on something published by the Royal College of Paediatrics and Child Health and which had also been published on the BBC website.

 

 

9.28

A question was asked about cases of Covid-19 in the student population and concern amongst other residents in the vicinity of the universities and student population and as to whether there was confidence in the universities opening safely and whether the Council should be leading on this issue.

 

 

9.29

Mr Fell responded that this was an issue concerning 18-25 year olds and which was the cohort in which the virus was increasing most quickly. With the return of the high number of university students to Sheffield, the increase in cases was inevitable, as it was in the other university cities.

 

 

9.30

He said that both Universities had worked hard, including with the Council and they had robust plans in place and, whilst it was not certain whether those plans were operating to an optimal level, he believed they were managing cases to the best of their ability. The certain way to stop transmission in the universities was to close them and that would be a decision for the Government. 

 

 

9.31

Mr Fell stated that the University of Sheffield had announced that it was ceasing face-to-face teaching for a fortnight and Sheffield Hallam University may follow. However, he said that he was not certain that action by itself would be sufficient to slow the spread of the virus in 18-25 year olds. He said that even with a policy of herd immunity, which he would not recommend, the spread would not be contained within that age group. The Government had been clear about the protection of educational opportunities and it was likely that action with regard to universities would be a last stage of government intervention and a further national lockdown. He said that work would continue with the universities, although he did not doubt that there would be more cases of Covid-19.

 

 

9.32

A question was asked about the effectiveness of antibody tests and whether those would be rolled out, if they were effective.

 

 

9.33

Mr Fell stated that antibody tests were not 100% accurate. There were false positives and false negatives with antibody testing and the tests were currently being used in the context of epidemiology. Some 100 thousand people were tested weekly as part of the Office for National Statistics national surveillance epidemiology. Based on the antibody response, six percent of the population had had the illness so far.  Whilst this was useful in terms of epidemiology and surveillance, because of difficulties of interpreting results for individuals, the use of antibody tests was actively discouraged outside of established research programmes.

 

 

9.34

With regards to antibody tests being more widely available at the point of care or to purchase from pharmacies, whilst they were available, he was not of the view that any such tests were regulator approved and where they had been found for sale, regulatory action was taken.

 

 

9.35

The Council noted the information reported and thanked the Director of Public Health for his update.

 

 

 

 

 

 

 

(NOTE: During the above item of business, it was - RESOLVED: On the motion of The Lord Mayor (Councillor Tony Downing) and seconded by The Deputy Lord Mayor (Councillor Gail Smith), that the provisions of Council Procedure Rule 5.5 be suspended and the termination of the meeting be extended by 30 minutes, to 6.00 p.m., to provide an opportunity for Members of the Council to ask questions of the Director of Public Health.)

 

 

 

Supporting documents: