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Agenda item

Covid Update and Forward Look

Report of the Director of Public Health.

Minutes:

5.1

The Committee received a report giving an update on Covid as the city moves into the winter months.

 

 

5.2

Greg Fell, Director of Public Health stated that the report was a working brief which he written about a week ago and would update Members as he outlined the key points of the report.  He said that infection rates in Sheffield were below the national average and that although numbers had peaked amongst the school age population, there had been a sustained fall following the “half term effect”.  Greg Fell stated the booster vaccine programme was having a definitive effect on older people, with 75% of that age group having had the booster and felt that numbers would continue to decline when take-up rates of the over 60s was known.  He said that infection rates continued to rise and fall amongst people of the “middle age” groups, the mid-range working people.  With regard to international infection rates, he said it was hard to interpret the full extent of the effects of the pandemic, as certainly in eastern European countries, and now amongst western European countries, the take-up of the vaccine was much slower than here at home.  Mr Fell reported that 25% of secondary school age children had now had the vaccine and that a significant number of children have had Covid, and the infection rates in Sheffield were lower than anywhere else in South Yorkshire.  He said that there were very few cases amongst primary school children.  He stated that timing between first and second vaccines was important as there was evidence of the effectiveness of it waning. He said that 70% of the whole population was vaccinated, but obviously that meant there were 30% that were not, and that was a worry as it amounted to tens of thousands of people not vaccinated, from a whole range of areas, some elderly. In Sheffield, there were differences in numbers of those not vaccinated in the east of the City and amongst the BAME community, than residents in the west.

 

 

5.3

Greg Fell stated that hospital admissions were high and were slowly rising, with most cases, but not all, involving people who were clinically vulnerable, immunocompromised and unvaccinated. He said that although it was one too many, there was one death per day due to Covid.  He said that the whole of the NHS and social care services would remain in an exceptionally difficult position throughout winter, due to an increase in the cases of those with flu or people with an acute illness, such patients would be prioritised and that would inevitably have a knock-on effect of those needing hospitalisation as a consequence.  Mr Fell anticipated that due to social distancing measures during the pandemic, which have now eased, the magnitude of an outbreak of influenza this winter was impossible to predict, and the infection of both flu and Covid could mean people would be acutely unwell.  With regard to a “Plan B” in dealing with an increase in cases, he said it was very much a case of wait and see what comes out of Government as there was not a significant amount of detail.  He said the wearing of face masks was impossible to enforce, and that it was a matter of consent and willingness of the public to wear them but added that the wearing of masks would contribute to reducing transmission.  He concluded by stating that the overall message was that there was an exceptionally difficult winter ahead and that GPs, ambulances and A&E departments were already seeing record numbers of patients, but the simple things to do were to get vaccinated, have the booster vaccine, work from home wherever possible, wash hands, wear a mask and be patient with the NHS. There were no easy fixes for this pandemic, but he hoped the country would be in a better place by  Spring 2022.

 

 

5.4

Members made various comments and asked a number of questions, to which responses were provided as follows:-

 

 

 

·                Communications inviting people to attend clinics to receive vaccines and the booster were in place, and the strategy for this was moderately effective.  The letter to be sent out to everyone in the city regarding GP services, vaccination centres etc., was awaiting final approval before being sent out. With regard to phone and video exclusion, primary care services were aware that there was a significant number of people that don’t want to use the telephone or video.   The “AskmyGP” service was an online consultation and workflow system that helped GPs manage patient caseload through operational change and digital triage, making it easier for patients to talk to their own doctor and help GPs to prioritise and deliver care through message, phone and video. 90% of patients have said that they preferred remote appointments.  In Sheffield, 85% of patients were offered phone or video appointments.  GPs and practice nurses occasionally preferred to see their patients face to face based on their medical records.  As yet, good data on measuring appointments in primary care was unknown.

 

 

 

·                With regard to the level of demand for appointments,  during September 2021, there were two million more appointments than two years ago. Locally and nationally, GPs were working extremely hard, and doing their best at managing a very difficult and high demand for services.

 

 

 

·                During the last two years, advice and support had been provided to small businesses to enable them to stay open and stay safe, as well as informing  what grants were available to keep businesses open.  Posters had been made available to display in shop windows, asking people to wear a mask when entering the premises.

 

 

 

·                With regard to care homes, 95% of residents were vaccinated so whilst reducing transmission, it was not entirely possible to eradicate.  There had been minor lapses in PPE in infection prevention and control, but these numbers were low.  Public Health was working with care homes with regard to outbreak prevention, and there was  highly functioning machinery in place to work with the sector to continually reinforce the need for prevention of this virus. It was also worth noting that what works to prevent Covid could also prevent the outbreak of flu and the norovirus.  Although the norovirus doesn’t necessarily kill people, it was highly infectious and could infect large numbers of staff, especially in hospitals, and closed down wards.  Care homes were high risk settings and outbreak needed to be carefully managed.  There was a weekly dashboard to keep track of infections in care homes, working with the Sheffield City Council and the CCG. Government guidance had been provided to every care home, not only for residents and staff of care  homes, but also to visitors.

 

 

 

·                With regard to the effectiveness of working from home, data showing the numbers of people working from home was not very clear.  About 30% of those that worked in an office were back in the office, with 70% still at home for all, or some of the working week.

 

 

 

·                With regard to the Health Impact Assessment (HIA), work had been carried out by many people, and the HIA was presented to the Health and Wellbeing Board about six months ago, which had been broadly accepted.  The Health and Wellbeing Board was not a decision-making body, and did not  have delegated decision-making powers, so it couldn’t accept all the recommendations, but many were taken forward.  Health and Wellbeing Boards across the country would stay, and it was anticipated that there would not be much change to the interface between the NHS and the Board, but the Terms of Reference for the Health and Wellbeing Board would be under review. 

 

 

5.5

RESOLVED: That the Committee:-

 

 

 

(a)      thanks Greg Fell for attending the meeting; and

 

 

 

(b)      notes the contents of the report and responses to the questions raised.

 

 

 

Supporting documents: