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Local Outbreak Engagement Board

(Health and Wellbeing Board sub-committee)

Monday 28th September 2020, 1.00pm

Present: Councillor Matthew Winnington (Chair), Councillor Judith Smyth, Cllr Jeanette Smith, Councillor Suzy Horton, Dr Linda Collie (Portsmouth CCG), Stef Nientowalski (Shaping Portsmouth), Roger Batterbury (Healthwatch), Helen Atkinson (Director of Public Health), Louise Wilders (HIVE Portsmouth), Steve Labedz (Portsmouth Education Partnership), Matthew Gummerson (Strategic Lead for Intelligence, PCC), Kelly Nash (Strategy Unit, PCC),

Apologies: Alison Jeffery (Director of Children’s Services).

  1. Notes of last meeting (24th August 2020)

The notes were agreed as an accurate record of the meeting.

  1. Local Intelligence Summary

Matthew Gummerson provided a presentation on the current data picture in Portsmouth, covering infections, deaths and emerging test and trace data.

  • Portsmouth rate has risen since the last Engagement Board meeting, although the peak was in April.
  • From this data set – 40 new infections in the previous week leading to publication date – giving a rate of 13.9/100,000.
  • The infection rate in the city remains lower than that in the South East and England, and very significantly below those areas in the country currently causing concern.
  • Numbers of Covid-19 admissions and in-patient diagnoses across HIOW are stable.
  • There have been 3 covid-19 deaths recorded at QAH since June.
  • The “excess deaths” data shows we are still below the average for this time of year

Cllr Horton asked if university tests are included in the city numbers – it was confirmed that this is the case.  It was noted that the university is carrying out asymptomatic testing programme, and therefore this may be increasing the overall number of cases recorded in the city when compared to other areas where there is not an asymptomatic testing programme.  However, it was also noted that it is positive that these cases are being identified and appropriate measures put in place to stop further spread.

Cllr Smyth asked if there is an increase linked to the return of schools.  Matt responded that although the increase in numbers coincides with the return to school, there are other factors as well, such as returners from European holidays.  There has also been an increase in testing of young people, and this is probably linked to cases of rhinovirus circulating at this time of year.

The Chair thanked Matthew Gummerson for the presentation.

  1. Director of Public Health Update

Helen Atkinson provided the following updates:

  • Testing sites – The site based at the University campus on Eldon Street is a walkthrough Local Testing Site. There had been a Regional Testing Site based at Tipner but that has now moved to Southampton Airport as the Tipner site is required as part of the Brexit preparations.  There is work underway to identify a suitable site for a Local Testing Site in the North of the city.  It is still possible to request a home testing kit to be sent.
  • Lab capacity is a problem nationally, which the LOEB have probably picked up from press coverage. There has been a significant increase in demand for tests, and therefore it has been necessary to ramp up the lab capacity, by moving to weekend working and looking to source additional lab capacity in the private sector.  DHSC are leading this work nationally and it is expected that capacity will be increased over time.
  • Keyworker testing has been a particular issue in relation to business continuity for health and care services and extra arrangements have been put in place locally, with an effort to include schools and teachers in these arrangements too – this is being worked on across HIOW.
  • Private/independent testing is gaining more interest and the view from DPH (in line with the wider PHE view) is that these should not be used to confirm cases – there are two main reasons for this – firstly, it is not possible to say whether the tests are quality assured and secondly, the outcomes from these tests are not necessarily fed into national test and trace system to follow up cases and outbreaks. It was noted that some organisations are carrying out asymptomatic testing but this is not recommended or advised by PHE.

Cllr Smith asked about people seeking tests and being directed to travel long distances – Helen Atkinson explained that each site has access to a certain number of tests each day and that when these are exhausted, people requesting tests via the national portal are directed to the next nearest site with availability.  There have been occasions where some people were directed to sites a long way away, but this should now be resolved.  No one should be encouraged to go to the Isle of Wight for a test because this would entail the use of public transport.  In response to a question, it was confirmed that the Eldon site is available to residents, not just university staff and students, although subject to the same restrictions as other sites on daily tests.  It was also noted that the council is seeking prioritised capacity for key workers in the health and care sector, and are arguing that this should be extended to teaching staff and VCS care staff. Cllr Smyth noted that some settings for vulnerable people are not yet included in the national whole care home testing programme and Helen Atkinson updated that Extra Care and Supported Living sites are the next sector to have ‘one time’ testing as part of the  national.

Dr Collie asked if lab capacity was being prioritised in those areas where there are high levels of infection.  Helen Atkinson confirmed that this was the case, and that mobile testing units are available for deployment if required when infection rates increase or we have local outbreaks.

It was agreed that if there were significant concerns to raise in relation to testing, then that should be sent to Helen Atkinson directly.

The Chair thanked Helen for her detailed update.

  1. Escalation framework

Helen Atkinson provided the Board with an update on the developing Escalation Framework for the city, noting that this takes account of local evidence and data in the city to assist in assessing what the alert level is, and therefore what measures need to be put in place.  It was explained that when the level is very high, a large number of these measures are likely to be set nationally.

The framework would be reviewed on a weekly basis by the Health Protection Board to ensure that there is agreement to the city alert level.

  1. Regulatory update

Rich Lee presented an update on the regulatory position to the LOEB.  It was noted that some additional officers have been appointed to Regulatory Services to provide support, and that a single point of contact has been developed on the PCC website to enable issues of business non-compliance to be reported.  The wider provision of advice is being dealt with through the business support team.

In terms of regulatory change, the latest set of Health Protection Regulations have been issued under the provisions of the Public Health Act 1984, and refer mainly to four key areas:

  • Business closure
  • Restricted opening hours
  • Restrictions on consumption of food and drink in premises
  • Rule of six

Nightclubs and dance halls remain closed, as do sexual entertainment venues and hostess bars, although it was noted that some local venues have changed their approach to become bars for the purposes of the regulations.  Restaurants, bars and takeaways must be closed 10pm-5am.  Exemptions exist for the delivery of food, but this cannot be collected in person (although drive-thru’s are allowed).  When in premises, customers must be seated and premises must take steps to ensure that customers remain seated (table service).  Bookings cannot be for more than 6 and groups cannot mingle.

Local authority enforcement is focused on business compliance, with police activity focused on domestic or open settings.  Under their powers, the local authority can restrict access, prohibit events or close outdoor spaces.  Regulations are clear that decisions must be based on an imminent risk to public health, so where this is not clear, there will be engagement before escalation to enforcement.  A framework is being developed to guide how that escalation might occur.

There was a discussion around the requirement for premises to close at 10pm, and whether this is leading to a spike in activity in off-licenses etc.  Richard Lee said that this had not yet been seen locally.  Helen Atkinson undertook to ask about the scientific basis for the 10pm rule at the DPH/CMO call.  Cllr Horton reported that already there were reports of house parties taking place after closing time.  It was noted that it is particularly important to be working jointly with the University around these issues.

The Chair thanked Richard for his report.

  1. Assurance report

The Board received the report which covered:

  • Local context – updated with the information taken from the data reporting
  • Local activity – bringing together a range of information about what our work is telling us about our preparedness
  • Assurance to PHE
  • Key risks, which in this case were noted to relate to the return of students to the city.

The Board noted the report and there were no questions.

  1. Local Outbreak Plan

The Board noted the revised Outbreak Plan where changes had been made to include:

  • the most up to date MOU with PHE SE for health protection
  • escalation triggers and flow charts
  • additional action cards including events, Gypsy, Roma, Travellers and Van Dwellers, and PPE access
  • Updated the membership of the Health Protection Board.

It was reported that a further update will be presented in October to include an updated section on testing options and to incorporate the escalation triggers.  This will be presented with changes highlighted on the document for ease of reference.

  1. Any other business

Helen Atkinson reported that a discussion will take place with Louise Wilders to consider what support may need to be in place for vulnerable people if shielding is resumed in some form, or to support those who are required to self-isolate.

The meeting concluded at 2.30pm.