Issue - meetings

45.1.      The Committee considered a report on the NHS response to COVID-19 in East Sussex and its ongoing impact on NHS services for East Sussex residents. The Committee also considered a presentation by Darrell Gale, Director of Public Health, on the current number of infections in East Sussex.

45.2.      The Committee asked whether there were any issues with capacity for the vaccine programme as people’s second jabs begin.

45.3.      Jessica Britton said that the local vaccine programme is on target to meet and in some cases exceed the national targets. The Executive Director said she is confident the current logistical set up will enable both first jabs and second jabs to take place in the coming weeks.

45.4.      The Committee asked whether the big difference in the death rate of the two waves may be in part due to less observation of the lockdown in the second wave.

45.5.      Darrell Gale said there had certainly been different behaviours between the lockdowns. The first lockdown was almost universally observed by people and people had been reluctant to travel to the coast, in part due to the early closure of activities by the local authorities. People, however, were far more reticent to go in to or observe the November lockdown. In addition, many employers had to stop trading in March but by the time of the second lockdown in November, a lot more businesses were open and requiring staff to go in.

45.6.      Darrell Gale added that the virology of the second variant was so different to the first that it was almost like a new pandemic with a much higher transmission rate and higher mortality rate.  Consequently, whilst the second lockdown did slow down the increase in cases from the original variant of the virus, the third lockdown over Christmas was in response to the new Kent variant but came too late to stop it. The third lockdown is also the predominant cause of the decline in infections currently being observed. This is because the vaccine is having an impact on hospitals and deaths nationally, but the numbers are too small to be able to see a definitive local trend.

45.7.      The Director of Public Health said he had been hearing anecdotally about a large numbers of visitors to the coast in the recent warmer weather. He reminded everyone that  the country is still in lockdown, so people are required to stay at home and only travel locally for essential supplies and exercise. 

45.8.      The Committee asked what the figures for uptake of the vaccine are in the Black, Asian and Minority Ethnic (BAME) community and how authorities planned to improve uptake amongst BAME residents.

45.9.      Darrell Gale said the figures nationally showed a poorer uptake in certain communities, particularly amongst the Black African community.  The data shows who has had the vaccine, but it takes a while to work out who has not and this task is more difficult where a population is small. The BAME population in East Sussex  ...  view the full minutes text for item 45

36.1.      The Committee considered a report providing an update on the NHS response to Covid-19 in East Sussex.

36.2.      The Committee asked why there has been a sudden increase in the rate of Covid-19 infections in the Hastings and Rother area.

36.3.      Darrell Gale, Director of Public Health, said that the Public Health Team had seen the rate of infection beginning to increase in Hastings and Rother prior to the start of the November lockdown. The rate slowed after two weeks of lockdown but figures from the 30th November, just prior to the lifting of the lockdown, showed a high rate of increase that continued to rise throughout the week. Due to the timing of this increase, the infections must have taken place prior to lockdown being eased.

36.4.      Having investigated the cause, the Public Health Team found that 50% of cases in Hastings and Rother were random and likely caused within households, rather than originating from a specific location or event. The other 50% were traced to care homes, hospitals, and schools, however, the infections in these places were originating from households and just being identified in these locations through testing of staff. Darrell Gale explained that care home staff are regularly tested and can be isolated very quickly before transmitting the virus to residents, who have been less affected than staff.

36.5.      The Director of Public Health added that the Public Health team has  issued communications to the residents in Hastings and Rother in response to the outbreak telling them that they now have a high transmission rate that is increasing and that they need to stop any behaviours that they were doing when they thought they were in an area with a low number of infections. He said that this included not doing things that are permitted in Tier 2 unless you have to; avoid or leave any areas that are too crowded; and that the easing of restrictions over Christmas should be treated with extreme caution and not be seen as an instruction to meet with lots of people or travel across the country. He added that Tier 2 only leads to a levelling of infection rates and that the rate over Christmas will undoubtedly increase infection rates. The Director of Public Health warned that if people nationally wish to avoid a further lockdown in the new year, they should consider whether it is necessary to meet during Christmas.

36.6.      The Committee asked for an update on how East Sussex Healthcare NHS Trust (ESHT) was coping with the increased rate of infections.

36.7.      Joe Chadwick-Bell, Chief Executive of ESHT, said the Trust has seen a sharp rise of cases, particularly in the last week. The Trust now has 61 positive cases as of 9th December – 16 in Eastbourne District General Hospital (EDGH) with 2 in the Intensive Treatment Unit (ITU); 36 cases in Conquest Hospital with 4 in the ITU; and 8 cases in community beds. Some of these are new admissions and some are  ...  view the full minutes text for item 36

26.1.      The Committee considered a report providing an outline of the NHS response to Covid-19 in East Sussex and the ongoing impact on NHS services for East Sussex residents.

26.2.      The Committee asked why Covid-19 rates had been so low in Hastings despite the levels of deprivation and Black Asian and Minority Ethnic (BAME) community.

26.3.      Darrell Gale, Director of Public Health, said that an investigation into why infection rates were so low in Hastings and Rother was underway. The current hypotheses include that:

·         Hastings Borough Council was decisive early on, cancelling some events due to be held in early spring and sending out messages warning people not to come and visit. This meant that people weren’t drawn into town before the lockdown began.

·         The relative lack of infrastructure between Hastings and Rother and the rest of the country, for example, the poor road and rail links, making the area relatively isolated.

·         Poor connectivity within Hastings, such as lack of pavements between North St Leonards, Churchwood and Hollington and the rest of town slowed the spread; and

·         The topography of ridges and valleys in Hastings means places like Ore Valley are quite remote from the town centre.

26.4.      The Committee asked whether, as cases had begun to rise again, there had been a corresponding increase in hospital admissions

26.5.      Joe Chadwick-Bell, Chief Operating Officer at East Sussex Healthcare NHS Trust (ESHT), confirmed that there was one positive Covid-19 case in the Trust and around six ‘Treat as Positive’ cases – where a person had a negative Covid-19 test but clinically were being treated as a positive case. There were also no patients in the critical care units with Covid-19.

26.6.      Darrell Gale said that hospital numbers had started to creep up nationally but had not yet locally. A lot of the increase locally and nationally in positive tests was amongst young people who were asymptomatic, or whose symptoms are so slight that they have what feels like a hangover for a day or two. This is a different cohort of people to that which had been affected during the spring.

26.7.      The Committee asked why cases had been low in Lewes District and asked whether it was due to a lack of community testing early on in the outbreak

26.8.      Darrell Gale said that initially testing was limited to Pillar 1 (tests in hospitals and care homes) because Pillar 2 (testing in the community via the sites at the Amex stadium and Bexhill) took longer to get up and running. This could explain why the infection rate in Lewes District appeared lower than may have actually been the case, i.e, there could have been a significant population  of people who caught the illness early on but would have been fit enough to not need hospitalisation and would also not have been able to be tested in the community. He added that the area does have a high infection rate amongst the elderly in care homes, particularly around Seaford.

26.9.  ...  view the full minutes text for item 27