Agenda item

15.       

16.       

17.       

18.       

18.1.      The Board considered a report seeking approval of the refreshed East Sussex Outbreak Control Plan (OCP).

18.2.      The Board asked for an update on the study into why the Covid-19 outbreak was much lower in Hastings than elsewhere in the country.

18.3.      Darrell Gale, Director of Public Health, said the University of Sussex study was progressing and the researcher, Steve Orchard, had been in contact recently with the Leader of Hastings Borough Council. He is expected to begin talking to others shortly about the data and qualitative information around why people believe that the rates in Hastings were so low, including the Chief Executive of ESHT. He said it was possible an interim findings could be provided in time for the December Board meeting, which will be included as part of the Outbreak Control Plan item. 

18.4.      The Board asked whether live music events should be added to the list of high risk places.

18.5.      Darrell Gale said that the Public Health Team (PH) had been surprised as the speed at which people had begun setting up events and creating new types of events, such as drive through parties, teahouse lawns in Wealden area, and live music events on Hastings Pier. The PH works closely with the district and borough licensing and environmental health teams and expects that all of these events will have completed a risk assessment. He said, however, there is often a short turnaround to for the PH to respond to request for event licenses. There is also an existing Safety Advisory Group that manages events under normal circumstances, which is a multi-agency group with environmental health colleagues that approve larger events.

18.6.      Darrell Gale advised that the PH would be able to prevent events going ahead where they posed a risk or were not exempt from the rule of six measures. He used the example of the public health team in Southampton recently managing to stop the Southampton Boat Show going ahead due to a rise in cases there. The Boat Show objected to the Secretary of State, who sided with the local authority.

18.7.      He added that Bonfire night is a big night coming up and some bonfire societies have cancelled already. PH is working with the Lewes Bonfire Societies around which aspects can go ahead, for example, the honouring of the Martyrs.

18.8.      The Board asked whether there have been discussions with care home agencies about assisting them with outbreaks.

18.9.      Darrell Gale said that an inter-agency group meeting is held every week that includes ESHT, Public Health and Adult Social Care Department. This looks in detail at care homes, including communications with the care sector; any outbreaks emerging; and testing rates of staff and residents. Members of the group are also in regular contact with the sector.

18.10.   The Board asked about the performance of test and trace and access to national data

18.11.   Darrell Gale clarified that Test and Trace was a national NHS programme and not the responsibility of local authorities. He said the vast majority of problems are at a national scale and centre around lab capacity, which is preventing local testing going ahead. There had been instances recently where testing sites in East Sussex had gone almost a full day without seeing anyone because slots had not been released nationally onto the portal to due to the lack of lab capacity.

18.12.   Darrell Gale said he is concerned that the responsibility for lack of capacity will be shouldered by the PH and he said he turned down a radio interview earlier in the week because he was not prepared to field questions on behalf of the Department of Health and Social Care or the Test and Trace programme, who were both unavailable.

18.13.   Darrell Gale said the Outbreak Plan relies on the PH having as complete data as possible and the current scenario means the Team is lacking data and is not in a position to positively predict Covid-19 positivity rates. This means the Team could miss an outbreak for a few days, or escalate concerns where they don’t need to, which would erode the public’s trust.

18.14.   The Board asked about the availability of testing sites in East Sussex.

18.15.   Darrell Gale said that even though the Amex was recently lost as a testing sites, there are enough swabs and enough testing sites on the ground to meet the demand of pillar 2 community testing. For example, there is:

• a regional testing site at Gatwick
• mobile testing sites that have visited Brighton, Eastbourne, and Uckfield.
• a satellite walk-in and drive-though testing site is opening soon in Bexhill.
• A satellite testing site has been identified at the Helenswood Academy site on the Ridge in Hastings
• A mobile test site location has been identified on Hastings seafront.

18.16.   He said the Public Health team lobbied Government to be allowed to establish the mixed testing site at Bexhill and Hastings, as it better fits the mixture in East Sussex of rural hinterland where people drive and urban coastline where people tend to walk.

18.17.   Darrell Gale clarified that further sites were being identified on top of these but they take an awful lot of work and relies on the East Sussex County Council Estates Team to identify potential sites alongside Deloitte, who confirms sites on behalf of the Test and Trace system.

18.18.   The Board asked if there was a priority system in place for testing.

18.19.   Darrell Gale confirmed that the priority system is set nationally and guidance was expected on how rationing will work for lab capacity as infection rates increase.

18.20.   Adrian Bull added that there are hospital laboratories across Sussex for testing patients in hospitals, which is pillar 1 testing. This capacity is being increased, for example, a new machine has been installed in Eastbourne District General Hospital (EDGH) that can process 500-1,000 tests per day, which will bring the Sussex-wide capacity up to 3,000 per day.

18.21.   Dr Bull said this system cannot be opened up to carry out pillar 2 community testing, as it would risk being swamped. The Trust, however, is making some of its capacity available to make up the national shortfall for certain priority groups until the lab capacity issue has been addressed. This includes:

• offering tests for the family members of NHS staff, who should be tested in the community but at the moment are waiting longer than they should for a test. This means NHS staff are having to self-isolate whilst a family member is isolating for displaying symptoms that may or may not be Covid-19.
• carrying out tests in care homes where there is a need for a specific investigation.
• Testing patients attending the hospital for elective surgery or investigation three days before they are admitted.

18.22.   The Board asked how much infection rates had increased over the past month in East Sussex.

18.23.   Darrell Gale said there has been a 167% increase nationally since August but in East Sussex there had been a very gradual increase since August. This was to be expected and was not too much of a concern due to the influx of tourists and Eat Out To Help Out schemes causing greater community transmission. He said over the past week and a half there had been short lived spikes locally relating to care homes with asymptomatic staff and residents, as well as a number of households of four and six infected. As figures were so low these small outbreaks created sudden spikes in infection rates. Contact tracing data has been used effectively to follow up these clusters.

18.24.   The Board RESOLVED to:

1) approve the revised East Sussex Outbreak Control Plan (Appendix 1); and

2) agree to receive a report at its December 2020 meeting on further developments of the Plan, an update on the position in East Sussex in relation to Covid-19, and the interim findings of the University of Sussex study into the Covid-19 outbreak in Hastings (if available).