This item provides a verbal update from the Director of Public Health on Covid-19 and the Council’s response in supporting residents throughout the pandemic.
Minutes:
Councillor Richardson welcomed Dr Nicola Lang and Linda Jackson to the meeting to provide a verbal update. Dr Lang reported that there had been 211 new cases of Covid-19 identified through extensive testing undertaken in the borough although the overall rates was in decline. The rates were calculated on a rolling seven-day average, testing 579 of every 100,00 people (compared to the London average of 300 per 100,00). The borough had the highest rate of infections in London at this time, but the figures changed daily. It was also noted that the borough had administered the highest number of tests.
Dr Lang also reported that Doc Tap, a private GP in the borough had found to attributed 130 Covid-19 positive cases to the borough’s public health numbers. Janet Cree confirmed that Doc Tap was a private contractor and that there was no contractual relationship, so they did not come under the jurisdiction of the CCG. Any action would need to be taken through the CQC (Care Quality Commission).
On the eve of a four-week lockdown Dr Lang confirmed that the borough planned to undertake targeted local testing. Dr Lang thanked Charing Cross hospital for their support, particularly Dr Paul Randell.
Linda Jackson explained that they had prepared action plans in response to the second wave of the infection which also incorporated a flu action plan and formed a critical part of the winter response in terms of managing the wider pressures collectively within the NHS. Targeted, mobile testing was underway with all the logistics being finalised. There was no indication that the government intended to reintroduce shielding but the council planned to continue to support clinically vulnerable people. The successful work around contact tracing was highlighted in the media and commended. 536 people had been contacted by the contact tracing team since 16 September 2020 representing a success rate of 95%, a significantly higher rate than had previously been managed by the central Government.
Janet Cree outlined preparations being undertaken in delivering primary care services to ensure that people were able to have face to face contact throughout a second lockdown. It was essential that access to healthcare services such as immunisation continued. Escalated primary care clinics for those with Covid-19 symptoms have continued to operate and preparations were being made to deal with a potential increase in patient volume. Action plans would be implemented once the threshold for implementation was reached.
Dr Bob Klaber highlighted the theme of collective and joint working which he felt was key across the wider health system. The difficulty was to ensure the continued delivery of essential health services balanced with the competing priorities of responding to Covid-19. There were also combined issues of maintaining segregated space and limited resources to support collaboration across north west London. Elective care numbers were almost on par with the same period in 2019 and that since Covid-19 in March there was a significant backlog that they were working hard to address.
Dr Klaber explained that there were key differences in how a patient responded to the infection in this second surge with a higher proportion of patients that were significantly unwell although with smaller numbers requiring intensive care treatment. Dr Klaber outlined different courses of treatment and related outcomes were explained; and a research partnership between Imperial College London and Imperial College Healthcare NHS Trust was progressing. Much was being done to ensure that hospital sites were accessible with significant investment to support this.
In response to a question from Keith Mallinson about lack of enforcement on public transport Linda Jackson confirmed that the council continued to negotiate with Transport for London (TfL), but this was limited in the absence of local government powers. Councillor Coleman stated that people were concerned about the lack clear signage, communication and engagement on this issue. Whilst TfL had offered assurance but there had been little progress and that improvements to enforcement would be welcomed.
Councillor Lloyd-Harris commended the work on test and trace but was concerned about the borough having the largest number of cases in London and asked if this was attributable to whether more could have been done or if the response could have been better.
Dr Lang emphasised that the testing rate within the borough was phenomenal, at twice the rate of the rest of London and so more likely to identify positive cases. The approach to testing in the borough was highly robust and targeted making excellent use of communications tools, business intelligence and the tactical positioning of mobile testing units. Councillor Coleman described how the council’s innovative and creative approach had garnered significant results. The data provided by the NHS contained details of individuals that had been unreachable and the council’s tracing team had exceeded expectations in contacting this cohort. Out of every 100 people tested, 6% return a positive result, a slightly lower rate compared to 7.7% across London. It was critical to look at the proportion of the number of cases being tested.
On a related point, clarification was sought about the eligibility for the flu jab for over 50’s and possible mixed messaging about this. Janet Cree clarified that the eligibility criteria prioritised vulnerable groups first although over 50’s were being encouraged to have the flu jab. There was an issue of poor uptake in the borough which historically had never exceeded 75% of take up.
Roy Margolis enquired about the current figures for cases in the borough. Dr Klaber explained that current ICU capacity was at 20% being treated for Covid-19%, with 80% following other treatment pathways. This was relatively low compared to April 2020, where 97% of those in ICU were being treated for Covid-19. In terms of the current modelling the number of Covid-19 cases was likely to increase but there was no expectation that it would reach similar levels again.
Jim Grealy commended the work on test and trace with Imperial but asked about what the local response was to address increasing mental health pressures. Linda Jackson explained that there was a big mental health impact on those that were shielding with a significant number suffering from depression. There were also those that were concerned about losing work and redundancies. People were offered proactive support through H&F Can and those needing additional support were being assisted by NHS colleagues. Councillor Coleman confirmed that the council had written to all those who had been shielding to offer support and information through H&F Can and the mutual aid groups (MAGs). Recognising that lots of families were falling into poverty the council had agreed early on to pay for eligible children to receive free school meals during school holiday periods.
RESOLVED
That the verbal report be noted.