Agenda item

7.1

The Director of Public Health, provided a Coronavirus (Covid-19) position statement.

In respect of the Epidemiology situation, he reported that from mid-October up until mid-December the rates of infections were coming down quite markedly, it was slightly rising from mid-December to the end of December, then it went up quite markedly. Currently the rate is coming down in both the whole population and most importantly within the elderly.  He stated that as of today the rate of incidence stands at about 250 per hundred thousand. Nationally the number of cases is dropping and in particular that was the case in London, the South East and most of the Home Counties.  This is important because it gives a significant amount of confidence that the lockdown measures that are in place are sufficient to hold the new variant of the virus.

In Yorkshire and the Humber we did not experience the marked increase in cases that was experienced at the end of December in other parts of the country.  This was driven by the fact we didn't have at that time a great deal of the B17 variant.  That has changed and we now do have that variant, but we are in a place where we've got some really quite restrictive measures, sufficient to hold the virus. There is growth in cases in the working age population, who are out and about more at work and travelling to and from work.  The rates are not growing really at all in school age children and are in fact coming down in the elderly, which is quite reassuring. Hospitals remain busy and are in a period of really sustained pressure that is having a knock-on impact in the ability to provide care.  However, the NHS is still open, both primary care, social care and the hospitals are open for business and are still providing great care.  Our rates are coming down but are too high and that gives us very little room for manoeuvre.   We cannot and must not do anything that will increase the pressure on the NHS and social care system.

He presented details of the deaths in both hospitals and the community over the course of the pandemic.  It was clear that there has been a significant rise from October through to November and although it did come down it has gone up again and unfortunately there will be a long tail with further deaths.

He reported that R0 was still above 1 but will come down to below one but with a much higher case rate.  There were less than 250 cases 100,000 population in seven day and falling, which is good news.  The proportion of people who have symptoms who get a test, testing positive is falling and was now 11%. A significant proportion of our hospital beds have a patient with Covid in them.  The new variant is in our City with a significant proportion of cases, more than 50%, relating to the new variant, thus he stated that there is little to no room for manoeuvre.

Our Outbreak Control Plan remains intact.  Additions are being made to the Plan and we will be developing it further, ready for when we come out of lockdown.  It was noted that our current epidemiology position means that we will have lower rates than the rest of the country at this point.  He stated that he envisaged that we'll be in a position where we have to manage Covid as an endemic disease and we will have to act accordingly for some considerable time to come.  We have control of some of the tools that we need, but we fit into a wider context and we don't have full control, so we will need to fit around the national government approach and guidance.  For the development of our Plan we will continue to push for rapid test and rapid test result for those with symptoms; more rapid and complete contact tracing; better support for those who are asked to isolate, especially financial; the long term adaption of the city; and high coverage of vaccination.

With regards the future, he confirmed that the lockdown is having the impact that is expected and that the vaccination programme has made huge progress but doesn't shift the need for the basic public health measures.

The new variant of the vaccine is about 60% of cases and is more transmissible.  This has had an upward impact on transmission and is likely to lead to a higher baseline rate when the current downward trend settles.  Pressure on hospitals will continue for some time to come.  From mid to late February, it is hoped that the tide will begin to slowly turn as a large number of the population will be vaccinated by then which will have an impact on mortality and hospitalisation, possibly on transmission, and we will be spending more time outdoors.  However, we will still have nowhere near enough coverage of vaccination to resolve the problem, so we will be living with Covid until at least summer.  We don't know the extent to which the virus may mutate further so we need to be careful for some considerable time to come.  The role out of vaccinations is progressing well by the 15 primary care hubs and the hospitals, which is credit to the NHS, supported by the voluntary and community sector and the Council.

There are uncertainties as we genuinely don't know the extent to which the vaccination reduces transmission. The one thing that that we cannot do is allow the virus to circulate freely in a population that is unvaccinated because that is inviting a further mutation and vaccine resistance.  The vaccine is clearly good news but it is not the single or sole solution to the end of the pandemic.