[The Director of Public Health will give a presentation on the latest information regarding Covid-19 cases, testing and vaccinations].
Minutes:
The Director of Public Health gave a presentation on Covid-19 cases, testing and vaccinations. For the seven days up to the 21 March, Wolverhampton had a Covid-19 case rate of 60 cases per 100,000 people. This was a marked difference from the earlier stages of the second wave, which had been a real challenge. Six weeks before Wolverhampton had a case rate of 1000 per 100,000. The average case rate per 100,000 for the region was 65.4, meaning Wolverhampton did not have a dissimilar rate. In some areas in the West Midlands the rates were increasing again. This emphasised that at a certain rate, probably around 100 cases per 100,000, any outbreaks would amplify the percentage increase rate at a local level. The levels of Covid-19 cases in Wolverhampton were now at a similar level to those in early September 2020. Due to an increase in lateral flow testing, they were now finding more cases which were largely asymptomatic.
The Director of Public Health presented a slide on Public Health’s strategic approach which was based on three key principles. These were the vaccination roll out, compliance and testing, and contract tracing. Protecting the most vulnerable was a key aim. The most vulnerable were those most likely to be hospitalised and had a greater chance of death. The strategic approach was outlined in the Outbreak Control Plan which was currently being refreshed and was due to be published on the forthcoming Friday. He commented that he would welcome the opportunity to present the Outbreak Control Plan at the next scheduled Health Scrutiny Panel.
The Director of Public Health presented a slide on Covid-19 testing within the City. The lateral flow sites for asymptomatic testing continued along with PCR sites for people exhibiting symptoms. There was a total of 11 testing sites within the City. Schools children and staff were now conducting tests in the home environment. In Social Care, routine testing was taking place and also with NHS partners. A local offer had just been launched to compliment the national offer to businesses, whereby they were incentivising organisations to embrace Covid-19 testing. The more testing which took place, the earlier they could identify cases and prevent the virus spreading. 95% of the cases in Wolverhampton were now the UK variant, a very transmissible strain of the virus. There was also a mobile testing unit in the City which was used in areas of high prevalence and also areas with low uptake for testing. It had proven to be exceptionally useful. In the past 7 days up to the 21 March, there had been 42,363 tests conducted in Wolverhampton. He regarded this as a phenomenal effort. They were averaging 42,000 tests a week within the City and this would be built on moving forward. This was a good position to be in as the country came out of lockdown. He stated that the National Test and Trace system picked up 78% of cases within Wolverhampton. Through the local tracing function, they picked up 62% of the remaining 22%.
The Director of Public Health presented a slide on the Covid-19 vaccine roll-out. Over 108,000 Wolverhampton residents had received their first vaccine. He gave praise to all the people who had helped to roll-out the vaccine within the City. The City’s model was largely GP led with help from the Royal Wolverhampton NHS Trust. The uptake of the vaccine for people over the age of 70 was currently over 90%. There had been a good initial uptake for people over the aged of 50 which he believed would increase with time as more people booked their appointments. The uptake for Carers (DWP) was over 60% and improving. The NHS and Social Care Workforce rate was over 75%. For the clinically extremely vulnerable the rate was over 80% and continuing to improve.
The Director of Public Health presented a slide on why some people weren’t coming forward for a vaccine. The key factors were not wanting to be first, distrust, safety concerns, people believing they did not need the vaccine, people believing it wouldn’t work, people concerned if they were pregnant, breast feeding and concerns about fertility. Some people felt it was a challenge to get to a clinic and didn’t realise the other options available. They were concerned about leaving the house after such a long time isolating. Some felt if they had not taken the vaccine when first offered, that it was a now missed opportunity and wouldn’t be able to access it again. It was therefore useful to keep contacting those individuals to give them information.
The Director of Public Health remarked that there was a cross sector partnership in the City to maximise the uptake of the vaccine. Data sharing played an important part, linking data together from different organisations gave better profiling. They had established a dedicated call centre within the Council and working with the GPs they were able to contact the people who had not taken up the offer of a vaccine. He spoke about pop up clinics and community champions to help increase the uptake of the vaccine. They had even carried out some pilot door knocking in areas where the uptake of the vaccine had been low.
The Director of Public Health showed a Covid-19 case rate heatmap for Wolverhampton. The situation had improved remarkably since the start of January, this was down to the vaccine roll-out and the lockdown.
The Chair asked if the Director of Public Health could detail any particular age groups in Wolverhampton that had been vaccine hesitant or he expected to be. The second question he asked, was if he could inform the Panel how many Council staff had received a positive PCR test result for Covid-19. His final question was about the current policy for lateral flow tests for people within the City. The Director of Public Health responded that it was widely acknowledged that there were real differences between ethnic groups and the uptake of the vaccine. The current data for Wolverhampton did show that this was not significant for people over the age of 80 in the City, but it was below this age group. Rather than vaccine hesitancy being considered under one heading of BAME, he felt it was important to consider everybody’s story as an individual to understand the hesitancy. Talking to people on an individual level he felt was more productive than general messaging. The uptake of the vaccine was improving in ethnic groups based on Public Health’s interventions.
In response to the question on Council staff receiving positive PCR tests the Director of Public Health stated that the Council did not monitor staff having PCR tests. The Council did reinforce the pathways for people who had symptoms. The Council were encouraging staff to incorporate lateral flow tests into their everyday lives. The general policy for people in the City was to test regularly, preferably twice a week, with lateral flow tests if they did not have symptoms. He did accept though that context was important and for someone who was always at home shielding, it was less important for them to test themselves regularly.
The Vice-Chair asked if the Director of Public Health could detail any intentions for the further or enhanced use of digital solutions to prevent and monitor Covid-19 cases and increase the uptake of the vaccinations in Wolverhampton. His second question related to whether the suspension / restriction of the use of the AstraZeneca Oxford vaccine in some European countries had impacted on the uptake of the vaccine in Wolverhampton. His final question was whether people that were eligible for the vaccine, who were housebound, had all received their vaccination.
The Director of Public Health spoke highly of digital solutions. Some people responded well to the use of digital, whilst others responded better to a phone call or a visit. The use of social media for key Covid-19 messaging had gone very well. The sharing of data across partners was a key element to digital solutions and had been embraced during Covid-19. This was a good learning point for the future. With regard to the AstraZeneca Oxford vaccine, on one day 6% people of people did not show for their appointment since the European issues. Thankfully working with the GPs, they had been able to fill the slots and no vaccine was wasted. The no show rate was now back to normal levels at about 1%. For people that could not get to a clinic, home visits did take place. They could also arrange transport for people to clinics, working with their NHS colleagues. The home visits had varied in terms of timeliness, but this was something they were trying to improve as they came down the age groups. This was all part of the equalities discussion.
A Panel Member thanked the Public Health Team for all their efforts with the vaccination programme. She commented that the amount of vaccine available was about to be reduced due to supply issues, she asked that when supplies returned to higher levels, whether the vaccination programme could be upscaled again. The Director for Public Health responded that the key element was planning and partnership working, which had been so successful. There was a partnership group which was co-chaired by him and the Managing Director of the Wolverhampton CCG. Wolverhampton did not have a mass vaccine centre, but it did have a colocation of GPs delivering at pace and scale in places like the Aldersley Leisure Village and Bert Williams Leisure Centre. The partnership working had meant they had been able to plan much better. They had been able to respond very quickly to supply changes. They were therefore ready to be able to scale up and scale down the vaccination programme within the City.
The Vice-Chair spoke about the Muslim Ramadan Festival and asked for this to be factored into the planning for the vaccination programme. The Director for Public Health responded that they were aware of the different religious festivals and celebrations approaching. Public Health Officers had successfully met with different faith groups and sometimes these meetings were occurring 4-5 times a week over the past year. Ensuring people celebrated safely and understanding the impact of religious events effecting people’s willingness to have the vaccine were areas that were commonly discussed.
As it was the last meeting of the Municipal year, the Chair on behalf of the Health Scrutiny Panel thanked the members of the Scrutiny Officer Team, Martin Stevens, Julia Cleary and Earl Piggott-Smith for all their help organising the meetings throughout the last Municipal year. He commented that they did an excellent job and through their work, the meetings had run smoothly. He also thanked the Director of Public Health and his team for their excellent work over the last year and praised their partnership work. He thanked all the health partners, commenting that the last twelve months had probably been the most difficult period in the modern-day health system in Wolverhampton. Partnership working by health partners had excelled during the pandemic. He added that it had been a tragedy for some families in the City, some of which were close to him personally. The position of the City in relation to the pandemic was now much improved. He thanked the West Midlands Ambulance Service for their efforts during the pandemic and the presentation given at the meeting. He thanked all the Panel Members for their support during the year and made particular mention of the Vice-Chair for his help.
The meeting closed at 3:53pm.