Shropshire, Telford & Wrekin Joint Health Overview and Scrutiny Committee
Monday, 2 March 2020
Directors of Public Health Statement on the preparedness for infectious disease outbreaks
Outbreaks and health protection incidents are not rare and often require the deployment of NHS and partner resources. Generally the most common outbreaks are norovirus and influenza type illness. This briefing provides the Shropshire, Telford & Wrekin Joint Health Overview and Scrutiny Committee with a summary of the local health economy and partner arrangements in terms of preparedness for outbreaks of communicable and infectious diseases, with a focus on the coronavirus emergency.
Arrangements for Health Protection Preparedness in Shropshire, Telford & Wrekin
The Shropshire Local Health Resilience Partnership (LHRP) coordinates appropriate action and resources to protect the public’s health by reducing harm, identifying a source and preventing the further spread or recurrence. The LHRP includes representatives from: NHS England and Improvement Emergency Preparedness, Resilience and Response (EPRR) leads, Shrewsbury & Telford Hospitals NHS Trust, Shropshire Community Health Trust, Robert Jones and Agnes Hunt Foundation Trust, Shropshire & Telford and Wrekin CCGs, both local authorities, Public Health England. A Shropshire Health Protection Response Memorandum of Understanding outlines the roles and responsibilities across local LHRP organisations and how the responses will work on the ground in different outbreak and incident scenarios.
The Coronavirus Public Health Emergency
The spread of a cluster of a novel coronavirus cases in Wuhan in China from late December 2019 has been declared by the World Health Organisation as a public health emergency of international concern. The global picture has been rapidly evolving and the UK Chief Medical Officers requested the respective governments to escalate planning and preparation in case of a more widespread outbreak. NHS England and Improvement, Public Health England and the Department of Health and Social Care have been centrally managing the response in England.
The risk to the general public in the UK is considered to be moderate as the infection and death rates for the virus appear to be broadly similar to seasonal ‘flu currently. From what we know about other coronaviruses, spread of COVID-19 is most likely to happen when there is close contact (within 2 metres) with an infected person. It is likely that the risk increases the longer someone has close contact with an infected person. The following symptoms may develop in the 14 days after exposure to someone who has COVID-19 infection; cough, difficulty in breathing, fever. Generally, these infections can cause more severe symptoms in people with weakened immune systems, older people, and those with long-term conditions like diabetes, cancer and chronic lung disease.
The UK is still in the management or containment phase of the incident, which means an identify - isolate - contain model of cases is being employed. A series of guidance has been issued by the government in England to support the management and of the incident.
As of 01 March at 9am, a total of 11,750 people have been tested in the UK, of which 11,715 were confirmed negative and 35 positive. Due to the outbreaks now occurring outside mainland China, such as those in Italy, South Korea and Iran, planning is rapidly being stepped up in the UK to prepare for the next phase. This new phase of planning includes establishing home and community testing and coordination centres for reporting of results.
How are we managing the incident locally?
Shrewsbury & Telford NHS Hospitals Trust (SaTH) have a priority testing service (POD) in place at Princess Royal Hospital and people requiring testing (in line with national guidance) are directed into the POD through the NHS 111 pathway. Samples are sent into the PHE laboratory system and reported back within around 48-72 hours.
As at 1 March 2020 there have been no positive local cases confirmed. Although as seen nationally, the numbers of people being tested has been increasing, particularly during the past week, due to the return from travel back from affected areas in February half term. Shropshire Community NHS Trust is supporting SaTH in the development of home and community testing.
The NHS trusts and both CCGs are regularly required to provide detailed assurance to NHS E/I Midlands on robustness of their planning and preparedness as the incident evolves and new guidance is released.
Both local authorities have been liaising with each other and with local NHS colleagues on a daily basis and with the LHRP core group which has been meeting on a weekly basis
The two local authority DPHs and Consultants in Public Health in their teams have also been, taking part in weekly PHE teleconferences and taking local action as required, disseminating national guidance, for example by communicating and reinforcing messages with staff, and through executive briefings and with schools, education settings and early years providers and working with internal health and safety colleagues giving advice to schools, staff and members of the public
Coronavirus Information for the Public
From 26th February the advice for returning travellers returning to the UK has been as follows;
1) If you have returned from the following areas since February 19, call NHS 111 to inform them of your recent travel, stay indoors and avoid contact with other people even if you do not have symptoms:
- Specific lockdown areas in Northern Italy* as designated by the Government of Italy
- Daegu or Cheongdo (Republic of Korea)
- Hubei province, China (returned in the past 14 days)
* Bertonico • Casalpusterlengo • Castelgerundo • Castiglione D'Adda • Codogno • Fombio • Maleo • San Fiorano • Somaglia • Terranova dei Passerini:
2) If you have returned from the following areas since February 19th and develop symptoms, however mild, you should stay indoors at home and avoid contact with other people immediately and call NHS111. You do not need to follow this advice if you have no symptoms.
- Northern Italy
3) If you have returned to the UK from any of the following areas in the last 14 days and develop symptoms of cough or fever or shortness of breath, you should immediately stay indoors and avoid contact with other people, call NHS 111 to inform them of your recent travel to the country.
- Other parts of China outside Hubei province
- Republic of Korea
- Hong Kong
Remember the Catch It, Bin It, Kill It messages:
- Always carry tissues with you and use them to catch your cough or sneeze.
- Then bin the tissue, and wash your hands, or use a sanitiser gel.
- Wash your hands often with soap and water, especially after using public transport.
- Use a sanitiser gel if soap and water are not available.
- Avoid touching your eyes, nose and mouth with unwashed hands.
- Avoid close contact with people who are unwell.
You can find the latest information and advice from Public Health England at www.gov.uk/coronavirus.
For more information please visit the Q&A below: