Agenda item

Local NHS / Public Health response to Covid-19

Representatives from Tees Valley Clinical Commissioning Group (TV CCG) and Director of Public Health for South Tees will be in attendance to provide an update in respect of the local NHS / Public Health response to COVID-19.



The Advanced Public Health Practitioner (South Tees) provided an update on the ongoing Covid-19 situation and made the following points:


·  In terms of the national summary, it was shown where the Tees Valley was sat in the national rankings, with Middlesbrough in 135th position and Stockton in 96th position in terms of prevalence. The point was made that in effect all of the prevalence rates in the Tees Valley were quite low, with sustained community transmission at around 300-400 cases per 100,000 population. This compared to the highest Local Authority rates of 860 cases per 100,000 population. However, the rates in the Tees Valley were increasing slightly. 

· In respect of cases by specimen date there had been a spike around October, which the data had shown reflected a return by schools after the half term break. Over the last couple of weeks there had been a slight fluctuation but rates seemed to be levelling while the England rate was rising.

· In terms of testing rates it was highlighted that the Tees Valley did have lower testing rates than the England average, as a proportion of the population.

· The cases by age band were highlighted and it was noted that for all of the local authorities within the Tees Valley the 5-9 and 10-14 age band up to 3 December 2021 had been significantly higher than the other age bands. In the most recent week Redcar and Cleveland had the highest rate in the 5-9 age band. There had also been a slight increase in the 30-40 age band, which was potentially caused by household transmission to parents and public health teams were continuing to work closely with schools and families. Cases were being monitored and support to schools provided.

· Reference was made to the hospital data, the number of hospital COVID patients in County Durham and Darlington was 59, South Tees 54 and North Tees and Hartlepool 33. The figures had decreased in recent weeks but the hospitals were still experiencing new cases. 

· Mortality rates across the Tees Valley were significant and the rates ranged from 284 per 100,000 in Stockton for those with COVID mentioned on the death certificate to 328 per 100,000 for Hartlepool, with excess deaths above the average figures for the period 2015 – 2019 being significant. All of the Tees Valley rates were higher than the national average.

· In terms of vaccination uptake, the figures showed the top 20 performing Local Authorities nationally, with Northumberland topping the charts for both first and second doses, with a coverage of 89.1 per cent and 82.9 per cent respectively. All of the Tees Valley Local Authorities had coverage rates above the national average of 78.2 per cent for first dose and 71.6 per cent for second dose, with the exception of Middlesbrough where coverage was 74.7 per cent and 67.1 per cent respectively. A real positive was that the booster uptake across all five local authorities was above the national average. Sustained efforts were being made to increase the vaccination rates and a pop up vaccination clinic had been held in Middlesbrough yesterday with 477 people attending for both first and second dose vaccinations. From January 2022 a rolling programme of pop-up vaccination clinics would be held.

· In effect the percentage coverage reflected the deprivation demographics across the Tees Valley, with Darlington and Redcar and Cleveland being more affluent than Middlesbrough and Hartlepool and thereby having higher take up rates of the vaccine. Middlesbrough’s figures were also impacted by a higher BME population, as vaccination rates in these communities tended to be a bit lower.

· In terms of the new Omicron variant it was advised that was displaying a growth advantage over Delta. This assessment was based on analysis of UK data showing an increased household transmission risk, increased secondary attack rates and increased growth rates compared. Omicron was likely to outcompete Delta in the UK and predominate. With regard to severity there was insufficient data at this time to assess infection severity, which was expected in the early period of emergence of a new variant.

· At present there were no known cases of the Omicron variant in the Tees Valley but cases were rising nationally.

· With regard to the JCVI advice on vaccinations in response to Omicron booster eligibility had been expanded to include all adults aged 18 to 39 years, as long as there had been a three month gap from the second dose. The booster was to be offered in descending age groups, with priority given to the vaccination of older adults and those in an at-risk group.

· The 12 to 15 year old cohort were currently being offered a second dose of the Pfizer vaccine so long as there had been a minimum of 12 weeks from the first dose. Phase 1 had been completed and the Tees Valley was now moving into phase 2.

· Plans were in development to develop capacity & workforce (CCG lead), with guidance expected to be released today.


The Director of Commissioning, Strategy and Delivery at Tees Valley Clinical Commissioning Group (CCG) advised that there was still a sustained degree of pressure in the healthcare system. Covid admissions to hospital had remained fairly static since the summer and that was being managed but the full impact of the Omicron strain was not yet known. At this point in time progress was being made in respect of planned operations and routine outpatient clinics were taking place as normal.


The Chief Executive of Tees Valley CCG advised that the vaccination programme was a moving feast because of announcements that were being made nationally. Huge progress was being made locally thanks to a combined effort the central team in Newcastle, the Primary Care Networks, the Pharmacies, the Hospitals, the school providers and significantly colleagues in the Public Health Department and the local authorities. There had been a fantastic team effort and the numbers were good but there was a need to try and vaccinate as many people as possible. The challenge would be how to turn the vaccination programme into business as usual, as it would be a programme that would need to be implemented for at least the next few years.


On behalf of the Committee the Chair expressed her thanks to everyone within the NHS and all of the other organisations involved in making the vaccination programme such a success. Members were afforded the opportunity to ask questions in respect of the information provided and a number of issues were raised.


It was queried as to why the gap between doses had been reduced so significantly, from six months down to three. In response it was advised that the decision to reduce the gap was symptomatic of learning from experience and as knowledge shifted and changed so did the response. Experience had shown that there was no advantage to waiting the six months and the reduction in time simply helped ensure more people received their booster vaccination sooner.


Reference was made to current vaccination uptake rate for 12 to 15 year olds in the Tees Valley, as it had not been very high. The second vaccine was now being offered and it was queried whether the take up rate had increased. In response it was advised that one of the initial challenges had been the speed at which had the programme had been mobilised from the Government directive. There had been issues with consent, parental knowledge and making booking arrangements with the schools. It was acknowledged that there had not been a great uptake with phase 1, as the vaccination teams had had limited time within the schools. However, it would now be a rolling programme and an out of school offer was also in place. A revisit to the schools was being arranged and it was hoped that uptake of the offer would improve.


Concerns were expressed in respect of the vaccine take up rates amongst the younger cohorts and a reluctance by many to continue to wear face masks. It was queried as to how this was to be encouraged given there were still many cases of Covid-19 present within the community. It was advised that was no single solution and it was a case of everyone repeating the message and emphasising the importance of being vaccinated and wearing face masks in public places. Joined up communications between all of the organisations was of the utmost importance and there was a significant amount of work being undertaken between the Council’s and Health’s communication leads to ensure those messages were being heard.


Reference was made to the allocation of the pop up clinics, as some of the locations used had very limited car parking provision for disabled users. It was queried whether ward councillors could be involved in suggesting appropriate venues. It was advised that the Teeswide Vaccination Board, headed up by Dr Janet Walker was responsible for co-ordinating the programme. The best way for ward councillors to put forward suggestions was for them to contact their Public Health teams directly, as the teams were key in delivering the vaccination programmes.  


Reference was made to the death rate from Covid-19 within the Tees Valley and it was confirmed that the rates for the Tees Valley were higher than the England average. The view was expressed that there were a number of complex factors for the rates including the general health of the population, high levels of deprivation and the high prevalence of Covid-19 in the sub-region at various times during the pandemic.  


ORDERED that the information presented be noted.