Issue - meetings

A verbal update is to be provided on the surveillance of the data and intelligence concerning COVID-19.

Witnesses:

Tom Bourne - Public Health Analyst Team Leader,Surrey County Council

Ruth Hutchinson - Director of Public Health, Surrey County Council

Key points raised in the discussion:

1.      The Public Health Analyst Team Leader (SCC) noted that:

·           Since the last meeting of the Board there had been significant changes to data availability as for example since the end of the provision of free universal symptomatic and asymptomatic testing for the public on 1 April 2022, recorded cases had become a less reliable measure of the prevalence of Covid-19 and instead the Office for National Statistics (ONS) Covid-19 Infection Survey, and measures such as hospital admissions and deaths were used.

·           Recorded cases of Covid-19 in Surrey over the course of the pandemic were just under 405,000, there were large drops in the number of recorded cases throughout March and since 1 April 2022.

·           The ONS Covid-19 Infection Survey showed the estimated percentage of the England population testing positive for Covid-19, the Survey asked people to test at fixed points once weekly whether or not they were experiencing symptoms. That up to the week ending 9 April 2022, cases remained high equivalent to 1 in 14 being infected; there had however been a decrease of cases in the last fortnight of data from 7.6% to 6.9% of the population.

·           The ONS Covid-19 Infection Survey showed the estimated percentage of the population testing positive for Covid-19 by region in England between 27 February to 9 April 2022, the lowest percentages were in the East of England, London and the South East - at 6.4% - and the North East had the highest percentage at 7.9% and that looked to be increasing.

·           The ONS Covid-19 Infection Survey showed the estimated percentage of the population testing positive for Covid-19 by age group in England between 27 February to 9 April 2022, the lowest percentage was 4.7% for those in school years 7 to 11 at secondary school; the highest percentage was 7% for those aged between 50 - 69 years and 7.2% for those aged 70 years plus - both percentages were plateauing.

·           A graph on the weekly number of people reporting Polymerase Chain Reaction (PCR) tests and PCR positivity in Surrey up to 12 April 2022 was shown whereby the number of PCR tests completed per week was around 15,000 compared to 50,000 tests per week in late January and 100,000 tests a week around Christmas.

·           A graph on the weekly number of people reporting Lateral Flow Device (LFD) tests in Surrey up to 18 April 2022 was shown whereby numbers continued to fall steadily.

·           A graph on Google Mobility data for London and Surrey, showing the percentage change compared to pre-pandemic baseline up to 15 April 2022 - minus the latest week for the Easter holiday - was shown whereby time spent in the workplace decreased by 25% compared to pre-pandemic levels.

·           A graph on the patients admitted to hospital in the South East up to 17 April 2022 was shown whereby  ...  view the full minutes text for item 15

A verbal update is to be provided on the surveillance of the data and intelligence concerning COVID-19.

Witnesses:

Dr Naheed Rana - Public Health Consultant, Surrey County Council

Ruth Hutchinson - Director of Public Health, Surrey County Council

Lorna Hart - Covid Vaccination Programme Director, Surrey Heartlands Integrated Care Service

Key points raised in the discussion:

1.    The Public Health Consultant (SCC) noted:

·         the ongoing review of the Covid-19 data on a daily basis concerning the cases, positivity rates, triangulation with the vaccination uptake, contact tracing and other intelligence, that information was disseminated with partners across the system and led to targeted actions.

·         the epi curve of Covid-19 cases in Surrey since March 2020, the graph showed the number of cases as well as the tracking of the seven-day averages and most recently there was a downward trend following the fluctuation over Christmas and New Year.

·         that the total number of positive cases to date in Surrey up to 8 February 2022 was 328,667.

·         that the fourteen-day rate was a more stable indicator and the seven-day rate provided a useful benchmark; for the most recent seven-period 6-12 February 2022 the seven-day rate for Surrey was 798.9 per 100,000 population which was above the South East rate at 736.5 per 100,000 population and above the England rate at 563.9 per 100,000 population.

·         the breakdown of Surrey’s boroughs and districts and their ranking nationally whereby all were above the England average; Waverley (ranked third) and Woking (ranked ninth) were ranked in the top ten nationally.

·         a bar chart highlighting the seven-day rates for Surrey’s boroughs and districts as compared to other areas and the London boroughs.

·         the publicly available infographic ‘Surrey Covid-19 Summary: Cases and Rates’ which showed the seven-day average of rates and cases within Surrey’s boroughs and districts which were on a downward trend.

·         the vaccinations uptake figures - first, second and booster doses - for Surrey and its boroughs and districts, compared to England and the South East; Surrey’s uptake across all three doses was above the England average, Surrey was ranked highly in terms of its uptake for those with learning disabilities or a serious mental illness - that was testament to the system-wide effort.

·         that Omicron was the dominant Variant of Concern (VoC) taking over from Delta, a BA.2 lineage was identified on 7 February 2022 but the BA.1 lineage remained dominant.

·         the heat map of cases per 100,000 population in Surrey by age group between 13 January - 5 February 2022 which showed a stripe across the age groups where more mixing took place, those rates were decreasing; heat maps were also shown for each of Surrey’s boroughs and districts.

·         the heat maps of weekly case rates per 100,000 population by local authority for Surrey and the surrounding areas from 2 January-12 February 2022, Surrey and the South East were on a downward trend.

·         the intelligence and triangulation undertaken regularly, looking at the seven-day case rate and first dose uptake and how they linked to the Index of Multiple Deprivation deciles, by Middle Super Output Area (MSOA) which was a smaller geographical  ...  view the full minutes text for item 6

A verbal update is to be provided on the surveillance of the data and intelligence concerning COVID-19.

Witnesses:

Dr Naheed Rana - Public Health Consultant, Surrey County Council

Ruth Hutchinson - Director of Public Health, Surrey County Council

Key points raised in the discussion:

1.      The Public Health Consultant (SCC) noted:

·         the Covid-19 daily monitoring, intelligence and surveillance information; reviewing triggers and escalations, and the epidemiology and situational reports. 

·         the epi curve of Covid-19 cases in Surrey whereby there were 150,651 cases in total up to 9 November 2021, cases continued to be monitored and the graph showed the number of cases as well as the tracking of the seven-day averages and the impact of the three lockdowns and the Government’s roadmap culminating in all restrictions eased.

·         a graph showing the Covid-19 cases in Surrey between 15 June - 15 November 2021 where cases rose in conjunction with start of the school term in September and fell in conjunction with the October half term, rising post half term; the school age population group were driving infection rates.

·         the number of cases and rates per 100,000 population in the most recent fourteen-day period 2-15 November 2021 and detailed the most recent seven-day period 9-15 November 2021 where the rate for Surrey was 464.2 per 100,000 population or 5,570 cases - which was above the England and South East rates.

·         Tandridge, Elmbridge and Mole Valley had the highest rankings compared with nationally and in Surrey, Tandridge’s rate in the most recent seven-day period was 600.8 per 100,000 population compared to Woking at 370.4 per 100,000 population.

·         the ranking of seven-day case rate for Lower-tier local authorities in England, 9-15 November 2021, Elmbridge and Tandridge were positioned at ninth and tenth.

·         that the number and distribution of cases fluctuated weekly, there were agreed actions and notifications to tackle the rates in Surrey - noting the work of the Communications team (SCC), colleagues involved in testing and vaccinations, and support provided by other partners such as Surrey’s borough and district councils.

·         that the publicly available infographic ‘Surrey Covid-19 Summary: Cases and Rates’ was updated on Tuesdays and Thursdays and the recent infographic indicated an increasing trajectory with 800 cases per day on average.

·         the publicly available weekly Friday intelligence summary, keeping Members and residents regularly informed.

·         that the Delta Plus variant that was currently in the whole of the UK, although at low numbers in Surrey and Delta remained the dominant variant in the UK.

·         the Covid-19 cases per 100,000 by age group in Surrey between 14 October-6 November 2021 shown through a heat map, highlighting an increase in cases for school age groups or 10-19 year olds - which was consistent in most of the boroughs and districts - and an increase in cases in 40 to 49 year olds; the slight increase in 60 plus year olds had stabilised.

·         a heat map of Surrey and surrounding areas: weekly case rates per 100,000 population by local authority between 5 October-15 November 2021; the fluctuation of cases was shown and culminated in the current high rates.

·         there had been a slow  ...  view the full minutes text for item 37

A verbal update is to be provided on the surveillance of the data and intelligence concerning COVID-19.

Witnesses:

Dr Naheed Rana - Public Health Consultant (SCC)

Ruth Hutchinson - Director of Public Health (SCC)

Key points raised in the discussion:

1.   The Public Health Consultant (SCC) noted:

·         the daily monitoring, intelligence and surveillance of data by the Public Health Team (SCC), including a review of the triggers and escalations concerning Covid-19 cases per 100,000 population, test positivity, transmission and vaccinations; agreed actions and notifications.

·         an overview of Covid-19 cases in Surrey up to 24 August 2021 shown via the epi curve across the three lockdowns and the Government’s roadmap out of lockdown, to date there had been 102,177 positive Covid-19 cases in Surrey.

·         the peak in cases as a result of the UEFA European Football Championship final and peak as a result of the easing of restrictions from Step 4 of the Government’s roadmap out of lockdown on 19 July 2021.

·         the number of cases and rates per 100,000 population for the 7-day period up to 29 August 2021: England - 296 per 100,000, South East - 267.9 per 100,000, Surrey - 242.9 per 100,000, Surrey Heath - 284.7 per 100,000 compared to Mole Valley - 195.3 per 100,000.

·         that rates over the last few months across the Boroughs and Districts in Surrey had been fluctuating, nationally Surrey’s Boroughs and Districts were ranked towards the bottom end of the lower-tier local authorities in England for the latest 7-day period to 28 August 2021, recognising the targeted efforts to achieve the decrease in case rates. 

·         that cases in Surrey were on a downward trajectory but could rise with schools starting and rates remained high as shown in the infographic on Surrey Covid-19 summary of cases and rates over a 7-day period published on 1 September 2021.

·         the heat map of cases per 100,000 population by age group across Surrey between 29 July 2021 - 21 August 2021 and within the Boroughs and Districts, with the highest cases in 20 to 29 year olds followed by 10 to 19 year olds. There was also a slight increase in cases for over 50 and 60 year olds.

·         the weekly case rates per 100,000 population in Surrey and surrounding areas between 19 July 2021 - 29 August 2021, areas with higher cases were holiday destinations.

·         that in Surrey up to 30 August 2021 around 84% the adult population had received at least one dose of the Covid-19 vaccination, 77% had received their second dose; uptake varied across the Boroughs and Districts.

·         the triangulation of vaccination rates and case rates, to target areas of higher rates and lower vaccine uptake.

·         the weekly Surrey Covid-19 Intelligence Publications, infographic and summary. 

2.    The Chairman sought an update on an action from the June Informal Board:

-       Minute item 19/21: 1. The Public Health team (SCC) will liaise with the Vice-Chairman concerning his offer of logistical support by Reigate and Banstead Borough Council through volunteers to encourage the uptake of vaccinations.

-     In response, the Director of Public Health (SCC) noted that the ongoing  ...  view the full minutes text for item 27

A verbal update is to be provided on the surveillance of the data and intelligence concerning COVID-19.

Witnesses:

Dr Naheed Rana - Public Health Consultant (SCC)

Key points raised in the discussion:

1.    The Public Health Consultant (SCC) noted:

·      how the Public Health team (SCC) monitored the intelligence and surveillance of Covid-19 cases daily through epidemiology and the situational report, as well as the triggers and escalations - cases per 100,000 population, trends, outbreaks, exceedance reports and triangulation with vaccination data to ensure that appropriate actions were taken immediately and in conjunction with Surrey’s system partners.

·      an overview of Covid-19 cases in Surrey up to 8 June 2021 shown via the epi curve over the three lockdowns as well as the three Steps in the Government’s roadmap out of lockdown; with a total of 71,961 positive cases and there were 666 new positive cases between 2-8 June 2021.

·      the slight increase in rates post the easing of Step 3 of the roadmap on 17 May 2021.

·      Surrey’s cases and rates per 100,000 population over the most recent 14-day period 31 May-13 June 2021 and 7-day period 7-13 June 2021 as a county, by Borough and District, and compared with the South East and England.

·      that Surrey Heath had the highest 7-day rate in Surrey at 81.7 per 100,000, which was higher than Surrey, the South East and England. Followed by Reigate and Banstead’s 7-day rate of 72.6 per 100,000 population, which was higher than Surrey and the South East.

·      that Waverley had the lowest 7-day rate in Surrey at 28.5 per 100,000 population, followed by Tandridge’s 7-day rate of 39.7 per 100,000 population. Which were both lower than Surrey, the South East and England.

·      the ranking of the 7-day case rate for Surrey’s Districts and Boroughs compared with other lower-tier local authorities in England, notably Blackburn with Darwen and Bolton with high rates. 

·      the Surrey Covid-19 summary of cases and rates over a 7-day period through the infographic currently published on Monday, Wednesday, Friday with trend information compared to the previous week, the 7-day average of cases was also tracked.

·      the case rate heatmap for Surrey between 18 May-14 June 2021 across age groups ranging from 0-4 to 80+, highlighting the increasing dark areas of greater cases between the age groups of 11-16 up to 19-24; compared to the lighter areas and lower cases in the over 60s - demonstrating the positive vaccination programme.

·      the case rate heatmap by local authority for Surrey between 18 May-14 June 2021, highlighting the recent changes across the age groups in Reigate and Banstead.

·      the Surrey and surrounding areas - South East - weekly case rate heatmap per 100,000 population by local authority from 30 April-6 May 2021 with the case rate predominantly at 0-24.9 per 100,000, slowly darkening to 4-10 June 2021 with the case rate predominantly at 25-49.9 per 100,000, with areas at 50-99.9 per 100,000 population.

·      the vaccination roll-out programme in Surrey whereby in total over 756,000 people or 58% of the total eligible population - 1% above the South East - had received at least one dose  ...  view the full minutes text for item 19

A verbal update is to be provided on the surveillance of the data and intelligence concerning COVID-19.

Witnesses:

Dr Naheed Rana - Public Health Consultant (SCC)

Key points raised in the discussion:

1.   The Public Health Consultant (SCC) noted:

·      that daily the triggers and escalations concerning the number of cases were reviewed and intelligence concerning infection rates and vaccinations was triangulated in order to understand the direction of travel.

·      that the latest reporting figures for Surrey for the fourteen-day period between 29 March - 11 April 2021 was 28.8 cases per 100,000 population and the seven-day period between 5 - 11 April was 12.1 cases per 100,000 population.

·      that the fourteen-day period provided a more stable view of infection rates and to be mindful of the reporting delays for the most recent four days. 

·      that over the fourteen-day period Surrey’s infection rate was lower than both England and the South East, and over the most recent seven-day period Woking had the highest case rate in Surrey of 23.8 per 100,000 and Elmbridge had the lowest case rate of 6.6 per 100,000 population.

·      the fluctuation in the epi curve over the three lockdowns, highlighting the first lockdown in March 2020 and the most recent reopening of schools on 8 March 2021 and non-essential retail opening on 12 April 2021.

·      the importance of continuing to track cases in relation to the Government’s roadmap out of lockdown with the total number of cases in Surrey as at 12 April 2021 was 69,848 since the beginning of the pandemic and the latest case rate was 46.8 per 100,000 population. 

·      the case rate heatmap for Surrey from March 18 - 8 April 2021 by age group was dominated by lighter colours due to lower cases as a result of the January lockdown, partnership effort and compliance of residents. 

·      the case rate heatmaps by districts and boroughs from 16 March - 12 April 2021 showed darker areas reflecting high infection rates in age groups following the reopening of schools, later moving to lighter colours.

·      the weekly case rates for Surrey and surrounding areas in the South East from 12 March - 8 April 2021 with the most recent heatmap dominated by lighter colours 0-24.9 per 100,000 population.

·      the triangulation work in which greater data and intelligence was being received in terms of case rates and vaccine uptake broken down by age, Index of Multiple Deprivation deciles at Middle Super Output Area (MSOA); which were used to tackle areas of concern.

·      the bi-weekly Covid-19 intelligence summary and the daily dashboard of Surrey Covid-19 cases - including vaccination data - were both being published weekly beginning 1 April 2021 due to smaller fluctuations in case rates.

Dr Charlotte Canniff joined the meeting at 2.13 pm

2.   The Chairman welcomed the comprehensive presentation and the graphics which showed Surrey’s journey through the pandemic.

3.   A Board member commended the surge testing for the South African variant in Surrey which was under control but noted the rise in cases in South West London such as Wandsworth, querying the current situation in Surrey in relation to that variant  ...  view the full minutes text for item 13

A verbal update is to be provided on the surveillance of the data and intelligence concerning COVID-19.

Witnesses:

Naheed Rana - Public Health Consultant (SCC)

Key points raised in the discussion:

1.      The Public Health Consultant (SCC) presented the latest reporting figures between 8-14 February 2021 noting that Surrey’s seven-day rate was 90.8 per 100,000 population, which was lower than the England rate of 130 per 100,000 population and the South East rate of 92.7 per 100,000 population. The downward trajectory indicated that the impact of lockdown and all the other targeted actions of Surrey’s health and care partners and local communities had a positive effect.

2.      The Public Health Consultant (SCC) noted that at present within Surrey, Spelthorne had the highest rate at 148.2 per 100,000 population and Elmbridge had the lowest rate at 63.6 per 100,000 population.

3.      The Public Health Consultant (SCC) presented the epi curve which showed the number of cases from the beginning of the pandemic - 66,594 - up to the current point on 15 February 2021 which showed a steep decline and the three lockdowns were highlighted.

4.      The Public Health Consultant (SCC) presented a heatmap on the age-specific confirmed case rate in Surrey between 19 January - 11 February 2021 from groups 0-15 to 60 plus years. Around 21 January the heatmap showed a very high case rate for 30-44, high rates for 16-29 and 45-59 years and by 11 February the case rate was low for all age groups.

5.      The Public Health Consultant (SCC) presented heatmaps of Surrey and surrounding areas which showed the weekly case rates per 100,000 population by local authority. The heatmap from 8-14 January 2021 showed very high case rates closer to the top range of 700 plus cases per 100,000 population and over a series of weeks to the most recent map 4-10 February 2021 showed low rates closer to the low range of 0-99.9 cases per 100,000 population.

6.      The Public Health Consultant (SCC) highlighted Surrey’s intelligence publications including the daily dashboard of Surrey Covid-19 cases which was published using publicly available data as well as the bi-weekly Covid-19 intelligence summary published every Thursday and Monday which provided further detail about vaccinations, the death rate, cases and the mapping of cases by postcode.

7.      The Public Health Consultant (SCC) provided assurance that surveillance and intelligence continued to be monitored daily by the Public Health team (SCC) in conjunction with partners to manage outbreaks and to support communications.

RESOLVED:

The Board noted the verbal update and presentation.

Actions/further information to be provided:

None.

Sue Sjuve joined the meeting at 2.22pm

Daily surveillance of COVID-19 data and intelligence is key to identifying increasing rates of COVID-19 in the community and taking prompt action as per Surrey’s Escalation Framework (ie deployment of mobile testing units, internal/external communications). A COVID-19 Intelligence Report for Surrey, summarising data that is in the public domain, is now being published every Monday and Thursday. In addition, 7-day cases and rates infographics is now being published daily. A process to support enhanced Local Contact Tracing data requirements is being established.

Witnesses:

Dr Rachel Gill - Public Health Consultant (SCC)

Key points raised in the discussion:

1.    The Public Health Consultant (SCC) introduced the COVID-19 Daily Data Dashboard, the bar chart showed the daily number of COVID-19 cases. Reporting delays meant that data could be incomplete for the most recent days, therefore the data shown was the last seven days of complete data for the week ending on 15 November 2020; in which there were 1,936 new cases in Surrey- there was a decrease of cases in Mole Valley and Guildford.

2.    Based on the number of cases, the rate for that seven-day period in Surrey was 161.8 per 100,000 population compared to 184 in South East England and 266.5 in England.

3.    She explained that the COVID-19 Intelligence Summary was published publicly on the Surrey County Council website bi-weekly every Monday and Thursday. The data was shared with a wide range of partners and it included data on the number of cases, the rate and R number nationally, county-wide, within Surrey’s eleven boroughs and districts, regional information and hospital activity, as well as further links to publicly available data sources with postcode level data.

4.    The Public Health Consultant (SCC) highlighted that Surrey ranked 98 out of all councils in England with a rate of 145.5 per 100,000 population in the seven days ending 16 November 2020 - with a range of 106.9 in Waverley to 220.3 in Runnymede per 100,000 population. The top ten ranking councils’ rates in England ranged from approximately 459 to 675.

5.    She noted the age-specific case rate heatmap for Surrey which showed that the 16-29 age range had the highest rates with cases spreading across the age groups and that mirrored the national pattern.

6.    She summarised the situational report for Surrey map which highlighted the number of cases in the last fourteen days by districts and boroughs ending 16 November 2020, with a range from 254 in Mole Valley to 445 in Spelthorne.

7.    Noted the change in the geographical allocation of cases due to PHE’s updated method in relation to the location of people who tested positive or negative for COVID-19. Previously the address was taken from an individuals’ NHS Summary Care Record created from GP medical records as opposed to the new location which prioritised the address given at the point of testing. The change meant the better geographical distribution of cases for example in the case of university students.

8.    She added that the change of location was applied retrospectively back to 1 September 2020 and as a result Surrey saw a 4% reduction of cumulative case numbers, with a 9% decrease in cumulative cases in Elmbridge and an 8% decrease in Waverley.

9.    Regarding the number of positive cases against the number of tests carried out, the Public Health Consultant (SCC) explained that the positivity rate was analysed daily and was the number of people who tested positive out of the number of people who were tested.

10.  A  ...  view the full minutes text for item 23

Daily surveillance of COVID-19 data and intelligence is key to identifying increasing rates of COVID-19 in the community and taking prompt action as per Surrey’s Escalation Framework (i.e. deployment of mobile testing units, internal/external communications). A COVID-19 Intelligence Report for Surrey, summarising data that is in the public domain, is now being published every Monday. 

Witnesses:

Naheed Rana - Public Health Consultant, Intelligence and Insights (SCC)

Ruth Hutchinson - Director of Public Health (SCC)

Andrea Newman - Director of Communications and Engagement (SCC)

Key points raised in the discussion:

1.      The Public Health Consultant introduced the report, noting that the COVID-19 weekly intelligence summary produced every Monday provided residents and partners with regular insight and intelligence into COVID-19 cases within Surrey and how that compared with the national and regional context.

2.      She explained that the COVID-19 weekly intelligence summary outlined the most up to date data available in the public domain - the Public Health team was mindful of confidential data sharing agreements with agencies such as Public Health England (PHE). She highlighted that:

·           The data was shared through various communication channels including the Board, the Health Protection Officers Group (HPOG), the Surrey Local Resilience Forum (SLRF) and, Surrey Heartlands Integrated Care System (ICS) and Frimley ICS. She commented that there had been positive feedback and further questions asked from residents.

·           The COVID-19 weekly intelligence summary report contained the daily rates and data trends over seven days for Surrey’s eleven boroughs and districts and how Surrey ranks nationally.

3.      The Public Health Consultant explained that data, intelligence and surveillance was being monitored daily, allowing the Public Health team to assess the triggers for prompt action to be taken in line with the Escalation Framework and in conjunction with the Communications team and health partners. She highlighted that:

·           The triggers were related to cases per 100,000 over the seven-day rate as well as the fourteen-day rate which had less variation due to reporting delays.

·           The fortnightly case rate for Surrey was 31.3 per 100,000, slightly higher than the South East rate at 25.3 per 100,000 and significantly lower than the England average rate of 79.2 per 100,000. The seven-day weekly rate for Surrey was 13.6 per 100,000 and the overall Surrey rate as well as the rates for each of the eleven districts and boroughs were benchmarked across three hundred and fifteen areas.

·           The direction of travel and speed of trends, the positivity rates, exceedance reporting, contact tracing intelligence post code level data and other sources of local intelligence were evaluated daily.

·           From the daily monitoring, situational reports were developed such as for the number of cases daily per age group within Surrey and the eleven boroughs and districts over a fourteen-day rate. Nationally and within Surrey, the number of COVID-19 cases for the 15 to 34 year age group was peaking, so the identification of such groups allowed targeted communications and the deployment of mobile testing units for example.

·           Data was available in tabulation form, through visual maps and interactive dashboards down to the post code level towards a comprehensive picture of COVID-19 cases within Surrey, regionally and nationally.

·           Spelthorne was recently placed on the national COVID-19 watchlist and was being monitored by the Public Health team on a daily basis with a detailed picture forming over seven and fourteen days. In  ...  view the full minutes text for item 15