Agenda item

A key element of successful outbreak management is access to timely and accurate intelligence to inform health protection action. Section 8 (Data Integration) of the Surrey Local Outbreak Control Plan describes existing intelligence resources and plans to develop further resources to support other elements of the plan.

The PowerPoint slides used are included as Annex 1

Sponsors:

Tim Oliver - Leader of the Council and LOEB Chairman (SCC)

Ruth Hutchinson - Interim Director of Public Health (SCC)

Witnesses:

Julie George - Public Health Consultant (SCC)

Key points raised in the discussion:

1.    The Public Health Consultant introduced the report noting that since the beginning of the outbreak, the team was developing the existing surveillance system and major incident processes to understand what was happening.

2.    She noted that on a daily basis a summary was provided to the SCG about outbreaks in specific settings. There was also a daily summary on the Tactical Dashboard of a variety of indicators such as Covid-19 cases, deaths and shielded persons. Twice weekly, the summary of deaths from the local registry data was circulated to the Adults Social Care, Care Settings and Death Management Cells.

3.    She noted that they were receiving a mass of complex data, such as:

·         Daily information from the Public Health England National team which was fed into Surrey’s local dashboard and included the number of cases and their contacts, exceedance reports - unusually higher than expected activity. 

·         Weekly postcode level testing data which it was hoped would be more regular, as well as weekly contact tracing data. 

·         Weekly update from PHE South East on the situation in children’s settings and a daily report on institutional outbreaks.

·         The PHE national dashboard which provided information on tests rather than cases, which was an issue due to repeat testing in care homes.

·         Local information from the public, businesses and partners including the Clinical Commissioning Groups (CCGs).

4.    The Public Health Consultant noted that as a result of the collated information, a daily call was stood up to review the data in the local and national dashboards and other surveillance tools and what action to take initially at district and borough level and then postcode level data.

The four main actions were:

·         No further action needed;

·         Watchful on-going review of the local situation;

·         Further intelligence required;

·         Take health protection action, including preventative measures like increased communications and deploying the mobile testing units.

The Test and Trace surveillance review was a continually updated process undertaken in collaboration with colleagues that share the same regional PHE Health Protection team - East Sussex, West Sussex and Brighton and Hove.

5.    She explained that the next steps up to August were to develop local surveillance tools and intelligence such as identifying the locations of businesses and diverse communities, to develop the common approach across Surrey and Sussex, to complete the necessary Information Governance (IG) documentation in order to share more information ensuring routine reports to partners such as the Board.

6.    She highlighted the specific lessons learnt from Leicester:

·         The importance of paying attention to border areas. In Surrey’s case it receives information from PHE South East and so it was important to also review data from London through the PHE national dashboard.

·         It had a different trend to other places so the challenge was knowing when it becomes a significant variation.

·         Regarding testing, the percentage of tests that were positive was important as testing was increasing all the time. The national PHE dashboard provided that information.

7.    A Board member queried the joint Surrey and Sussex common approach and whether there were links with Hampshire and Berkshire. In response, the Public Health Consultant explained that Surrey and Sussex were part of the same Health Protection team at PHE. She noted that there were good intelligence links with the Frimley system and noted the importance of working across borders such as the lessons learnt from Slough and the Black, Asian and minority ethnic (BAME) mortality reduction board.

8.    The Public Health Consultant highlighted the national surveillance picture based on positive tests from cases through healthcare (Pillar 1) and from community testing (Pillar 2). The cumulative rates started out in London and spread, they were now seeing the North catching up as for example Surrey’s rate was 3 cases per 100,000 population on the week ending 8 July, compared to plus 45 in Leicester and 30-44.99 in Blackburn with Darwen. Since 26 June Surrey had less than the five-year average for excess deaths, registering no deaths on 15 July since the outbreak.

9.    In response to a query by the Chairman on the median R value of 0.96 in Surrey, the Public Health Consultant noted that this was starting increase coinciding with the easing of lockdown - the lowest R value was roughly 0.60 during the lockdown.

10.  The Public Health Consultant noted that she was working with the Communications team to ensure that the surveillance and intelligence information on the County Council’s website was more accessible.

11.  She added that the information within the Middle Layer Super Output Area (MSOA) would be available publicly and she went through various links which showed the infographics, charts and maps on testing, cases and deaths, as well as the weekly national Covid-19 surveillance report.

12.  The Chairman thanked the rigorous work of Public Health team led by the Interim Director of Public Health, who in turn thanked the Public Health Consultant for her work and noted that she would shortly be leaving the County Council to take up a new role elsewhere.

RESOLVED:

The Board noted the rapid progress made to date and provided comments on the workstream to Public Health.

Actions/further information to be provided:

The links shown to the Board which included the infographics, charts and maps on testing, cases and deaths, as well as the weekly national Covid-19 surveillance report will be circulated to the Board and are included below:

https://www.gov.uk/government/publications/national-covid-19-surveillance-reports

https://coronavirus-staging.data.gov.uk/

https://coronavirus.data.gov.uk/#category=ltlas&map=rate