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Gateshead COVID-19 Local Outbreak Control Plan
Our COVID-19 local outbreak control plan focuses on preventing further localised outbreaks and responding quickly if there are positive cases in a key location, like a school or care home.
It will support residents, care homes, schools and key locations to understand how they can play their part in preventing outbreaks by reinforcing social distancing, good hygiene and supporting vulnerable members of their community.
The plan outlines how Gateshead will ramp up national testing programmes, maximise localised and mobile testing and ensure residents understand the symptoms, how to get tested and how to isolate safely to protect their community.
The national approach to contact tracing
Gateshead COVID Control Board
Local Outbreak Engagement Board
Social or clinical support for individuals
Data management and governance
Use of local authority Test and Trace Service grant
As national lockdown restrictions are eased it is important to maintain local vigilance to prevent and reduce the opportunities for the virus to spread within the community and key settings within Gateshead.
This COVID-19 Control Plan sets out the role of the Gateshead system in preventing and controlling COVID-19 with a focus on robust management of outbreaks and providing support for complex settings, communities, and individuals where required. It aims to protect the health of Gateshead's population from COVID-19 and assure stakeholders, and the public, that efficient and effective arrangements are in place.
The plan outlines how partners in Gateshead will work together to prevent and control COVID-19 at three levels:
- Primary prevention - preventing spread at a population level
- Secondary prevention - dealing with cases in complex settings and with communities of interest
- Tertiary prevention - management of complex local outbreaks of COVID-19, where local support is called for through the NHS Test and Trace system
The plan sets out the different roles in prevention, contract tracing, and the management of outbreaks, and their consequences, for those individuals, families, communities and organisations that are affected.
Our purpose is to reduce transmission of COVID-19 in Gateshead, to protect the vulnerable, prevent increased demand on healthcare services and ensure provision of an effective and timely response in the event of cases being identified.
We know that our most disadvantaged communities are those most impacted by this disease, for a complex range of reasons. We will work with our most vulnerable communities to minimise the impact of COVID-19 in Gateshead.
Public Health leadership: this plan is based upon a public health approach, under the leadership of the Director of Public Health. This means we will be concerned with:
- surveillance: so that action is informed by an understanding of the needs of the people of Gateshead
- evidence: our actions should be based on the evidence of what works
- policy and strategy development: through this COVID Control plan
- collaborative working for health and wellbeing
A whole system response: the capabilities of the whole system need to be mobilised in preventing and managing outbreaks.
An efficient and effective system: the need for clear communication and timely access and sharing of information, data and intelligence amongst local agencies and between local, regional and national systems to inform action, monitor outcomes and deliver rapid and proactive management of outbreaks.
A properly resourced response: each agency will have the necessary capability, both financial and in respect of skills and expertise, to carry out their responsibilities.
Along with local partners, we believe that the best approach to outbreak management is to aim to prevent outbreaks occurring. There will be five strands to this approach:
1. Media and communication
We will continue to take a pro-active approach to encourage residents to reduce the risk of COVID-19 by adopting measures to stay safe.
This will be supported by communication of general messages about how COVID-19 is spread through direct and indirect routes, and therefore the importance of key messages on social distancing, minimising contact with those who are unwell, respiratory hygiene (catch it, bin it, kill it) and infection control (including handwashing, cleaning, etc in all settings and use of personal protective equipment where required). Further important information is contained in Appendix 1.
We will establish a Local Outbreak Engagement Board (LOEB).
3. Targeted work with complex settings
Key settings such as care homes and schools already receive support and advice from us and NHS partners on issues including infection control, health and safety, PPE and welfare. Plans have been developed for other high-risk settings.
4. Promotion of testing for symptomatic residents
We will actively promote testing for COVID-19 to all those eligible to encourage maximum local uptake. This will put us in a better position to identify those who are infectious and prevent them passing the infection on to others.
5. The four E's - Engage, Explain, Encourage and Enforce
Lastly, working with the Northumbria Police we will use their established 4 E's approach for targeted work with the public where there are concerns about COVID-19 advice being followed. As a very last resort, we will consider the use of enforcement powers to prevent the spread of infection only where other measures have failed.
In future the COVID-19 pandemic is likely to be characterised by regular localised outbreaks in high risk settings or communities. Outbreak management is the approach to both identifying where there are clusters of cases of disease and then putting in place control measures to reduce further spread. In this way, we reduce the risk of further 'waves' of the virus, and therefore reduce the risk to people and key services.
By identifying cases and their contacts and asking them to isolate as quickly as possible, we reduce the opportunities for further spread. These contacts may also be tested themselves, and if positive their contacts traced, and so on. Targeted testing, tracing and isolating people who have COVID-19 plays a vital part in reducing the R (basic reproduction) number of the virus which then reduces the likelihood of a 'second peak'.
Outbreak management can be more complex in some settings and communities. This can be due to the vulnerabilities or circumstances of different groups or the potential impact of having to self-isolate as a result of being identified as a contact of a person with COVID-19. These settings and groups include:
- potentially complex settings such as schools, care homes and other care settings, residential children's homes, health care premises, refuges, sheltered and supported housing, houses of multiple occupation
- potentially complex individuals including rough sleepers; asylum seekers
- potentially vulnerable individuals and households including clinically shielded; learning disability; mental illness; domestic abuse victims; complex social-economic circumstances
- community settings, for example BAME communities and some tower blocks
The national approach to contact tracing continues to develop and information on what to do if contacted by the NHS Test and Trace Service can be found on the NHS website.
The Gateshead COVID Control Board will take management responsibility for this plan and overall management of the local response. The group will be responsible for:
- leading and co-ordinating our work to prevent the spread of COVID-19 in Gateshead
- identifying local high-risk places, locations and communities and planning how outbreaks will be managed in each
- reviewing data on outbreaks and cases to monitor epidemiological trends in Gateshead
- managing local testing capacity with partners to ensure swift testing of those who have had contacts in local outbreaks
- using local knowledge to help with contact tracing in these complex settings
- supporting vulnerable local people to get help to self-isolate and ensuring services meet the needs of diverse communities
- using our local Environmental Health enforcement powers in response to outbreaks if required
- reporting to Council Members and partners including PHE; linking to the Local Resilience Forum
- establishing governance structures
The COVID Control Board will be accountable to the Health and Wellbeing Board. It will also work with the Local Outbreak Engagement Board which will provide advice on how to ensure our messages on both prevention and dealing with outbreaks reach all our communities and settings. Membership of the COVID-19 Control Board is at Appendix 2.
A requirement of local outbreak control plans is to have in place 'local outbreak control boards' which provide political ownership and public-facing engagement and communication for outbreak response.
The LOEB will provide leadership on communication and engagement with affected communities, using established mechanisms and trusted relationships. This will include of the arrangements for supporting those who are self-isolating with food, essentials, errands and practical problem-solving around work, housing, benefits and education. The LOEB will also provide advice and support to the Health and Wellbeing Board on this.
The LOEB will be chaired by our Deputy Leader and have a core membership including the Council Leader, Chair of the Health and Wellbeing Board, Cabinet member for Communities and Volunteering, the Director of Public Health and representatives of Social Care, Education, NHS partners, Emergency services, business, faith leaders and BAME leaders. Others will be co-opted as necessary an on ad hoc basis.
The Public Health England (PHE) Health Protection Team (HPT) will be notified of cases associated with complex situations / settings by the NHS Test and Trace Service. The HPT will assess risks, arrange testing, provide health protection and infection control advice and have responsibility for management of the outbreak.
The HPT will alert the Local Authority (LA) of any need for local system follow-up to provide additional support to either the individual or the setting.
If the Local Authority or partner staff become aware of an outbreak, then the HPT will be informed.
Local HPT contact - email@example.com
Local HPT contact number - 0300 303 8596 option 1.
Responsibility for activation of the local COVID-19 Control Plan will rest with the duty Public Health Consultant, considering advice from the HPT. The duty consultant will determine whether local activation should be initiated immediately, or the following morning or next working day. This will be informed by the risk assessment provided by HPT and the issues that the LA needs to provide support on.
Escalation to an emergency situation or major incident
Outbreak planning and response is locally managed by each individual Local Authority Director of Public Health and Public Health Teams, in partnership with the PHE HPT. If additional support is required mutual aid can be requested from neighbouring LAs through existing Mutual Aid agreements through DsPH or Chief Executives.
If the management of the outbreak causes a significant test to our capacity and capability to respond and manage the issues, then consideration should be given to the declaration of an emergency situation or major incident, and activation of the existing Emergency Response Process.
Northumbria Local Resilience Forum (LRF)
Some outbreaks may require a multi-agency response at the strategic level in order to provide a resolution. In such incidents, the LRF will convene a Strategic Co-ordinating Group (SCG) to determine policy between the lead organisation, the emergency services and other organisations involved directly in the incident and ensure there is that wider collaboration and coordination where required.
Wherever a Gateshead outbreak is identified, either through notification by the PHE HPT or an alert from local staff, a duty Public Health Consultant will lead the local response in line with agreed detailed plans. These set out:
- initial assurance steps, including review of HPT risk assessment and checking that control measures are being implemented
- consideration of need for a local outbreak response group, membership and purpose of such a group
- implementation of agreed actions to support those affected by the outbreak and ensure the outbreak is controlled, including:
- how infection control and health protection advice and support will be provided (including assurance that advice is being followed)
- business continuity issues following closure or partial closure of setting or high levels of absenteeism
- contain and enforce: the use of powers to ensure compliance with advice
- arrangements for testing those who are symptomatic - from the Gateshead NHS FT laboratory wherever capacity allows, signposting to Pillar II, and rapid deployment of mobile testing
- communications: with cases and families; with other contacts; briefing of Members; media requests
- escalation to the PHE HPT if it becomes clear the situation is not under control
All outbreaks will be reported to the COVID-19 Control Board for assurance and oversight. Standard operating procedures are being developed for key settings such as Care Homes, workplaces and schools, but it is recognised that each outbreak will require a specific and probably individual response.
NHS Test and Trace may identify individuals who will need additional support during isolation for example because of their social circumstances or clinical need. They may also identify individuals who may be unwilling or unable to comply with restrictions such as self-isolation. Some may not engage with the process of identifying their close contacts. In these circumstances the case could be escalated to the PHE HPT and then notified to the Local Authority for follow-up.
Gateshead residents in need of help during this emergency can register online at www.gateshead.gov.uk/staysafe and schools, community leaders, employers and Council staff will be able to help people to register. Only for those who cannot access the website, calls can be made to our Customer Service Unit on 0191 433 7112 Monday to Friday, 8am to 5pm.
We can provide support, in partnership with local third sector organisations including:
- emergency food parcels
- help with routine shopping
- collection of prescriptions
- support if people want to talk to someone
- help and advice with money, benefits, employment or housing problems
Where an individual is unwilling or unable to comply with restrictions such as self-isolation, the following process will be followed:
- the duty consultant will share the information on the individual with key services including the CCG, social care, Housing Substance Misuse and Police to determine whether the individual is already known to services
- either the existing key worker or the CCG and duty consultant will convene a multi-disciplinary discussion with relevant services to put in place a risk-based action plan to ensure the individual's social, clinical and others needs are met
A detailed operating procedure will be developed, and the COVID Control Board will agree arrangements for monitoring the delivery of these action plans.
Contact tracing will be undertaken by the NHS Test and Trace service and the PHE HPT. The local system may be called upon to assist in contact tracing as part of the activation process described in Section 9. The potential roles will include:
- For complex individuals, asking the multi-disciplinary team around an individual to plan how best to engage with them over the disclosure of their close contacts, and/or (subject to data governance) to identify known associates who may be close contacts;
- In the event of an outbreak working directly with relevant organisations to help them identify potential contacts
- through the Local Engagement Board and Communications teams encouraging individuals who may have been in contact with someone they know to have symptoms to come forward
We will develop a local surveillance system to monitor the on-going incidence and prevalence of COVID-19 in Gateshead. We will analyse and interpret this data to inform the action we need to take at a community level, in a timely way, to prevent and respond to further cases. We will seek to develop links with NHS Test and Trace as well as using existing local and national data sources. We will need to establish appropriate information governance arrangements to oversee use of this data.
The duty consultant will be responsible for informing and involving the communications lead, in line with Council policies, given the public interest and potential anxiety around outbreaks, to ensure appropriate stakeholder engagement, community engagement and clear communication through the media should it be required.
- to ensure the appropriate dissemination of critical information within relevant organisations, standard communications protocols should be followed
- to inform key stakeholders and the wider community and support broader public understanding through responding to media requests / proactive media
- we need to be open and honest with our community to help to further build on existing relationships and trust
- we can expect people to be interested and concerned (we don't operate in a vacuum our work is very visible)
- take a collaborative approach across our organisations locally and nationally
- take a learning approach - look to improve
Local authorities in England are being provided with a Government grant to cover costs incurred in relation to the mitigation against and management of local outbreaks of COVID-19. The grant for Gateshead is approximately £1.5m. The grant will be used to support 5 key areas of focus:
- surveillance: secure local data flows, arrangements for scrutiny and interpretation to enable
- rapid identification of clusters and outbreaks
- decision making about local prevention actions
- community buy in
- provision: strengthen local capacity to provide robust infection, prevention and control advice and support
- knowledge and skills: equip local leaders to take local COVID-19 prevention action
- communication and engagement
- support for those who need to isolate
A risk register has been prepared to assess the delivery of the seven key areas this plan is expected to address:
- Planning for local outbreaks in care homes and schools (for example defining monitoring arrangements, identifying potential scenarios and planning the required response).
- Identifying and planning how to manage other high-risk places, locations and communities of interest including sheltered housing, dormitories for migrant workers, transport access points (e.g., ports, airports), detained settings, rough sleepers etc (for example defining preventative measures and outbreak management strategies).
- Identifying methods for local testing to ensure a swift response that is accessible to the entire population. This could include delivering tests to isolated individuals, establishing local pop-up sites or hosting mobile testing units at high-risk locations (for example defining how to prioritise and manage deployment).
- Assessing local and regional contact tracing and infection control capability in complex settings and the need for mutual aid (for example identifying specific local complex communities of interest and settings, developing assumptions to estimate demand, developing options to scale capacity if needed).
- Integrating national and local data and scenario planning through the Joint Biosecurity Centre Playbook (for example data management planning including data security, data requirements including NHS linkages).
- Supporting vulnerable local people to get help to self-isolate (for example encouraging neighbours to offer support, identifying relevant community groups, planning how to co-ordinate and deploy) and ensuring services meet the needs of diverse communities.
- Establishing governance structures led by existing Covid-19 Health Protection Boards and supported by existing Gold command forums and a new member-led Board to communicate with the general public.
Prevention - key messages
1. Minimise contact with individuals who are unwell
If you have, or are showing symptoms of, coronavirus (a new continuous cough, or fever, or a loss of, or change in, your normal sense of taste or smell (anosmia)), or have someone in your household who is, you should be at home, in line with the guidance for households with possible coronavirus infection.
2. Clean your hands often
Clean your hands more often than usual, particularly after arriving at your setting, touching your face, blowing your nose, sneezing or coughing, and before eating or handling food.
To clean your hands, you should wash your hands thoroughly for 20 seconds with running water and soap and dry them thoroughly or use alcohol hand rub/sanitiser ensuring that all parts of the hands are covered.
3. Respiratory hygiene (catch it, bin it, kill it)
Avoid touching your mouth, eyes and nose. Cover your mouth and nose with disposable tissues when you cough or sneeze. If one is not available, sneeze into the crook of your elbow, not into your hand. Dispose of tissues into a disposable rubbish bag and immediately clean your hands with soap and water or use a hand sanitiser.
4. Clean surfaces that are touched frequently
In work or community spaces, to prevent the indirect spread of the virus from person to person, regularly clean frequently touched surfaces, such as:
- door handles
- play equipment
- electronic devices (such as phones)
When cleaning, use your standard cleaning products, (like detergents or bleach), as these will be very effective at getting rid of the virus on surfaces. Follow the Public Health England (PHE) guidance on cleaning for non-healthcare settings..
5. Minimise contact and mixing
Individuals and households should stay home as much as possible, minimising contact with others to only necessary and unavoidable contact. If you are responsible for an organisation, you should, as much as possible, alter the environment of your setting (such as classroom layout) working arrangements to minimise contact and mixing.
6. Personal protective equipment (PPE)
Use PPE wherever indicated by Government guidance.
All residents and workers within Gateshead will be encouraged to register with NHS Test and Trace and arrange to be tested if they are symptomatic. This will be supported by activity to raise awareness of the signs and symptoms of COVID-19 and isolation advice.
Membership of the Gateshead COVID Outbreak Control group
Director of Public Health
Strategic Lead - Communities
Consultant in Public Health
Consultant in Public Health
Emergency Planning, Resilience and Response Manager
Communications Team Leader
Gateshead Council and Newcastle Gateshead CCG
Dr Lynn Wilson
Director for Gateshead System
Service Manager - Transformational Commissioning
Public Health Advanced Practitioner
Environmental Health Manager
Service Director - Schools
Gateshead Health NHS Foundation Trust
Director of Nursing, Midwifery and Quality, Director of Infection Prevention and Control
Gateshead Health NHS Foundation Trust
Gateshead Health NHS Foundation Trust
Community Services Clinical Lead
The Gateshead Housing Company
Head of Neighbourhood Services
Harrogate and District NHS Foundation Trust
General Manager, Gateshead, Sunderland and Darlington 0-19 service
NHS Newcastle Gateshead CCG
Executive Director of Nursing Patient Safety and Quality
Published: 30 June 2020
Alice Wiseman, Director of Public Health