Chapter 4: Coming together to respond to the pandemic

On 23 March 2020, the Prime Minister announced the first lockdown and told people they must stay at home, only leaving for essential reasons such as buying food and exercising once per day. The NHS initially wrote to around 1.3 million people nationally, who were considered to be at the highest clinical risk from Covid-19, to inform them that they should stay at home at all times and avoid all face-to-face contact for a period of at least 12 weeks. Over time, 2.2 million people were asked to shield.

I was in the shielded group and that had a huge impact on me. I've worked at the hospital for many years so I'm used to being around people and all of a sudden, I wasn't. I had to do all my meetings online. My husband also had to shield by proxy. For 18 months, we only left the house 21 times and most of those times, it was appointments for doctors and blood tests. 
Joanne Coleman, Quality Improvement Lead, Gateshead Health NHS Foundation Trust

Individuals, local communities and statutory, voluntary and community organisations, across Gateshead, came together to respond to the pandemic, and support those who were shielding, and others who needed support. 

The shielding hubs, as they were known as initially, went from a concept to being operational a week after the announcement of the first national lockdown.

The network of eight community hubs were staffed by employees from across the Council and some of our key partners. Their aim was simple - to ensure no resident was left without support.

The hubs initially focussed on providing emergency food parcels, helping with routine shopping, the collection of prescriptions or other medical supplies, providing support if people wanted to talk to someone, and the co-ordination of volunteers on hand to offer help with other errands. The hubs were quickly operating at full capacity.

By 12 April 2020, the network reached its peak, responding to 133 requests for help in one day!

One year on, the community hubs were still operating and very much at the heart of the ongoing community support to the pandemic. The needs people had for support changed throughout the year. The overall need for emergency food decreased and from the autumn, and throughout the winter, the network saw a 64% increase in residents requesting help with utility bills and financial issues. 

In their first year, Gateshead community hubs: 

• Responded to over 8,500 requests for help  
• Contacted almost 27,000 residents over the phone  
• Made up, distributed and delivered over 14,930 food parcels 1,400 cook 'n' eat boxes 1,400 school meal packed lunch parcels 865 Christmas hampers  
• Wrote to over 36,000 residents to check they were okay  
• Connected thousands of volunteers to help out  
• Spoke to 11,000 residents classed as being Clinically Extremely Vulnerable 
• Delivered 54 essential oxygen monitors to residents suffering from Covid 

On 19 March, sports and leisure facilities closed for the pandemic. On 23 March, I received a phone call asking if I would lead on the government's help for emergency food in Gateshead.

I received a delivery of emergency food for the most vulnerable residents of Gateshead direct from the central government. Then it started from there. We:

• turned Gateshead stadium into a food distribution warehouse
• provided cook 'n' eat boxes for the weekly food box delivery scheme during school holidays to families who would normally receive free school meals
• put together Christmas hampers for residents with a link to Children's Services. The continued support throughout the pandemic of staff coming together to assist with this has made this possible and it will be good to see this through to the end.  

Ian Banks, Operations Manager, Gateshead Council 

People need to receive accurate and easy-to understand information about the pandemic to help keep safe and feel more in control. In a world of frequent government announcements, 24-hour news, and often misleading social media, it's not surprising that people were often confused or switched-off altogether. 
Some communities have faced bigger challenges in accessing information that meets their needs.

Gateshead Council's Public Health Team have worked with volunteer Covid Community Champions and local communities to help make sure that people across Gateshead were able to access correct and consistent information. These arrangements also helped us understand what was working well in our communities and what was not. The community champions have played an essential role in sharing information with family, friendship groups, workplace, networks and communities, to myth bust and ensure people were getting accurate information in a way that works for them.

Seeing people taking on board what was being said and changing their behaviour be it wearing a mask, washing hands, and taking up the vaccination all because of the messages from the Gateshead Covid Community Champions has meant a lot. Meeting other Community Champions from different organisations has allowed us to share good practice in what works to support clients and our communities. 
Sihle Mapanda, Managing Director, 2 Way Tenancy Solutions CIC 

Taking part of the training has given me confidence to talk to people at Lawnmowers about certain Covid topics e.g. Track and Trace and the benefit of getting your vaccination. I am also the Film Editor on all of our Public Health England raps we have done, and this has kept me busy both in and out of lockdown! I feel by doing the raps we are giving out correct information to the wider public and our community. I attend the meetings so there is representation of the Learning-Disabled Community and to also make sure what is been discussed or produced is accessible to Lawnmowers and our wider Learning-Disabled Community. 
Louis Huckle, Filmmaker and Technical Support, Lawnmowers Theatre Company 

Disadvantage, poverty, language barriers, culture and lack of trust in authority made it difficult to get information out about the pandemic to some refugee and new migrant communities. A lack of information in community languages and cultural barriers has led to conspiracy theories.

Past traumatic experiences affect trust in the government and relationships with officials. It made it difficult for communities to trust the messages that they were receiving. It was important to involve communities in developing their own information.  
Sirak Hagos, Director, Integration Station 

Around 6,000 children have taken part in the Young Covid Champions programme. We developed the programme because of concerns that young people were not always getting the information that they needed. We recognised the power of young people to influence their families.

We developed short informative cartoons and also used local Makina MC Tazo to spread the message about coronavirus to young people with the launch of a new track. It's had more than 60,000 hits on YouTube. It showed the importance of getting the message to local communities in a way that they can digest and understand.
Sarah Gorman, Chief Executive Officer, Edberts House 

I am aware that many Deaf people have struggled to get information because of the access barriers they face. One example of these barriers was the lack of interpreter provision for the live broadcasting of the Prime Minister's Coronavirus briefings and subsequent information updates, and this impacted on the Deaf community's ability to fully understand the content: although subtitles/captions were provided, the Deaf BSL using community use British Sign Language as their first language and English is a second language. It was this lack of interpreter provision and poor access to life saving information that caused huge frustration for many people.

The health awareness of the Deaf community was placed at a disadvantage compared to that of the hearing community who were able to access the television and the radio for updates, briefings and general announcements at all and any time to the detriment of the Deaf community. 
Robin Herdman, Teacher in BSL/Deaf Awareness Course, Self Employment and Part time BSL Teacher at University 

As a digitally excluded community where many households do not have access to mainstream media such as TV, radio, internet and social media, ensuring that basic health messages around staying safe and other crucial government advice reached the Jewish community took on vital importance. Through its relationship with Gateshead Council, the Jewish Community Council of Gateshead (JCCG) ensured that ongoing conversations with Public Health allowed for the free and easy transfer of information both ways, ensuring that the community were cared for in the optimum way with full consideration for its cultural norms.

For example, the JCCG took responsibility for the publication of weekly informational bulletins, delivered in hard copy to each community household, detailing essential safety information and Government advice. In addition, the JCCG assisted Public Health in accessing the services of the local Community Advertiser for the posting of material relating to ongoing messages around staying safe, inputting on the content to ensure appropriateness, effectiveness and timeliness of adverts. 
Jewish Community Council of Gateshead (JCCG) 

Covid information is very confusing at the best of times for both the public and for professions. So being part of this Champions Team has helped us to be more confident in our ability, for example, to keep people informed and up to date with covid and the law. 
Shirley Bain, Volunteer Secretary, Leam Lane Community Centre 

In December 2020, Gateshead Council teamed up with our six neighbouring local authorities to launch a regional communications campaign. Beat Covid NE featured real local voices thanking North East residents for playing their part in keeping themselves and others safe, through key behaviours such as wearing face coverings, social distancing and adhering to local and national restrictions. Evaluation showed that the campaign felt relevant to local audiences, gave them a clearer understanding of how to stay safe and motivated them to do more in the fight against Covid. 

"Thank you Gateshead for everything you're doing to fight Covid"

Our local contact tracing service supports the national NHS Test and Trace Service.

Gateshead Council set up a team in April 2020 to contact clinically extremely vulnerable, clinically vulnerable and older residents to offer support.

In summer 2020, when the pandemic appeared to be easing, we stood down the team but re mobilised, in September 2020, as a new 'Case Investigation Team' when Covid cases were rising.

Our role, this time, was to contact people who had been asked to isolate by the national Test and Trace service, gather local intelligence about potential outbreaks, and to see if people needed additional support to self-isolate. We seconded staff from libraries and leisure services.

In February 2021, Gateshead Council joined a 'local tracing partnership' (LTP) to undertake contact tracing 'phone calls for cases classed by the national system as 'hard to reach', or where the national system hasn't been able to make contact with a case within 24 hours. We can also signpost to support such as the self-isolation fund or make a referral to a community hub for support. From June 2021, we've worked alongside the regional Covid hub coordination and response centre (CRC) to carry out this work. 
Lynn Littler, Business Manager, Gateshead Council 

I think that it has been quite an experience speaking to people of different age groups who have differed in the severity of their illness. So, at times it has been challenging emotionally due to the nature of the calls but it has been very rewarding, because for some people who are isolated it has been nice to have someone to talk to.

Many have appreciated having a little giggle here and there and have commented that the call has cheered them up despite their situation. For me that makes a huge difference and makes me feel happy to be able to do the job and help people in any way I can.

Being able to support them, even if it's just by listening, is so important and very much needed at a time like this. 
Call handler 

The first Covid-19 vaccine was delivered in Gateshead on 8 December 2020, helping many residents to feel more positive about the future, By the end of 31 October 2021, 149,341 first doses and 136,692 second doses had been given. (Gov.uk (2021) Coronavirus (COVID-19) in the UK (opens new window))  

Covid-19 vaccination uptake at 31 October 2021 

As with other childhood and adult vaccination programmes, some people have delayed accepting or refused Covid-19 vaccines. However, research from other vaccine programmes suggests that the main reasons behind Covid-19 vaccine hesitancy can be summarised as 'the three Cs' 20:  

• Complacency - perceptions of the personal risk of contracting Covid-19; and perceptions of the severity of Covid-19.  
• Confidence - in the safety of the Covid-19 vaccine; and confidence in the effectiveness of the Covid-19 vaccine.  
• Convenience - barriers and access to being vaccinated against Covid-19.  

National data from ONS 21 suggests that adults living in the 20% most deprived areas of England expressed greater vaccine hesitancy (8% hesitant), than those living in the 20% least deprived areas (2% hesitant).

The age groups who appeared to be most hesitant about receiving the vaccine were those aged 16 to 17 years (11% hesitant) followed by 22 to 25 year olds and 26 to 29 year olds (9% hesitant for both). Those aged 40 and over showed the lowest vaccine hesitancy at 4% or less.

The national data also suggests that vaccine hesitancy is highest in people with a Black or Black British background (21% hesitant) compared to people from a White background (4% hesitant). People from a Mixed Ethnic background (7% hesitant) and Asian or Asian British background (6% hesitant) also appeared to be slightly more hesitant than those from a White background, however overlapping confidence intervals suggests this difference may not be statistically significant.

Health professionals and volunteers have worked together to deliver the vaccination programme. 

The vaccination programme was really lovely although tough to organise. Everyone loved doing it and it was great to see all of our patients back in the practice again. We were doing appointments back-to-back and seeing hundreds of people a day. The community really rallied around again. We had retired GPs and volunteers coming in to help. One lady came in with her elderly mother for a vaccination. She was in tears because she was so relieved that things were getting back to normal again and had been so worried about her mother. People hadn't been out for months, they felt that the jab was giving them their freedom back.
Teresa Graham, Business Partner and Practice Manager, Second Street Surgery, Oxford Terrace and Rawling Road Medical Group and CBC Health GP Federation.

When the national vaccination programme started, members of the Jewish community, a Black, Asian and minority ethnic communities disproportionately affected by the pandemic, were keen to receive their jabs.

Gateshead Public Health reached out to the Labriut Healthy Living Centre, the Jewish Community Council of Gateshead's flagship health and wellbeing project, for assistance in arranging and facilitating sessions for the Jewish community.

Working with local GP surgeries, immunisation sessions were arranged specifically for the Jewish community at a local vaccination centre, accounting for cultural considerations and enabling greater engagement in the programme. Sessions were arranged at very short notice, with Labriut staff working late hours to book appointments in time. Putting their knowledge of how the community 'ticks' to good use, Labriut used the services of a commercial community-wide texting service to advertise the sessions, and appointments were booked directly through Labriut. Using texts to inform the community of sessions geared specifically for the community had a huge impact in terms of raising awareness, and every successfully completed vaccination session further cemented the culture of immunising within the community.

People were allotted appointment times to suit their daily routine, and reminders texts were sent out, resulting in 100% attendance. A lovely community atmosphere was felt at the sessions and vaccine recipients shared their experience with others, encouraging more people to come to the next session. For those requiring support with travelling to the centre, Labriut arranged transportation.

The vaccination sessions were supported by personnel from Hatzola (Community Voluntary Ambulance and First Response) whose familiar and reassuring presence further enhanced the experience for people arriving to receive their vaccine. Once bespoke sessions were no longer available due to vaccine shortage, Labriut continued to support people by spreading the word and signposting people to walk-in clinics, the vaccine bus and the national booking system. 
Chavi Gluck, Project Co-ordinator, Labriut Healthy Living Centre - a project of the Jewish Community Council of Gateshead 

Gateshead Council's Public Health and Wellbeing Team has played a key role in supporting the local response to the pandemic.

Organisations and services have had to change the way they operate in order to meet Covid-19 legislation, government guidance and evolving needs. Necessity has sparked innovation. Some service users have welcomed new ways of accessing services, for others it is more difficult. 

Set up in 2018, Art Diamonds uses arts activities to improve wellbeing and connections in people of retirement age through creativity.

We've stayed in touch through fortnightly newsletters with creative ideas to try at home, posted out Art activity packs, virtual tours with galleries and online workshops. Our Art Diamonds have really appreciated feeling part of a community and sharing what they've been up to individually at home. With additional support through the Loneliness Fund in 2021, we focussed on new activities that weren't online to reach Art Diamonds who hadn't been able to engage with screen-based workshops.

A local artist found a creative solution to working with communities in residential care and sheltered housing. 'Windows' enabled older residents to connect safely with the artist through a drawing activity on each side of a glass window, watching each other's artwork grow. 
Karolynne Hart, Cultural and Arts Programme Manager, Gateshead Libraries, Arts and Heritage, Gateshead Council. (Art Diamonds Window Project, photo by Mark Savage) 

Throughout the lockdown periods core primary care services continued to be needed and GPs have turned to the telephone and to video conferencing to communicate with many of their patients. Using these modern tools has enabled GPs and nurses working in practice and in the out of hours periods to contact and provide care to patients and reduce the dangers to more vulnerable patients for whom an attendance at a surgery premises could be risky.

The continued, and currently increasing, risk of infection makes the need for the ongoing use of these consulting methods necessary although an increasing number of patients are being seen face to face. 
Dr Alexander Liddle, GP, CBC Health Gateshead 

The Gateshead Sexual Health Team rapidly developed a new online condom and community collection scheme to support the provision of contraception during Covid-19.

Access to longer acting contraception, such as the injection and implant, was restricted during the pandemic and could have led to unwanted pregnancies and potential future pressures on the social care system. Gateshead Sexual Health Team quickly developed online schemes to make other forms of contraception much more readily available. The scheme proved a big success with over 1,000 online orders and enabled local people to have condoms delivered direct to their door during lockdown.
Dan Dobson, Sexual Health Outreach Lead, South Tyneside and Sunderland NHS Foundation Trust 

We're at an interesting crossroads, there is a real appetite for change. We've been able to implement things that we've talked about for a long time like digital access. There is a whole world of opportunity that has opened up. However, there is also a need to give people a sense of security and a return to normality. 
Sarah Gorman, Chief Executive Officer, Edberts House

The next chapters focus on the impact of the pandemic on our Health and Wellbeing Policy strategic objectives. 

Next - Chapter 5: Give every child the best start in life