On Tuesday the Local Outbreak Control Plan was published by and for Cambridgeshire and Peterborough. This was required by Government on a June 30th deadline and is the local arm of the national Test and Trace system that’s supposed to help prevent a second Covid-19 outbreak, and to stamp out any small outbreaks that occur in ‘settings’ – places where people congregate, like schools, care homes and workplaces, whether offices or food processing factories. And manage outbreaks where they occur.

This week’s marching orders

So if someone develops Covid symptoms, they should report this to NHS Test and Trace which then organises a test, and seeks to contact and ‘trace’ all the people that person will have come into contact with during the lead-up to symptoms when they’ll have been contagious. And then depending on the test result, you either self-isolate for fourteen days as must all your contacts while they go through the testing regime, or you’re fine and you go back to normal and so do all those contacts. Obviously the speed of testing is important in making all this work, and so while there’s an assurance of a quick turn-around, my colleague’s eleven-day wait for a test result throws a wrench into the works.

Keep your distance and wash your hands, please

We know that the Plan is useless without society continuing to observe social distancing and hand hygiene. Whatever the government says about a two-metre distance or a ‘one-metre plus’ distance, the name of the game is to avoid physical contact with people outside your household. Or your bubble – the small, same and only group you spend time with at school or work, etc. Difficult of course that the Plan and its guidance is published in the same week that pubs are reopening. One local pub owner in my division threw up his hands and said he was considering just waiting a bit.

Who knows what and who doesn’t know anything?

Who gets told what, if and when there’s a ‘local’ outbreak? Your councillors at Cambridgeshire County Council, the local Public Health Authority, have so far been unenlightened, more often than not learning what they know in the local newspaper. A significant outbreak at a Cambridge care home, and consistently higher numbers of Covid deaths in Huntingdonshire, are largely unexplained: we don’t really understand the circumstances and the specific sequence of events that have led to local outbreaks, except that, as is now well known, during the first weeks of national lockdown hospitals regularly discharged Covid patients into care homes, sometimes knowingly (with certain protocols then to follow) and sometimes unknowingly (a false negative Covid test giving false confidence).

It was hoped that the publication of the Local Outbreak Control Plan would lead to your elected representatives being better informed about what might be going on in their communities, allowing them to take a proactive role on behalf of the people they represent, and through local knowledge, supporting the whole aim of the endeavour, i.e. to prevent local outbreaks. Turns out not to be the case. The Plan has what’s called a ‘Local Engagement Board’, but that’s made up of the Chair of the Health Committee and the Chair of the Health and Wellbeing Board, and one representative for all seven districts comprising the Cambridgeshire and Peterborough Combined Authority. So three elected representatives for the whole of Cambridgeshire, plus two from Peterborough. This meets monthly. The local councillor is only brought in after an outbreak has occurred.

Local support – what happens now?

If someone tests positive and has to self-isolate, then ‘local’ support systems are meant to kick in to place. Someone to help with your essential food shopping, getting your prescriptions, all the things that local Covid community support groups have been doing brilliantly for months now. The organically grown network of truly local groups that were in place almost overnight, even before the formal ‘hubs’ established at County and District Council level. At the core of this overall support effort has been the ‘Shielded List’ generated by the NHS and filtered down to councils has been the basis for regular contacting and supporting people who are particularly vulnerable and must observe the strictest isolation. Ultimately it was the local Covid support groups that could provide the ‘last mile’ of information about someone in the village on the Shielded List who hasn’t answered the door or the phone, or drawn their curtains or turned on a light.

But now that the government has said that Shielding People don’t need to shield anymore, those people are venturing outside and local Covid community support groups are winding up as organically as they formed in the first place – but without any systematic learning captured by the local public health authority, just at the time when the focus is meant to be on preventing and managing local outbreaks. And where does that leave the District and County Hubs, staffed largely by council officers employed to do very different things, like highway repair? And what happens to highway repairs?

Questions, questions

We’ve raised lots of questions about all the things that aren’t clear and that we’re concerned about, or that people we represent ask us to try and find out, but while there’s a record of due diligence in having asked them, doing so hasn’t changed anything fundamentally. Local information remains elusive and government’s damaging mixed messages – the standard set into stone by Dominic Cummings Covid-19 lockdown escapade – threaten to disrupt this week’s new marching orders. Nevertheless, it’s all about public health protection during a global pandemic that’s far from over, so we’re going to do our very best to support The Plan.

   Leave a comment