Gold update from Andrew Jones 11 March 2021
Published: 15 March 2021
Prynhawn da pawb,
The Gold group began this week’s meeting with our standing agenda item reviewing our response level. This week we once again confirmed that we remain at Enhanced level. This is in the context of an improving epidemiological picture with the average 7-day incidence rate now at 41.9 per 100,000 for Wales. At the same time, the number of new incidents is reducing, as is the number of Covid-19 related hospital admissions, admissions to ICU and daily reported deaths. This is an improving picture however there are still areas where the incident rates are not declining as much as others.
As ever, we keep a close eye on incidence in settings and it has been encouraging that since the under 7s returned to school on Monday 22 February 2021, we have not seen a significant spike in infections in schools. The Welsh Government has announced a return to school for more children from today, Monday 15 March 2021 and we will continue to monitor the effect of this closely. As part of this, lateral flow testing (LFT) in schools will be put in place and we are working closely with Welsh Government digital teams to build the data systems and provide surveillance reporting.
As we’ve said before now, we can expect the SARS-CoV-2 virus to continue to mutate and there are now four specific Variants of Concern (VoC) under surveillance in Wales, as well as a number of Variants Under Investigation (VUI). We continue to work with partners across the four UK nations and internationally to provide surveillance on these. To that end, the Incident Management Team (IMT) with Microbiology is working to further strengthen the strategy for identifying and sequencing VOCs, with some new PCR testing being piloted in advance of Whole Genome Sequencing) .
Staff vaccination continues apace with 1143 of our staff having received a first dose of the COVID-19 vaccination. I’d like to encourage all staff to read the daily staff e-bulletin and updates on the intranet about our vaccine rollout so that you can keep up to date with the latest information and developments.
Twice-weekly LFT testing is being offered to all health boards for all NHS Wales staff with a focus on patient-facing staff. Welsh Government has now also set out a broader testing strategy to include employers with more than 50 staff. . In terms of next steps, Public Health Wales is looking at workplace testing schemes in the areas where this will be of greatest benefit to both our staff and patients and service users. Plans are in development and you can expect an update once these have been scrutinised and approved.
Next week we will be publishing the findings from two studies, ACTS and CABINS, which investigate confidence, adherence and challenges to self-isolation amongst contact of COVID-19. The report provides behavioural insights from contacts of cases of COVID-19 starting and completing self-isolation in Wales. I want to highlight some key considerations from the report which will be shared with Test Trace Protect (TTP) Programme Board to inform action.
Over November 2020 to January 2021, 90% of respondents (from a total of 14,090 contacts of COVID-19) said they were confident they knew what to do when asked to self-isolate and 78% reported having adhered to the guidance. Although those who responded were not fully representative of all contacts of COVID, the high prevalence of adherence in Wales does point towards promoting adherence to self-isolation as the social norm here.
What was really clear in the research is that people who made plans for self-isolation and who had support to do this were more likely to adhere to self-isolation.
There are four key areas for action to address the common challenges to self-isolation in Wales.
Firstly, people reported concerns about their mental wellbeing and lack of social support. An action to support this could mean TTP contact tracers providing links to local support services for all contacts.
Precarious financial situations, and worries about access to food or medicines are another clear barrier to adherence. An action to address this could be for TTP to identify those at higher risk as part of the contact tracing conversations, and signpost to support.
The third finding is around exercise. The most common reason for people to leave home when self-isolating is exercise, including walking dogs. For that reason, we need to reinforce that when self-isolating, exercise is not a reason to leave home and this can be addressed both in TTP conversations but also in our broader public messaging, helping people to understand the rules and alternative options for exercising while isolating.
Finally, older adults, people living alone, or those providing care for someone else reported these factors being barriers to adherence. Again, some changes to the TTP calls scripts could help address this, in particular using the contact tracing mechanism as a touchpoint for understanding individual concerns and barriers in order to signpost appropriate support.
As we learn to live with and adapt to the presence of Coronavirus in Wales, conversations with our partners in the Welsh Government continue about what the ‘new normal’ looks like, and what this means for the Coronavirus response. There will be a lot happening this year around surveillance and genomic sequencing, and how will they hang together over the next six to nine months. As part of this move to the ‘new normal’, CDSC is evaluating the frequency of reports and outputs with a view to moving towards a five day reporting week, moving away from weekend reporting where this is not adding value.
Whilst conversations about the future are ongoing, the Health Protection Response Plan remains in place and appropriate for where we are now. I remain grateful to staff across the whole of Public Health Wales who continue to provide dedicated, professional and valued support to the Enhanced Response.
Cofion caredig ac aros yn ddiogel ac yn iach.
Kind regards, and stay safe and well.
Andrew