The lockdown in Leicester constitutes a foreseeable crisis of the Government’s own making. It has come too late and, by being imposed on the locality, rather than being developed and implemented with the locality, it risks creating uncertainty, dissent, and even disorder. In the case of Leicester, and for future such cases, we advocate a response that is led by local government, supported by agencies such as PHE Health Protection Teams, the NHS and the Police and with additional funding from central government. The imposition of local restrictions should only be considered in the context of such an overall package of support, they should only be a last resort and used as a temporary measure. Such an approach will maximise both the efficacy of infection control measures and public support for these measures.

1. The situation in Leicester was both predictable and avoidable. It derives from the premature lifting of lockdown restrictions at a time when the virus is still circulating widely in some areas, when there is still no functional system of find, test, trace isolate and support and when the Prime Minister was sending an implied message that things are ‘back to normal’.

2. The current situation arose out of a failure to respond to the increase of infections in Leicester (and other localities) at an early stage and before they reached crisis levels. This was a result of several factors: (a) an excessive centralisation and unavailability of data; (b) the fragmentation of the testing system; (c) a lack of coordination with both the local authorities and with the NHS, PHE and other agencies locallyin understanding the cause, nature and response to the outbreak. This has eroded trust in government and the information it provides about COVID-19 risk.

3. Leicester is a city rich in multiple cultures and traditions, yet also has high levels of disadvantage and poverty. The imposition of a lockdown, without the prior involvement of local authorities, has already created massive confusion about who can do what, where and when. It risks creating a deep sense of resentment and of inequity in the local populations. It also creates a situation in which racist groups may politicise that resentment by blaming ethnic minorities for the lockdown.

4. These resentments and divisions feed into resistance to restrictions. If this is met by repressive measures on behalf of the police and other authorities then there will be a serious risk of local outbreaks of disorder and for that disorder to spread to other areas with similar resentments. Widespread disorder would be disastrous for the entire national response to the pandemic.

5. Rather than responding to local increases in infection with centrally imposed restrictions and repression we call for a local response rooted in additional support to the affected population. This has five elements:

  • First, rapid availability of all local data deemed necessary by the local authority, with sufficient detail (down to postcode level at a minimum) to underpin and help inform the local response
  • Second, a substantial increase in active case finding, supported by enhanced local testing facilities, located so as to be accessible to the affected populations and with outreach to those unable to access them. While a telephone-based system of contact tracing can play a role, long experience with epidemics elsewhere shows that it is essential to “walk the streets” to gather intelligence on the nature of the outbreak, for example whether transmission is in homes, at a workplace, or somewhere else. These activities should be undertaken in close consultation with the local communities most affected, explaining both the need to be tested, provide contacts, and why it is important for cases and their contacts to self-isolate, and also the practical steps involved in doing so (such as where to get tested) using tailored public information campaigns in appropriate languages. These need to be done in a culturally appropriate manner with rapid but meaningful co-production of measures working with local community networks.
  • Third, the coordination of the actions of all organisations involved in testing and tracing, delivering a single data pipeline to local authorities and other agencies that need it, with ownership vested in local authorities that are known to and trusted by local populations
  • Fourth, the provision by central government of substantial support to those cases and contacts who are required to self-isolate which addresses the specific needs of affected populations (e.g. those living in multi-generational households) and which, at a minimum, fully covers loss of income and organises free accommodation for isolation where needed.
  • Fifth, the use of additional restrictions on local activity. However, these should only be applied as an emergency last resort while the enhanced testing process identifies hotspots and achieves the isolation of those infected. Moreover, they should be accompanied by full financial compensation to those affected and their contacts, particularly local small, medium, and large businesses, many of which have been making substantial investments to re-open safely.

6.  This approach demands clear lines of accountability. At a local level, it is local authorities that have the appropriate democratic mandate to take action and who can be held to account. They bring together a range of functions necessary for a comprehensive response and, where they do not, they have extensive experience in convening multi-agency responses. However, they operate within a national legal framework, albeit one that lacks clarity in various respects, and they vary in their capacity to develop an effective response. Consequently, there should be a statutory obligation on local authorities to set out in detail how they will respond once a threshold of cases has been exceeded. The German threshold of 50 cases per 100,000 population over a seven day period seems appropriate.

7.  We expect further instances of local “spikes” of infection in other towns and cities. We call on the government to coordinate with local authorities in order to achieve early identification of problems, to define their criteria for intervention and also their criteria for terminating these interventions.

Suspected Covid-19 outbreaks in English workplaces double in a week

The data shows the spread of the virus in workplaces is trending up while transmission in most other settings is in decline. Workplaces are now the only location where the spread of the virus is clearly on the increase.

Caelainn Barr 

Suspected outbreaks of Covid-19 in workplaces in England almost doubled in the past week, prompting concern as more people return to their jobs.

Public Health England (PHE) said 43 acute respiratory outbreaks were reported in workplaces in the week ending 28 June, up from 22 in the previous week.

The data shows the spread of the virus in workplaces is trending up while transmission in most other settings is in decline. Workplaces are now the only location where the spread of the virus is clearly on the increase.

Low-paid, manual workers, face a much greater risk of dying from coronavirus than higher-paid, white-collar workers. Security guards, care workers, construction workers, plant operatives, cleaners, taxi drivers, bus drivers, chefs and retail workers are all at a greater risk of dying, according to analysis of Covid-19 fatalities from the Office for National Statistics.

People began to return to work in England from 13 May, although those who could work from home were encouraged to continue to do so. Since then, construction sites, warehouses and some restaurants and cafes have started to reopen. Employers have been issued with guidelines on how to keep workplaces safe, including advice to stagger shifts and cleaning.

However, the return to work has clearly caused an increase in outbreaks in workplaces. Figures show clusters started to increase two to three weeks after people began to return to work. In the week ending 7 June there were 24 reported outbreaks, up from five in the previous week. At the time of the outbreaks, the data published by PHE did not make clear that these clusters were occurring in workplaces, as the cases were recorded under “other settings”.

An outbreak is determined by PHE when two or more lab-confirmed cases of Covid-19 have been linked to a particular setting. Suspected clusters are also counted and investigated by local PHE teams, although not all of the cases will prove to be related to the virus. Of the 43 incidents reported in workplaces, 36 had two or more cases of Covid-19 linked to that setting.

Outbreaks of the virus in England have slowed in almost every other setting and are down by almost a quarter overall, to 171, from 223 in the previous week. There were 58 outbreaks in care homes last week, down from 112 in the week before.

Prisons are the only other setting where outbreaks of the virus increased, from two to four cases in the past week.

More outbreaks of the virus have been detected since pillar 2 testing became open to everyone during week 21 of the pandemic. This has lead to greater detection of the virus in “settings with healthy younger populations”, according to PHE.

Coronavirus: About 117 people dying each day as deaths remain stable

Official data shows that the seven-day rolling average of deaths has stayed broadly stable at about 117 over the past week, with only a 1.2 per cent fall from the week before. In the seven days to Wednesday deaths totalled 825, compared with 823 the week before.

Chris Smyth, Whitehall Editor | Anna Lombardi
Deaths from coronavirus appear to have stopped falling as infections also continue to plateau.

Official data shows that the seven-day rolling average of deaths has stayed broadly stable at about 117 over the past week, with only a 1.2 per cent fall from the week before. In the seven days to Wednesday deaths totalled 825, compared with 823 the week before.

This compares with weekly falls of more than 20 per cent in both of the three previous weeks and experts said the consequences of flat-lining infection rates were feeding through to mortality figures.

The Office for National Statistics (ONS) said infection rates were flat, with 3,500 people catching the virus every day, not significantly different to the week before.

The ONS also estimates that one in 2,200 people in England — the equivalent of 25,000 people — has the virus. Although this is half of last week’s figure, it is not considered a clear sign that infections are falling. The figure could be anywhere between 12,000 and 44,000 given uncertainties in a survey in which only 12 out of the sample of 23,203 tested proved to have the virus.

“At this point, we do not have evidence that the current trend is anything other than flat,” the ONS concluded.

Kevin McConway, a professor of statistics at the Open University, said: “The levelling off did not happen as a sudden change, so it’s difficult to say exactly when it started — perhaps since early or middle June.

“In principle, it would be the incidence figures of new infections that might tell us something about the immediate effects of changes in policy, such as various loosenings of lockdown, but the changes in incidence rate are not really estimated accurately enough to make that link clear.”

Jose Vazquez-Boland, a professor at Edinburgh University, said that the flat trend of infection was likely to explain why the steep decline in deaths had stopped. “The short answer is yes,” he said, when asked if one led to the other.

The seven-day average of deaths peaked at 945 in mid-April and has been falling since. It fell below 200 on June 11 but has not fallen noticeably for the past week. However, deaths are not reported on the day they happen and Jason Oke, of the University of Oxford, said: “It is unclear, when and where these deaths come from and why they fluctuate so much.”

On Tuesday 176 deaths were reported but most were outside hospitals, even though most people with coronavirus do die in hospital, Dr Oke said.

Looking at figures on the day people actually die, he said: “ONS recorded 66 deaths occurred on June 19 in all settings in England and Wales continuing a downward trend in deaths since mid-April. We need to know how many of the deaths outside of hospital are current to be able to judge whether the trend is plateauing.”

His team’s data does not cover people who died last week because of the delay of several days in reported deaths.

The other way of looking at the toll is to count “excess deaths”, which have totalled more than 65,000 since the start of the crisis. Weekly death numbers have returned to normal, however, with official figures this week finding that the total number in the week to June 19 from all causes is slightly below the five-year average.

Coronavirus test results too slow for effective contact tracing

Most coronavirus tests are too slow for effective contact tracing, figures suggest. The scheme is also struggling to trace people as they move around more.

looks like another Boris pledge is going to be missed – Owl

Chris Smyth, Whitehall Editor 

Just 8 per cent of home testing kits and 14 per cent of the batch kits sent out by post have results within 24 hours, making it much harder to hit the goal of tracing and isolating contacts within 48 hours of someone becoming ill.

Six in ten home tests take more than 48 hours and officials are now encouraging people to go to testing sites in person if they can.

Postal kits made up 58 per cent of the “pillar 2” or community tests carried out over the past week, with the remainder processed by drive-through and mobile testing units.

These were significantly faster, with 72 per cent and 60 per cent of tests getting results within 24 hours respectively in the week to June 24.

However, Boris Johnson’s pledge to have all of these tests done within 24 hours by the end of June appears to be in significant doubt. Officials argue that more than 97 per cent of non-postal tests are now coming back the next day. With these they believe they are getting closer to the goal of isolating 80 per cent of contacts within 48 hours of a person becoming ill.

This is the benchmark set by the Scientific Advisory Group for Emergencies for an effective system that can avoid a second wave and allow secondary schools to reopen in September.

The figures also do not include “pillar 1” tests carried out in NHS hospitals and Public Health England laboratories, which measure speed differently. The NHS says its average turnaround time is 14 hours but in 10 per cent of labs the average is more than 24 hours.

Baroness Harding of Winscombe, executive chairwoman of NHS Test and Trace, said: “We have seen significant improvements in the time it takes to process test results, an important step to rapidly reach the contacts of those testing positive and ask them to self-isolate to prevent them spreading the virus further.”

She argued that the real issue was ensuring people did not soldier on when they were ill but ordered a test quickly, saying: “If you have coronavirus symptoms, get a test immediately.”

The latest figures also show that a quarter of people with confirmed coronavirus referred to the scheme still cannot be contacted.

Justin Madders, a shadow health minister, said that the number of people being contacted was “well below the levels we need to effectively contain the virus”. He added: “The performance so far simply isn’t good enough and far from the world-leading system we were promised. We know for there to be an effective testing and tracing system . . . results need to be back quickly.”

The scheme is finding it harder to reach trace contacts, with the proportion reached and asked to self-isolate falling from 90 per cent in the first week of the scheme to 73 per cent last week. This is because at the start of the scheme the vast majority of contacts were part of outbreaks in places such as care homes and schools, but now rising numbers involve contacts in ordinary daily life.

Planning Applications validated in East Devon Week Commencing 22 June

Planning Applications validated in East Devon Week Commencing 22 June

Coronavirus: Care home staff and residents to get regular COVID-19 tests from next week

Staff and residents in care homes in England will be regularly tested for coronavirus from next week, the government has said.

Meanwhile, Mr Hancock is facing legal action from the daughter of an 88-year-old man who died of suspected COVID-19 in a care home. [Dr Cathy Gardner Owl] /story/

Care home workers will be tested weekly, while residents will receive a test every 28 days, according to the Department of Health and Social Care (DHSC).

It has also promised intensive testing in any care home facing a coronavirus outbreak or an increased risk of a flare-up.

care homes  

Coronavirus and its impact on care homes (see original article for video)

The programme will be rolled out from Monday to all care homes for people aged over 65, and those with dementia, which have registered to receive re-testing over the next four weeks.

It will then be expanded to the entire care home sector from August.

Health Secretary Matt Hancock said the government’s response to the pandemic “has always been led by the latest scientific advice from world-class experts”.

“We will now offer repeat testing to staff and residents in care homes, starting with homes for elderly residents before expanding to the entire care home sector,” he added.

The government has faced criticism for failing to protect care homes from coronavirus.

There have been more than 14,600 deaths linked to COVID-19 in care homes across England and Wales registered up to 19 June, according to the latest Office for National Statistics data.

A National Audit Office report in June claimed that around 25,000 hospital patients were discharged into care homes in England at the height of the pandemic without all being tested for COVID-19.

Research published last month revealed a third of care home residents had not been tested for COVID-19, despite government promises that all residents and staff would be tested by “early June”.

The research from The Data Analysis Bureau suggested that while testing had risen over that month, many residents were still missing out.

Meanwhile, Mr Hancock is facing legal action from the daughter of an 88-year-old man who died of suspected COVID-19 in a care home.

Dr Cathy Gardner  

Daughter’s legal action over care home claim (see original article for video)

Dr Cathy Gardner is demanding the health secretary retract his claim that he placed a “protective ring” around care homes following the death of her father Michael Gibson.

The new testing strategy follows the latest advice from the government’s Scientific Advisory Group for Emergencies (SAGE) and new evidence indicating a higher prevalence in care homes, the DHSC said.

The Vivaldi 1 study, which surveyed almost 9,000 care home managers and analysed data from care home tests, identified higher levels of the virus among care workers – particularly among temporary staff working in multiple care settings.

The study suggested that care home staff may be at increased risk of contracting the virus which they could then pass on to others if they have no symptoms, the DHSC said.

The new repeat testing programme was welcomed by care sector leaders who said it was “essential” to support care homes managing the spread of infection.

Vic Rayner, executive director of National Care forum, added: “Access to repeat and regular testing is absolutely central to support care homes in managing the spread of infection within care homes.

“Testing has proved to be a vital tool in the box for providers and the continued expansion of the testing regime is essential.”


Council funding helps Ottery traders smarten up their shopfronts

Shops and businesses in Ottery Town Centre are to get a facelift as they reopen after lockdown, following successful applications for grants to repair and improve their premises.

Philippa Davies

The town council made a fund of £10,000 available, and has been offering up to £500 towards maintenance and upgrading work, on condition that the business pays the same amount or more towards the total cost.

Several businesses applied for the funding by the initial deadline of June 14, and have been granted money towards work such as repairs, repainting, cleaning and new signage. Some also plan to add hanging baskets and other decorations.

More than £5,000 in total was allocated at the town council meeting on Monday, June 15. But the councillors were aware that not all traders had been aware of the scheme, because of the difficulties of publicising it during lockdown, and have extended the deadline until Saturday, July 4 to enable more businesses to benefit.

The next set of applications will go before the council’s meeting on Monday, July 6.

Cllr Dean Stewart, who is also chair of the Ottery Business Forum, said this would be the first of several schemes by the town council to help local traders recover from lockdown and make the most of the summer trade.

He said so far the town’s businesses have adapted well to the Covid-19 secure social distancing measures that were needed for them to reopen safely.

He said: “I think the shopkeepers were nervous to start with, but they’ve all got their processes in place now.

“There are one-way systems and lots of red and white tape saying ‘walk this way’, ‘wait here’ and ‘keep two metres apart’.

“Shopkeepers have been very responsible and are taking it very seriously, and people know they can confidently shop in Ottery.”

Meanwhile, eight jobs are being created by the opening of a new branch of Argos inside the Ottery St Mary branch of Sainsbury’s.

Argos already has a collection point in the supermarket in Hind Street.

Work is now underway to turn it into a digital store, scheduled to open in August this year, where customers buy items instore via a tablet, or collect items they have ordered online.

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