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The public health briefing below was issued to Enfield councillors on 7th May.

PUBLIC HEALTH BRIEFING NOTE
CORONAVIRUS (COVID-19) - INFORMATION FOR COUNCILLORS

1. Current Situation 7th May 2020 (09:00)

The information below provides a summary of published and publicly available data to date:

  • In the UK there have been 201,101 confirmed cases and sadly 30,076 of these cases have subsequently died
  • There have been 848 confirmed cases of Covid-19 in Enfield
  • Between 20th March and 21st April there were 230 Covid related deaths in Enfield compared to 226 non-Covid related deaths.
  • 91% of deaths nationally involving Covid 19 had at least one pre-existing condition.
  • London passed the peak in mid-April but risks of subsequent peaks remain until a vaccine is available (expected within 18 months).

Please note:

  • These figures are expected to change rapidly so please refer to the regular updates on the Public Health England dashboard.
  • These figures will not include all deaths in community and care home settings.
  • These briefings will be provided regularly to keep councillors aware and up to date.

2. Excess Mortality in Enfield

There is some debate nationally about how to most accurately describe excess mortality, that is the additional mortality that is due to the corona virus and taking into account those people who would have died regardless. Within this there is the question of whether someone died with the virus or of the virus. Factors such as age, gender,. socio-economic status, underlying conditions also need to be accounted for. Statisticians tend to agree that the most robust measure is all-age, all-cause mortality which will not be available for many months.

Whilst a precise estimate of effect is very difficult to calculate it is very clear that the coronavirus has had a very significant effect on the numbers of deaths in Enfield; in Enfield in April 2020 there were 627 more deaths than in April 2019.

difference in number of deaths between 2019 and 2020Source: Enfield death registrations

In line with the national picture local data indicates the risk factors for Covid-related deaths are gender, age, and country of birth.

covid in enfield socioeconomic factors

 

3. Antigen Testing

Testing capacity has been dramatically expanded nationally to include:

  • All essential workers with symptoms
  • All over 65s with symptoms
  • Anyone with symptoms whose work cannot be done at home
  • Anyone with symptoms and lives with any of the above
  • Social care workers and residents in care homes (with or without symptoms)
  • NHS workers and patients without symptoms

A full list of essential workers is available here.

There are 3 testing sites in Enfield: Chase Farm, the North Middlesex Hospital and Lee Valley. Tests can be booked online. Home testing is also available.

Please note that this is the antigen testing for current infection, not an antibody test for immunity. On 6th May the Prime Minister indicated a target of 200k tests a day.

4. Lockdown

Lockdown measures now seem to be having an effect with evidence that, under current lockdown measures, we have reached the plateau of the number of corona related deaths:

daily additional deathsDaily additional COVID-19 associated UK deaths by date reported

It should be noted that collection systems mean that some deaths are reported before others giving fluctuations in the numbers of deaths by day. A 7 day rolling average helps to smooth these inconsistencies. This has fallen from 674 on 30th April to 568 on 6th May.

Lockdown measures are expected to be reviewed on Sunday 10th May.

Draft guidance on measures that business will need to take to return to work has been privately issued by the Department for Business, Energy and Industrial Strategy (BEIS).

The Council Recovery Workstream is currently establishing a plan of how a return to work will happen, including consideration of what might be the ‘new normal’ in terms of working practices.

5. Contact tracing

As part of easing lockdown measures contact tracing (test, track and trace) will be implemented. This will involve identifying someone who has Covid, identifying who has been in contact with them and then asking both the case and contacts to self-isolate. Public Health England is looking to recruit a workforce of some 18,000 with the programme due to start ‘in the middle of May’.

A trial of contact tracing has begun on the Isle of Wight using an NHS app on smartphones. If successful this will be rolled out to the rest of the country.

6. Personal Protective Equipment (PPE)

As of 4th May LB Enfield had approximately one week’s supply of PPE for Care Home staff. The situation has improved since the first weeks of the outbreak.

Advice for which PPE is appropriate in different settings has been provided to staff. PHE has also provided infection control training to care homes.

7. Inequalities

Analysis of data at both a local and national level has indicated that BAME groups have been disproportionately affected by Covid. Public Health England is expected to produce an initial report on this by the end of May. An initial paper from the Centre for Evidence-based Medicine has concluded that there may be a number of factors related to this including the overrepresentation of BAME populations in lower socio-economic groups, multi-family and multi-generational households, co-morbidity exposure risks, and disproportionate employment in lower band key worker roles. Local analysis will use available data to provide a better understanding of the impact of Covid 19 on the residents of Enfield.

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