It is clear from the progress of the outbreak so far, not only that staff and residents of care homes are among the most vulnerable groups in our community, but that they have also taken a big part of the burden of illness and death in the outbreak. Furthermore, there has been much discussion through national media about the degree to which this outcome was partly as a result of policies that protected the capacity of the NHS, when there were fears that it could quickly become overwhelmed.
Detailed plans are now being put in place to monitor and protect these institutions. Indeed, much good local work has been done already, including a lot of work training for care staff in infection prevention and control.
Our schools, and other early years settings like nurseries, are also places where very many people come together: children, teachers and other staff, who are also fully integrated into local communities.
Children themselves tend to have mild illnesses when infected by coronavirus, but they can spread infection to others, and so any outbreaks in schools must be identified quickly, and steps taken to minimise wider risks of infection. And because schooling is so important to the wellbeing and future of our children, schools must operate in ways which minimise the likelihood of having to restrict access again, in the face of future cases and outbreaks.
Therefore, one full theme of the LOMP is focused on these two settings. It should be noted that B&NES has two large universities and a multi-campus college, and we are also working with these settings to enable them to continue their important work in ways that minimise risks from coronavirus.
It should be also be noted that the NHS itself (and particularly hospitals, such as the RUH) are the biggest other area of concern, in terms of specific settings more vulnerable to infection spread. The reason that the LOMP is not asked to focus on NHS settings so closely is that the NHS has capacity of its own to manage these so called “nosocomial” outbreaks, although wherever this happens, the local authority is still a key partner, along with Public Health England.
In addition, a further theme of the LOMP is to identify other high risk groups in the community, whether by specific location or other circumstances or characteristics (such as homelessness). There are many such groups and places, so there will not be a specific detailed plan built for all possible eventualities. Rather, the aim is to identify and be ready to react swiftly to address concerns. This will depend on a good network of contacts and the application of our well-tested, generic communicable disease outbreak control plans which we have developed with Public Health England.