Lecture 10.2 - SARS-CoV-2 - The Public Health Perspective PDF

Public health system: ◦Local system partners come together through the health and wellbeing board ‣ Local government public health ‣ NHS - clinical commissioning groups, sustainable transformation partnerships, integrated care systems, primary care networks, p...

Public health system: ◦Local system partners come together through the health and wellbeing board ‣ Local government public health ‣ NHS - clinical commissioning groups, sustainable transformation partnerships, integrated care systems, primary care networks, place based partnership board, provider collaboratives ‣ Community and voluntary sector ‣ Academic sector ‣ Business community Inequalities in Birmingham: Birmingham City council public health structure: Our statutory responsibilities: ◦Local authority Public health teams have a range of statutory responsibilities that were set out in the health and social care act when public health returned to the local authorities from the NHS, these include: ‣ Health and wellbeing board and its strategy for reducing health inequalities and improving health and wellbeing ‣ Joint strategic needs assessment ‣ Commissioning of the mandated public health services ‣ Provision of public health specialist advice to the council and the NHS Health and wellbeing board: ◦Statutory sub-committee of cabinet with responsibility to protect and improve the health and wellbeing of the population ◦Chaired by cabinet member for adult health and social care ◦The health and wellbeing board vision is: ‣ To create a city where every citizen, whoever they are, wherever they live, and at every stage of life, can make choices that empower them to be happy and healthy ◦Membership includes: ‣ Elected members - cabinet member for adult health and social care, shadow member from opposition, cabinet member for children and young people  ‣ Council officer - director of public health, director of adult social care, director of children ‣ NHS - clinical commissioning Group/integrated care system, NHS providers ‣ West midlands police ‣ Birmingham community and voluntary sector ‣ Academia Strategy: NHS integrated care system: ◦Birmingham and solihull is an integrated care system which brings together West Birmingham and Birmingham and solihull clinical care commissioning group to support around 1.4m people ◦Governance is through NHS ICS board and ICS partnership. The ICS partnership sets the 10 year strategy for the ICS and the ICS board sets the 5 year operating framework to deliver it ◦In Birmingham there is a place board and five locality partnerships, in Solihull there is one place board Health protection response structures: ◦UK health security agency (UKHSA) health protection teams: ‣ Infectious disease notification ‣ Outbreak response ‣ Toxin/environmental response ◦Local authority response: ‣ Public health teams - outbreak surge response ‣ Environmental health teams - face to face investigation and enforcement ◦Police and enforcement Initial stages: ◦What are the symptoms? - case definition ◦Who is affected? - cohort at risk ◦When did symptoms start? - time frame of exposure ◦Where are they now and where have they been? - geography of exposure ◦How might it have been spread? - transmission vector ◦Which tests or investigation might be needed? - diagnosis ◦Transmission disruption  What is a pandemic?: ◦An outbreak is a greater-than-anticipated increase in the number of endemic cases. It can also be a single case in a new area. If it's not quickly controlled, an outbreak can become an epidemic ‣ 15 cases of measles ‣ 2 cases of TB ‣ 1 case of ebola ◦Endemic is something that belongs to a particular people or country ‣ Malaria in Africa ‣ Dengue fever is endemic to certain regions of Africa, Central and South America, and the Caribbean ◦An epidemic is a disease that affects a large number of people within a community, population or region ‣ HIV in gay and bisexual men ‣ 1918 Typhus epidemic in Russia ◦A pandemic is an epidemic that's spread over multiple countries or continents ‣ Spanish Flu in 1918 ‣ Small pox pandemic ‣ Plague COVID-19 timeline: ◦31 Dec 2019 - WHOs Country Office in the people's republic of China picked up a media statement by the Wuhan Municipal Health Commission from their website on cases of 'viral pneumonia' in Wuhan, People's republic of China ◦9 Jan 2020 - WHO reported that Chinese authorities have determined that the outbreak is caused by a novel coronavirus ◦22-23 Jan 2020 - the WHO director-general convened an IHR emergency committee (EC) regarding the outbreak of novel coronavirus ◦30 Jan 2020 - the director-general declared the novel coronavirus outbreak a public health emergency of international concern (PHEIC), WHOs highest level of alarm ◦11 Mar 2020 - deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction, WHO made the assessment that COVID-19 could be characterised as a pandemic COVID-19 in Birmingham: ◦Up to the 24th March 2022: ‣ Over 330,000 confirmed cases of COVID-19 ‣ Over 7.4 million reported COVID-19 tests completed ‣ Over 21,600 patients admitted to hospital with COVID-19 at UHBT ‣ Over 3,680 deaths with COVID-19 on the death certificate ‣ Over 750,000 citizens have had at least 1 dose of COVID-19 vaccine and 450,000 are triple vaccinated, and over 1,880,500 vaccinations have been given, over 70% through general practice Responding to COVID: ◦Testing - PCR and LFD ◦Surveillance ◦Case and outbreak management ◦Contact tracing ◦Community engagement ◦Communication and media ◦System resilience  Challenges and opportunities: ◦Challenges: ‣ Science ‣ Kit ‣ Capacity ‣ Engagement ‣ Politics ‣ Baseline resilience Health Community Economic ◦Opportunities: ‣ Partnership working ‣ Accelerated innovation ‣ Community engagement Looking at recovery and mitigation: