Surveillance, testing and 'breaking the chain of infection' will be the key watchwords if Tameside sees a local outbreak of coronavirus.
The government has asked all local authorities to draw up plans explaining how they will tackle hotspots of Covid-19 and prevent further outbreaks.
It comes as lockdown restrictions were tightened in Leicester, with non-essential shuts shop and most schools closing from Thursday because of concern over the rise of cases in the area.
According to chiefs in Tameside, an outbreak is defined by having two or more confirmed cases of coronavirus in the same setting within 14 days, who have been directly exposed to others within two metres, for longer than 15 minutes.
Prevention of outbreaks is at the core of planning by local officials, with a focus on mass testing and use of the satellite site at Ashton Primary Care Centre, alongside mobile pop-up testing site at Curzon Ashton and postal tests.
Addressing the health and wellbeing board, director of public health, Jeanelle de Gruchy said: “There are outbreaks happening in Tameside and across the country.
“We’ve got to stop transmission. We’ve got to ensure that one person who falls ill, that that doesn’t go on to transmit and become an outbreak.
“We’ve got to know what is really going on in the community and that’s where surveillance is really important. Some of that’s our data, some of that’s soft intelligence.
“When there is an outbreak we’ve got to know there is an outbreak or something’s happening and then everyone has to know what they do in that circumstance and we’ve got to get on top of it very quickly.
“We learn lessons from Anglesey and Leicester and Kirklees and you continue to evolve and develop your plan.”
The public health team are developing proposals to deal with a ‘surge’ where additional swabbing may be necessary, such as when they are trying to establish the number of cases during an outbreak, or within care homes.
Extensive testing will also lead into another pillar of the response, which is the use of data to be able to map and tailor responses to hotspots, where decisions can be made at a neighbourhood level.
But at the moment they do not have a completely ‘granular’ local breakdown of where cases are occurring. which is hampering the ability to utilise the data.
“We don’t have the information where we could say anything with confidence about what’s going on,” Ms de Gruchy added.
“Five cases could all be in one household, that would be very different to five different adults who came together to do something or went somewhere in a car and all infected each other and went on going home to their five respective households.”
The key areas of focus will be care homes, hospitals, schools, and other ‘high risk’ facilities such as homeless shelters. Geographical areas where there are known to be large number of BAME and shielding people will also be targeted.
To deal with outbreaks in communities, authorities are also looking at making the mobile testing capacity more flexible.
Some people who have been infected may not agree voluntarily to be tested or self isolate, which would be dealt with by negotiation, explanation and encouragement, with enforcement as a last resort.
Where a significant risk of rising cases is identified, a joint decision will be taken between Tameside council and Public Health England to declare an outbreak.
The location of the outbreak would be provided with ‘stringent’ infection control measures and enhanced cleaning as well as PPE, social distancing and a possible requirement for closure.
Assistant director of population health, Debbie Watson, gave the example of a ‘typical’ outbreak in care homes that occurred between April 27 and May 10, where a home had seven confirmed cases.
When this outbreak was picked up it was followed with daily contact with the home, enhanced cleaning and whole care home testing for residents and staff.
“As a result of that we identified another two asymptomatic staff members who weren’t showing any symptoms who were then isolated, and within the May 10 there were no subsequent cases,” she said.
“But you can see it’s a three week process of identification, of insight looking at what we need to do, formulating those actions and then implementing the testing and putting in place controls that would stop that outbreak.”
An outbreak will be declared to be over once there have been no confirmed cases for 28 days within the environment of the initial cases.
Tameside council’s population health consultant, James Mallion added: “It’s about having all these things working really well and in place to stop that transmission and break that chain of infection so that that one case doesn’t turn into a problem in a particular setting or a wider outbreak affecting more and more people.
“As much as we want to prevent these outbreaks from happening we know, as we’ve seen in other parts of the country, some of these situations do occur and we need to have a really clear process of what we will do in those situations and how we will manage them as effectively as possible.”
View of Ashton-under-Lyne. Photo: Charlotte Green LDR.