Level 3 Covid-19 Contact tracing National Overview Learners Guide - Level 3 - An overview of Covid-19, NHS Test and Trace, Contact Tracing and the ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Level 3 Covid-19 Contact tracing
National Overview
Learners Guide
Level 3 – An overview of Covid-19, NHS Test and Trace,
Contact Tracing and the national and local response
1
Version 5.1. 15/12/2020
Contents
Page
Background – The Virus and Disease 3
Transmission 4
Signs and Symptoms 5
NHS Test & Trace overview 7
Lateral Flow Testing 10
Backward Tracing 11
Information Test & Trace will gather 12
Isolation Periods – Positive Cases and Contacts of Positive Cases 13
Enhanced Contact Tracing – Local approach 16
Covid Restriction Measures – The 3 Tiers 17
Tier 1 - Medium 19
Tier 2 - High 20
Tier 3 – Very High 21
Exemptions 23
Bubbles 24
Christmas Bubbles 25
Local Outbreak Control Plan (OCP) 27
Disparities in Risks 29
2
Version 5.1. 15/12/2020
Background to Covid-19
The name for the disease created by the virus is Covid-19. This is made from the following:
COV: stands for Coronavirus
D: stands for disease
19: for the year it was detected, 2019
SARS –CoV-2 is the actual virus and the abbreviation means:
SARS: stands for Severe Acute Respiratory Syndrome
CoV: for Coronavirus
2: because it is similar to another Coronavirus outbreak in China, SARS-CoV in
2003, so the 2 is a reference to being a 'relative' or the second to that
outbreak
There are hundreds of different types of coronavirus, of which 7 can infect humans, from a
mild cold to severe respiratory illnesses, such as SARS-CoV in China, 2003; Middle Eastern
Respiratory Syndrome (MERS- CoV) in Saudi Arabia 2012.
3
Version 5.1. 15/12/2020
Transmission Routes
Transmission is mostly through close person-to-person contact through respiratory droplets
and enters through the nose, mouth and eyes.
Can spread by:
• coughing, sneezing, talking, laughing, singing
• touching surfaces containing the virus
Groups create a perfect environment for transmission due to close proximity.
Can also spread through airborne transmission, when droplets remain in the air after the
person with the virus leaves the area.
The reproductive number (the R naught), which represents how quickly a disease can
spread, for SARS-CoV-2 is 2 -3, meaning that for every one person that has the virus they
can potentially infect 2 to 3 other people.
The higher the reproductive number, the more people will be infected over the course of any
outbreak.
4
Version 5.1. 15/12/2020
Symptoms
If infected the symptoms someone is likely to experience are:
• High temperature – this means feeling hot to touch on the chest or back
(Temperature does not need to be taken)
• A new, continuous cough – this means coughing a lot for more than an hour, or 3 or
more coughing episodes in 24 hours (if usually have a cough, it may be worse than
usual)
• A loss or change to sense of smell or taste –noticing cannot smell or taste anything,
or things smell or taste different to normal
Most people with coronavirus have at least one of these symptoms, whereas some may
have a few or all.
Some though can be asymptomatic and the severity of symptoms can vary from very mild to
severe that can be life threatening or leading to death.
Most of these symptoms are similar or common to other diseases symptoms so it can be
difficult to establish if it is Covid-19 without a test, apart from the loss of sense of taste and
smell, as this is rare in other conditions, and is a useful measure as an indicator of Covid-19.
5
Version 5.1. 15/12/2020
Advice regarding symptoms
If someone has any of the main symptoms of coronavirus they need to:
• Get a test to check if have coronavirus as soon as possible. A test can be organised
via: https://www.nhs.uk/ask-for-a-coronavirus-test or can apply online on GOV.UK.
Or call 119 if have problems using the Internet.
• They must stay at home and not have visitors until they get the test result and only
leave home to have the test. Anyone they live with, and anyone in their *support
bubble, must also stay at home until they get the result.
*What are support bubbles? A support bubble is where someone who lives alone (or just
with their children) can meet people from another household.
They can use the NHS 111 Online coronavirus service or can call 111 if cannot get help
Online. Use these service if:
• worried about symptoms
• not sure what to do
They must not go to places like a GP surgery, hospital or pharmacy as risk spreading the
virus.
https://www.nhs.uk/conditions/coronavirus-covid-19/symptoms/
Last accessed 6/12/2020
6
Version 5.1. 15/12/2020
NHS Test and Trace
The NHS test and trace service – Normal process ensures that anyone who develops
symptoms of coronavirus (COVID-19) can quickly be tested to find out if they have the virus,
and also includes targeted asymptomatic testing of NHS and social care staff and care home
residents.
They contact tested cases to provide them with their results and if positive provide support
links in how to isolate and what a positive test means.
Helps trace close recent contacts of anyone who tests positive for coronavirus and notifies
them that they must self-isolate at home to help stop the spread of the virus.
As of 28/11/2020 the process of contact and isolation advice was updated. A primary (Index)
case within a household will be able to provide the required details of contacts in their
households and take responsibility to advise the contacts to isolate – these contacts can
then be marked as complete and will not need to be separately invited for the digital journey.
Previously every member in the household would have been contacted by NHS Test &
Trace meaning households received multiple contacts. This amendment addresses that
issue, reducing the amount of contacts made to the household.
The aim of NHS test & trace is to help return life more to normal, in a way that is safe and
protects the NHS and social care. The service will allow the spread of the virus to be traced
and isolate new infections, playing a vital role in giving early warning if the virus is increasing
again, locally or nationally.
NHS Test and Trace index cases/contacts will receive a maximum of 10 calls, with calls
attempted up to 96 hours from the time of notification into the NHS Test and Trace system. If
after these attempts there is no contact made with the case then the case is closed and
classed as a Follow Up Failed.
7
Version 5.1. 15/12/2020
How it works:
Tier 2: People who test positive for COVID-19 are contacted by NHS Test and Trace by
email, text message or phone call, and will get advice via the Test and Trace website or from
a contact tracer over the phone.
They will be invited to go onto a secure website to complete the questions or can answer the
questions over the phone with a Tier 2 Clinician. All of this information remains confidential
and is only used for contact tracing reasons. It is not shared with any other authority bodies.
Questions cover:
• When symptoms started or date of their test if no symptoms to be able to provide
advice on their isolation time period. They will be tracing contacts they had from 48
hours before symptoms started or their positive test up to 10 days post symptoms.
• Contacts are checked by category of both household and non-household
• If have school or nursery school age children
• Check on their place of work.
• Check if they are within the *clinically vulnerable or extremely clinically vulnerable
classification, who need to have extra support and advice for their isolation period.
*This group during the initial stages of lockdown back in March started isolation before the general population
and had prolonged isolation to shield them from the risks of the virus.
All of these questions are vital as they identify if there is a risk of the virus spreading in
complex settings. If any of these settings are identified that the positive case has visited,
works in or children are at school then the details are escalated to Tier 1 for the incident
management team to handle working in partnership with Public Health England.
Tier 2 are also doing backward tracing from 7-10 of onset of symptoms to establish places,
venues, areas positive cases have been. This is to see if there are common areas of spikes
that other positive cases have visited and if a certain setting/environment/place is an area of
risk for the virus spreading.
Once all questions have been completed and advice given to the person with the positive
result, Tier 2 end the conversation or the website questions are completed if doing on line.
All contacts information is then passed to Tier 3.
Tier 3: Call close recent contacts of anyone who tests positive for coronavirus and notifies
them that must self-isolate at home to help stop the spread of the virus. The contact will
receive the same format of notification, a text/email or phone call and complete similar
questions on line or with a call handler.
Tier 1: There are cases such as those linked to care homes, prisons, homeless hostels or
schools, which are more complex to contact trace and are referred to PHE health protection
teams, often working in partnership with local government, who will do the contact tracing.
Tier 1 are now also completing enhanced contact tracing on positive cases that NHS Test
and Trace have been unable to contact. Tier 1 will also do Backward tracing.
At this stage of local contact tracing we will be tracing those with a positive test, checking
they are well, have all the support they need, understand about self-isolation and seeking to
identify their most recent contacts. We will gather this information, input it to contact tracing
system but we will not be tracing the contacts.
8
Version 5.1. 15/12/2020
During the process of contact tracing must ensure that reassurance is offered to the contacts
regarding confidentiality and that all information will be treated with privacy, respect,
collected in good faith for the publics wellbeing, fair and just and totally confidential and that
the aim is to reduce the spread of the viruses, not to share their information with any other
agency outside of contact tracing.
Due to legal requirement it is also important to explain the legal implications of isolation and
risk of fines if isolation is not adhered to.
No contact of a positive case will know the details of the case, they will simply be informed
that they were in contact with someone who received a positive result.
9
Version 5.1. 15/12/2020
Lateral Flow Testing
Lateral flow tests are rapid turnaround tests that can process COVID-19 samples on site
without the need for laboratory equipment, with most generating results in under half an
hour.
How it works:
Antigen lateral flow tests are very accurate are designed to detect the presence or absence
of coronavirus by applying a swab or saliva sample to the device’s absorbent pad.
Lateral flow devices do not require a laboratory to process the test.
Swabbing and processing of these tests must currently be conducted at a dedicated testing
site by trained personnel.
The devices are designed to be intuitive and require minimal training to operate, and we are
looking at how this test could be self-administered.
The sample runs along the surface of the pad, showing at the end a visual positive or
negative result dependant on the presence of the virus.
Proactively testing asymptomatic individuals will help identify those who unknowingly have
the virus and enable those who test positive and their contacts to self-isolate, which can help
drive down the R rate locally and save lives. This is crucial to break the chains of
transmission of the virus and to support critical industries, key workers and institutions.
With lower rates of transmission, those at highest risk from the virus will be more protected
and residents will feel more confident in getting back to their day-to-day lives.
10
Version 5.1. 15/12/2020Backward Tracing
What is it?
Contact tracing often targets ‘downstream’ individuals, who may have been infected by the
index case (‘forward tracing’); i.e. those who have been in contact with the index case after
the index case likely became infectious (2 days before illness onset for COVID-19 ).
However, ‘backward tracing’ can also be used to identify the upstream primary case who
infected the index case (or a setting or event at which the index case was infected) by
retracing history of contact to the likely point of exposure, i.e. up to 14 days prior to symptom
onset. If this primary case is identified, a larger fraction of the transmission chain can be
detected by forward tracing each of the contacts of this primary case.
11
Version 5.1. 15/12/2020Information NHS Test & Trace will gather
Information they need:
NHS Test and Trace needs to collect personal identifiable information so that they can
provide advice to people who have coronavirus and protect the people they have been in
contact with.
The information collected on people with coronavirus or those with symptoms includes:
• Full name date of birth home postcode & house number telephone number email
address
• The type of symptoms people have and how these are changing over time.
The information NHS Test & Trace collects on the contacts of people with coronavirus
includes, where available, their:
• Full name home postcode & house number telephone number email address
This information is used by Public Health England to help control the spread of coronavirus
by providing advice to people with coronavirus and those who have symptoms; identifying
people who have been in contact with someone with coronavirus symptoms and who may be
at risk of developing the infection; and asking anyone who is infectious to stay at home until
they stop being a risk for others.
12
Version 5.1. 15/12/2020Isolation Periods
How the NHS test and trace service works
There are two parts. Part 1 is for those with symptoms, Part 2 is the process for contacts of
positive cases.
Part 1: for someone with symptoms of coronavirus
They must Isolate for at least 10 days as soon as experience coronavirus symptoms and
need to order a test immediately at www.nhs.uk/coronavirus or call 119 if have no internet
access.
Anyone else in their household must self-isolate for 10 days from when the person started
having symptoms
If the test is positive, they must complete the remainder of their 10-day self-isolation. Anyone
in their household must also complete self-isolation for 10 days from when the person
started having symptoms.
If the test is negative, if you feel well and no longer have symptoms similar to coronavirus,
you can stop self-isolating, this is the same for household members.
If test positive for coronavirus, the NHS test and trace service will send a text or email alert
or call with instructions of how to share details of people with whom they have had close,
recent contact and places have visited. It is important to respond as soon as possible so that
appropriate advice can be given to those who need it. This will be done online via a secure
website or they will be called by one of NHS contract tracers.
After 10 days, if they still have a temperature they should continue to self-isolate and seek
medical advice. They do not need to self-isolate after 10 days if only have a cough or loss of
sense of smell or taste, as these symptoms can last for several weeks after the infection has
gone.
13
Version 5.1. 15/12/2020Please note: If asymptomatic but have test positive must self-isolate for at least 10 days,
starting from the day the test was taken. If develop symptoms during this isolation period,
must restart 10-day isolation from the day develop symptoms.
The 10-day period starts from the day when they first became ill.
Ending isolation:
After 10 days, if the first person to become ill feels better and no longer has symptoms other
than cough or loss of sense of smell/taste they can return to their normal routine.
If they live with others, then everyone else in the household who remains well should end
their isolation after 10 days. This 10 day period starts from the day the first person in the
household became ill. People in the household who remain well after 10 days are unlikely to
be infectious.
Part 2: someone is contacted by the NHS test and trace service because they have
been in close contact with a positive case for coronavirus.
They are alerted by the NHS test and trace service of their contact with a positive case. The
alert will usually come by text, email or phone call advising them to log onto a NHS Test and
Trace website, which is normally the easiest way for them and the service to communicate
with each other. If this is not possible a trained call handler will talk through with them what
they need to do.
Under-18s will get a phone call and a parent or guardian will be asked to give permission for
the call to continue.
If a translator is needed, have to check which language and seek permission for a translator
to support the contact tracing call. The call may have to be rearranged while the translator is
organised through local arrangements.
14
Version 5.1. 15/12/2020They will be told to begin self-isolation for 10 days from their last contact with the positive
case. It’s really important to do this even if they don’t feel unwell because, if they have been
infected, they could become infectious to others at any point up to 10 days.
Their household doesn’t need to self-isolate with them, if they do not have symptoms, but
they must take extra care to follow the guidance on social distancing and hand-washing and
avoid contact with them at home.
If develop symptoms of coronavirus they must book a test at www.nhs.uk/coronavirus or call
119 if have no Internet access. Members of their household must self-isolate immediately at
home for 10 days.
If the test is positive, they need to continue to stay at home for at least 10 days and NHS
Test and Trace will get in touch to ask about contacts.
If the test is negative, they must still complete their 10 day self-isolation period because the
virus may not be detectable yet, this is crucial to avoid unknowingly spreading the virus.
If anyone else in the household starts displaying symptoms, they must stay at home for at
least 10 days from when their symptoms appear, regardless of what day they are on in their
original 10 day isolation period.
Stay at home: guidance for households with possible or confirmed coronavirus (COVID-19) infection
- GOV.UK (www.gov.uk)
NHS Test and Trace: how it works - GOV.UK (www.gov.uk)
Last accessed 15/12/20
15
Version 5.1. 15/12/2020Enhanced Contact Tracing
Contact tracing is used to help prevent the infection spreading further and is a fundamental
part of outbreak control that’s used by public health professionals around the world.
Aims:
Ensure anyone that has tested positive for Coronavirus is quickly contacted – with an aim to
achieve an 80% contact rate for positive cases.
Local contact tracing teams will be following up on people who have tested positive for
Covid-19, but who haven’t responded to a call or email from the national Tier 2 service.
National Tier 2 Teams will make the initial attempt at contact and if after 48 hours there is no
contact will pass information to the local team (Tier 1) who are involved with complex cases
and outbreaks. An example of a ‘complex’ case would be where there has been an
identified positive case in a setting, e.g. school or care home and Tier 1 have to implement
process to manage the situation within that environment.
Local contact tracing teams will initially make contact by phone, text or email asking people
to call a local number - which earlier experiences in contacting shielded people, has been
found to be more effective than a contact from a national number. If this fails the contact will
be referred for a door knock, which can take two forms:
1. Door knock to establish have correct contact telephone number and to leave a
card outlining the contact trace team will be in touch.
2. Door knock to complete the contact trace if telephone call follow up unsuccessful
The contact traces work from the Contact Tracing Advice Service (CTAS) script and update
information collected back into CTAS and the local Case Management System (CMS).
The CMS can be used to record or outbreak related cases/contacts and outbreak
management, allowing different teams to view all the information in relation to a case
situation and contact trace, e.g. if escalated internally for follow up within a workplace can
view progression via CMS.
16
Version 5.1. 15/12/2020Covid Restriction Measures
Source: Local restriction tiers: what you need to know - GOV.UK (www.gov.uk) Last accessed 2/12/2020
Why the government is introducing tiers
Applying tighter restrictions where prevalence is highest. In September and October, the
virus spread rapidly in all parts of the country. The government responded with new national
restrictions. These have brought transmission back under control.
On 2 December a regionally-differentiated approach was introduced, where different tiers of
restrictions apply in different parts of the country.
These tiers will be strengthened compared to the previous tiers in order to prevent a return
to growing infections. We know that social contact spreads the virus. We need to impose
these restrictions and it is right to target the toughest measures only in the areas where the
virus is most prevalent or where we are seeing sharper increases in the rate of infection.
There are 3 tiers for local restrictions:
Tier 1: Medium alert
Tier 2: High alert
Tier 3: Very High alert
Across all tiers, everyone:
• Must wear a face covering in most indoor public settings, unless they have an
exemption
• should follow the rules on meeting others safely
• Should attend school or college as normal, unless they are self-isolating. Schools,
universities, colleges and early years settings remain open in all tiers
• should walk or cycle where possible, plan ahead and avoid busy times and routes
when travelling
• Must follow the gathering limits at their tier except for in specific settings and
circumstances.
• Visits to care homes can take place with arrangements such as substantial screens,
visiting pods, and window visits. Regular testing will be offered to up to 2 family
members or friends per resident by Christmas, which – when combined with other
17
Version 5.1. 15/12/2020infection-control measures such as PPE – will support indoor visits with physical
contact. Detailed guidance will be published shortly.
All businesses and venues that are open are expected to follow COVID-19 secure
guidelines to protect customers, visitors and workers.
In all tiers, the following businesses and venues can remain open:
• Essential and non-essential retail, including indoor and outdoor markets and car boot
sales
• Certain leisure and sporting facilities such as gyms, sports courts and facilities,
leisure centres, fitness and dance studios, golf courses, swimming pools, riding
centres, outdoor playgrounds – subject to relevant social contact rules in each tier.
Indoor group activities and classes should not take place at tier 3
• Personal care and close contact services such as hairdressers and barbers, beauty
salons, tattoo parlours, nail salons, spas and beauty services, massage parlours and
tanning salons
• Public buildings, such as libraries, community centres and halls. They should not
host events for private hire, such as birthday parties or most other social activities in
tier 3
• Allotments, recycling and waste centres, public toilets, car parks
• Essential public services such as the NHS and medical services, courts, and
jobcentre plus sites
• Places of worship – communal worship can now resume, subject to relevant social
contact rules in each tier
Everyone who can work from home should do so. Where people cannot do so – including,
but not limited to, people who work in critical national infrastructure, construction, or
manufacturing – they should continue to travel to their workplace.
Public-sector employees working in essential services, including education settings, should
continue to go into work where necessary.
18
Version 5.1. 15/12/2020Tier 1: Medium alert
Must not socialise in groups larger than 6 people, indoors or outdoors, other than where
a legal exemption applies. This is called the ‘rule of 6’.
Businesses and venues can remain open, in a COVID secure manner, other than those
which remain closed by law, such as nightclubs.
Hospitality businesses selling food or drink for consumption on their premises are
required to:
• provide table service only, for premises that serve alcohol
• close between 11pm and 5am (hospitality venues in airports, ports, on
transport services and in motorway service areas are exempt)
• stop taking orders after 10pm
Hospitality businesses and venues selling food and drink for consumption off the
premises can continue to do so after 10pm as long as this is through delivery service, click-
and-collect or drive-through.
Early closure (11pm) applies to casinos, cinemas, theatres, concert halls, museums,
bowling alleys, amusement arcades, funfairs, theme parks, adventure parks and activities
and bingo halls. Cinemas, theatres and concert halls can stay open beyond 11pm in order
to conclude performances that start before 10pm.
Public attendance at outdoor and indoor events (performances and shows) is permitted,
limited to whichever is lower: 50% capacity, or either 4,000 people outdoors or 1,000 people
indoors.
Public attendance at spectator sport and business events can resume inside and
outside, subject to social contact rules and limited to whichever is lower: 50% capacity, or
either 4,000 people outdoors or 1,000 people indoors.
Places of worship remain open, but you must not attend or socialise in groups of more than
6 people while there, unless a legal exemption applies.
Weddings and funerals can go ahead with restrictions on numbers of attendees – 15
people can attend wedding ceremonies and receptions, 30 people can attend funeral
ceremonies, and 15 people can attend linked commemorative events.
Organised outdoor sport, physical activity and exercise classes can continue.
Organised indoor sport, physical activity and exercise classes can continue to take
place, if the rule of 6 is followed. There are exceptions for indoor disability sport, sport for
educational purposes, and supervised sport and physical activity for under-18s, which can
take place with larger groups mixing.
Travelling between Tiers: If you live in a tier 1 area and travel to an area in a higher tier
you should follow the rules for that area while you are there. Avoid travel to or overnight
stays in tier 3 areas other than where necessary, such as for work, education, youth
services, to receive medical treatment, or because of caring responsibilities. You can travel
through a tier 3 area as part of a longer journey.
19
Version 5.1. 15/12/2020Tier 2: High alert
This is for areas with a higher or rapidly rising level of infections, where some additional
restrictions need to be in place.
Must not socialise with anyone you do not live with or who is not in your support
bubble in any indoor setting, whether at home or in a public place.
Must not socialise in a group of more than 6 people outside, including in a garden or a
public space – this is called the ‘rule of 6’.
Businesses and venues can continue to operate, in a COVID-Secure manner, other than
those which remain closed by law, such as nightclubs.
Pubs and bars must close, unless operating as restaurants.
Hospitality venues can only serve alcohol with substantial meals. Hospitality businesses
selling food or drink for consumption on their premises are required to:
• provide table service only, in premises which sell alcohol
• close between 11pm and 5am (hospitality venues in airports, ports, transport
services and motorway service areas are exempt)
• stop taking orders after 10pm
Hospitality businesses and venues selling food and drink for consumption off the
premises can continue to do so after 10pm as long as this is through delivery service, click-
and-collect or drive-through.
Early closure (11pm) applies to casinos, cinemas, theatres, museums, bowling alleys,
amusement arcades, funfairs, theme parks, adventure parks and activities, and bingo halls.
Cinemas, theatres and concert halls can stay open beyond 11pm in order to conclude
performances that start before 10pm.
Public attendance at outdoor and indoor events (performances and shows) is permitted,
limited to whichever is lower: 50% capacity, or either 2,000 people outdoors or 1,000 people
indoors.
Public attendance at spectator sport and business events can resume inside and
outside, subject to social contact rules and limited to whichever is lower: 50% capacity, or
either 2,000 people outdoors or 1,000 people indoors.
Places of worship remain open but you must not socialise with people from outside of your
household or support bubble while you are indoors there, unless a legal exemption applies.
Weddings and funerals can go ahead with restrictions on numbers of attendees – 15
people can attend wedding ceremonies and receptions, 30 people can attend funeral
ceremonies, and 15 people can attend linked commemorative events such as wakes or
stone settings.
Organised outdoor sport, and physical activity and exercise classes can continue.
Organised indoor sport, physical activity and exercise classes will only be permitted if it
is possible for people to avoid mixing with people they do not live with (or share a support
bubble with). There are exceptions for indoor disability sport, sport for educational purposes
and supervised sport and physical activity for under-18s, which can take place with larger
groups mixing.
20
Version 5.1. 15/12/2020Travel: Can continue to travel to venues or amenities which are open, but should aim to
reduce the number of journeys you make where possible.
Travelling between Tiers: If you live in a tier 2 area, you must continue to follow tier 2 rules
when you travel to a tier 1 area. Avoid travel to or overnight stays in tier 3 areas other than
where necessary, such as for work, education, youth services, to receive medical treatment,
or because of caring responsibilities. You can travel through a tier 3 area as a part of a
longer journey.
Tier 3: Very High alert
This is for areas with a very high or very rapidly rising level of infections, where tighter
restrictions are in place.
Must not meet socially indoors or in most outdoor places with anybody you do not
live with, or who is not in your support bubble, this includes in any private garden or at
most outdoor venues.
Must not socialise in a group of more than 6 in some other outdoor public spaces,
including parks, beaches, countryside accessible to the public, a public garden, grounds of a
heritage site or castle, or a sports facility – this is called the ‘rule of 6’.
Hospitality settings, such as bars (including shisha venues), pubs, cafes and restaurants
are closed – they are permitted to continue sales by takeaway, click-and-collect, drive-
through or delivery services.
Accommodation such as hotels, B&BS, campsites, and guest houses must close. There
are several exemptions, such as for those who use these venues as their main residence,
and those requiring the venues where it is reasonably necessary for work or education and
training.
Indoor entertainment and tourist venues must close. This includes:
• indoor play centres and areas, including trampolining parks and soft play
• casinos
• bingo halls
• bowling alleys
• skating rinks
• amusement arcades and adult gaming centres
• laser quests and escape rooms
• cinemas, theatres and concert halls
• snooker halls
Indoor attractions at mostly outdoor entertainment venues must also close (indoor
shops, through-ways and public toilets at such attractions can remain open). This includes
indoor attractions within:
• zoos, safari parks, and wildlife reserves
• aquariums, visitor attractions at farms, and other animal attractions
• model villages
• museums, galleries and sculpture parks
• botanical gardens, biomes or greenhouses
21
Version 5.1. 15/12/2020• theme parks, circuses, fairgrounds and funfairs
• visitor attractions at film studios, heritage sites such as castles and stately
homes
• landmarks including observation decks and viewing platforms
Leisure and sports facilities may continue to stay open, but group exercise classes
(including fitness and dance) should not go ahead.
No public attendance at spectator sport or indoor performances and large business
events should not be taking place. Elite sport events may continue to take place without
spectators.
Large outdoor events (performances and shows) should not take place, with the
exception of drive-in events.
Places of worship remain open, but you must not attend with or socialise with anyone
outside of your household or support bubble while you are there, unless a legal exemption
applies.
Weddings and funerals can go ahead with restrictions on the number of attendees – 15
people can attend wedding ceremonies, wedding receptions are not allowed, 30 people can
attend funeral ceremonies, 15 people can attend linked commemorative events.
Organised outdoor sport, and physical activity and exercise classes can continue,
however higher-risk contact activity should not take place.
Organised indoor sport, physical activity and exercise classes cannot take place
indoors. There are exceptions for indoor disability sport, sport for educational purposes and
supervised sport and physical activity for under-18s.
Travel: Can continue to travel to venues or amenities which are open, but should aim to
reduce the number of journeys you make where possible.
Traveling between Tiers: avoid travelling outside of your area, including for overnight stays
other than where necessary, such as for work, education, youth services, to receive medical
treatment, or because of caring responsibilities. You can travel through other areas as part
of a longer journey.
22
Version 5.1. 15/12/2020Exemptions from gatherings limits in all tiers
• as part of a single household, or a support bubble
• for work or providing voluntary or charitable services, including in other people’s
homes
• for childcare, education or training – meaning education and training provided as part
of a formal curriculum
• for supervised activities provided for children, including wraparound care (before and
after-school childcare), groups and activities for under 18s, and children’s playgroups
• for formal support groups, and parent and child groups – up to 15 people aged 5 and
older
• to allow contact between birth parents and children in care, as well as between
siblings in care
• for arrangements where children do not live in the same household as both their
parents or guardians
• for prospective adopting parents to meet a child or children who may be placed with
them
• for birth partners
• to attend a funeral – with no more than 30 people present – or a commemorative
event such as a wake for someone who has died – with no more than 15 people
present
• to see someone who is terminally ill or at the end of life
• to attend a wedding or civil partnership – with no more than 15 people present
• to provide emergency assistance
• to avoid injury or illness, or to escape a risk of harm
• to fulfil a legal obligation, such as attending court or jury service
• to provide care or assistance to someone vulnerable or to provide respite for a carer
• to facilitate moving home
23
Version 5.1. 15/12/2020Bubbles
Support bubbles have been expanded. From 2 December you can form a support bubble
with another household if any of the following apply to you:
• you are the only adult in your household (any other members of the household
having been under 18 on 12 June 2020) or are the only adult who does not have
a disability that needs continuous care
• you have a child under 1
• You live with a child under 5 with a disability that needs continuous care.
24
Version 5.1. 15/12/2020Christmas
Arrangements that will be in place over the Christmas period. From 23 December to 27
December, you may choose to form a Christmas bubble. A Christmas bubble will be able to
spend time together in private homes, to attend places of worship, or meet in a public
outdoor place.
From 23 December to 27 December
From 23 December to 27 December, you may choose to form a Christmas bubble.
A Christmas bubble will be able to spend time together in private homes, including homes
and caravans, to attend places of worship, or meet in a public outdoor place.
If you do form a Christmas bubble, you should not meet socially with friends and family you
do not live with in your home or garden unless they are part of your Christmas bubble.
In all other settings, people should follow local restrictions in the tier in which they are
meeting.
If you do not form a Christmas bubble, you should continue to follow the guidance for the tier
you are in.
Christmas Bubbles:
• you can form an exclusive ‘Christmas bubble’ composed of people from no more
than three households
• you can only be in one Christmas bubble
• you cannot change your Christmas bubble
• you can travel between tiers and UK nations for the purposes of meeting your
Christmas bubble
• you can only meet your Christmas bubble in private homes or in your garden,
places of worship, or public outdoor spaces
25
Version 5.1. 15/12/2020• you can continue to meet people who are not in your Christmas bubble outside
your home according to the rules in the tier you are meeting in
• if you form a Christmas bubble, you should not meet socially with friends and
family that you do not live with in your home or garden unless they are part of
your Christmas bubble
You should travel to meet those in your Christmas bubble and return home between the 23
and 27 December. Anyone travelling to or from Northern Ireland may travel on the 22 and 28
December.
Existing bubbles and Christmas:
Existing support bubbles count as one household towards the three household limit. This
means that if you are in a support bubble, you can collectively form a Christmas bubble with
two other households.
This applies only to support bubbles as set out in law. You should, however, consider the
risks of doing so and keep your Christmas bubble as small as possible.
The two households in a support bubble can choose to join separate Christmas bubbles.
26
Version 5.1. 15/12/2020Local Outbreak Control Plan (OCP)
The Government announced in May that part of its national strategy to manage and control
the pandemic is for every area in England to develop a Local Outbreak Control Plan (OCP)
for COVID-19 by the end of June 2020.
In Cambridgeshire and Peterborough the OCP builds on existing outbreak plans and relies
on working closely with local communities to reduce the risk of transmission of the infection,
establish systems to identify new cases and reduce outbreaks.
Where clusters of new COVID-19 cases arise they will be identified swiftly, and by working
with Public Health England (now National Institute for Health Protection (NIHP)) Health
Protection Team, will put measures in place to control them, to support the continued lifting
of lockdown restrictions and the gradual return to normal life.
The Local Outbreak Control Plan (OCP), has two principal aims:
1.1 Prevention
Support communities and businesses to understand and observe national guidance and
prevention measures, reducing the likelihood of contracting or spreading the virus.
Reinforcing key public health messaging on hand washing and social distancing.
1.2 Surveillance & Response
Quickly identify any new cases of COVID-19 and their contacts to reduce spread.
Put steps in place to control outbreaks – particularly in high risk settings -and stop them
spreading.
Prevention and resilience is at the heart of the Cambridgeshire and Peterborough Outbreak
Control Plan. Social distancing, hand washing, self-isolation, getting tested and following
advice, and helping to contact trace are all key to success in preventing spread. This is
achieved by working with the communities, community champions, volunteers, businesses,
health partners, education & childcare settings, staff and councillors to stop the spread of
COVID-19 infection.
27
Version 5.1. 15/12/2020Across Cambridgeshire and Peterborough a network of coordination and response hubs
have been set up and working extremely well.
Aim to provide support, guidance and links to everyone within the local authority areas.
Complementing the Environmental Health capacity, a core hub team is established to create
more capacity to respond to an unexpected surge that overwhelms specialist capacity, to
also ensure the specialist expertise within Environmental Health is able to focus on more
complex outbreaks and provide subject matter expertise.
Using the revised redeployment process that is being developed a scalable resource will be
able to support the local pilot and the longer term planning:
Support to local enhanced contract tracing
• Provide localised data e.g. contact details
• Support the household contact tracing led by Environmental Health where a positive
case is identified
• Coordinate the self-isolation support package offer – ensuring people have access to
essential supplies and working closely with each district and city to arrange financial
support where needed
• Collate the learning of the pilot to support the future Countywide rollout
Support for longer term work
• Support survey work as part of the one-off asymptomatic testing and engagement
with employers associated with recent outbreaks
• Support to shielding in the event of a local lockdown
• Maintaining the 0345 phone line (research shows over 80% calls were not referred
due to dedicated line and training)
• Coordination of the rapid response for each district and city
28
Version 5.1. 15/12/2020Disparities in Risks
Source:
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_da
ta/file/908434/Disparities_in_the_risk_and_outcomes_of_COVID_August_2020_update.pdf
A review published by PHE in May 2020 found that the impact of COVID-19 has replicated
existing health inequalities and, in some cases, has increased them. The graph shows that
further to the right the line the higher the risk of death.
The largest disparity found was by age. Among people already diagnosed with COVID19,
people who were 80 or older were seventy times more likely to die than those under 40.
Risk of dying among those diagnosed with COVID-19 was also higher in males than
females; higher in those living in the more deprived areas than those living in the least
deprived; and higher in those in Black, Asian and Minority Ethnic (BAME) groups than in
White ethnic groups.
These inequalities largely replicate existing inequalities in mortality rates in previous years,
except for BAME groups, as mortality was previously higher in White ethnic groups.
The analysis takes into account age, sex, deprivation, region and ethnicity, but they do not
take into account the existence of comorbidities, which are strongly associated with the risk
of death from COVID-19 and are likely to explain some of the differences.
29
Version 5.1. 15/12/2020You can also read
