'My diary of the Battle against Covid'
- Credit: Torbay Business Forum
Caroline Dimond has just retired as Torbay’s director of public health.
The former World Health Organisation worker should have been putting her feet up a lot earlier. But one thing got in the way. The pandemic.
For the past year, almost exactly to the day, Caroline has been steering the English Riviera through some of the stormiest waters in a lifetime. She has captured the battle against Covid in a diary style for her annual report. Some extracts:
Public health officials have been aware since late December of a new virus which has emerged in the Chinese city of Wuhan. It is spreading with “worrying rapidity” and “has all the hallmarks” of being a pandemic. The Torbay public health team carries out a flu pandemic exercise on January 24, and starts planning with council colleagues. “The first cases in the UK are reported on January 31, in returning travellers.
More cases from returning travellers are seen across the UK. Planning in Torbay is stepped up with key partners including the Torbay and South Devon NHS Foundation Trust, and meetings are held with the community and voluntary sector. The need for personal protective equipment is discussed. “At this point we had no idea what we would be asked to take on just a few months later.”
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Covid-19 reaches Devon, with two people returning from Italy after the half-term holiday. The cases included the first child in the country to be infected, a pupil at Churston Ferrers Grammar School. Dr Dimond takes the call on Sunday, March 1, and by lunchtime the next day an Incident Response Centre is set up on a floor in Tor Hill House, Torquay.
“Our outbreak response had begun in earnest. Diaries were cleared and we worked together with our key partner, Public Health England. I immediately dispatched two of my team to support the school connected to the cases involved, help with contact tracing to prevent spread, to consider particularly vulnerable students, and generally support the head.
“People at this time were pretty frightened of this unknown virus. The school appropriately closed. Other headteachers took a decision to close their schools. They reopen after being given reassurance.”
The Torbay Helpline, run by the Community Development Trust, is set up. Volunteers help to deliver food and medicines to those shielding. By the end of the year, the call-handlers have taken 17,300 inquiries, and 1,212 volunteers have come forward.
The first national lockdown is announced by Prime Minister Boris Johnson on Monday, March 23. The first deaths of patients with Covid-19 are confirmed at Torbay Hospital on Friday, March 20, two people in their 80s with underlying health conditions. “A new area of work with the crematorium, funeral directors, the hospice and local faith leaders began to support the bereaved.”
“The virus was now felt to be circulating widely in the community and as well as dealing with Covid cases and outbreaks, we now also needed to deal with the impacts of being in lockdown.”
Public health groups are set up to focus on: mental health; wellbeing for people in lockdown and those shielding; people who are vulnerable due to homelessness, substance misuse, and domestic or sexual violence; economy and poverty; access to health services.
The team get involved in sourcing PPE which is facing a national shortage. Working with partners, they successfully control outbreaks in care homes.
The peak of the first wave is passed with the message changing from ‘Stay at Home’ to ‘Stay Alert’. The Test and Trace system is set up, with 50,000 contact tracers recruited, but it has a slow start and proves controversial, with an initial lack of capacity and slow turnaround of results.
“Locally, we were forced to mitigate against this by prioritising testing across settings to match supply to need, and maximise the use of local hospital labs in response to long turnaround times for national testing. The lack of robust data to enable us to identify emerging outbreaks, frustrated us greatly over the months to come, compromising our ability to contain the virus at local level.”
A Local Outbreak Management Plan is developed, with a Local Health Protection Board to oversee the work. Children return to school after half-term.
Cases remain low and the focus moves to prevention and response to outbreaks.
National powers are brought in to allow local lockdowns.
Outbreaks across the country rise, local focus is on communication about how to stop community transmission, including a social media post using the height of hotelier Basil Fawlty to illustrate the two metre social distancing rule. The actor shares a post which goes viral.
The number of cases is on the rise. Demand outstrips the availability of tests in the national system, carried out locally at a mobile unit in Lymington Road car park in Torquay. A local system is established with Torbay Hospital to provide urgent tests for pupils and teachers. The NHS app is launched.
Tests are still taking four to five days to return a result. Local teams step in to improve test and trace by reaching contacts of cases. Local teams take on more responsibility for managing outbreaks.
Second national lockdown introduced. Cases rise quickly in Brixham to more than 600 per 100,000 population, linked to pubs screening sports events, but fall again following enforcement action and the impact of lockdown.
“Staff resilience was becoming an issue but yet again with our schools, care homes and communities working together we got the cases down.”
Covid-19 Community Champions scheme launched in Torbay, with the number reaching more than 200 by the end of the year.
“Communications became for me one of the most important weapons in the fight against Covid.”
The director produces weekly video updates. “I tried to be honest about the challenges we all faced.”
Cases in Torbay fall to fewer than 10 a day due to the lockdown, and the infection rate around Christmas is the lowest in the country. “We had all worked so hard, the team of teams.”
The Riviera International Conference Centre is selected as Torbay’s main vaccination centre. News emerges of a new variant of Covid-19 circulating in the South East.
Concern rises about the increasing number of cases linked to the new variant, during the “toughest months of the winter”.
“The news was filled with images of hospitals under pressure and admissions to hospital exceeding those in the first wave…Torbay continued to have one of the lowest rates in the country. Our collective hard work together with the compliance to guidance within the population was still paying off. We knew however that rates would inevitably rise.
It was therefore with some relief when Lockdown 3 was announced on January 5. This meant we had an opportunity to halt this rise.”
Focus shifts towards tacking the wider Covid-related challenges, including health, children’s learning and development and emotional needs, economic damage and the resulting poverty.