Richmond Covid-19 Local Outbreak Management Plan

COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond RICHMOND COVID-19 LOCAL OUTBREAK MANAGEMENT PLAN

1 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond Contents

1. Purpose and Objectives 4 1.1. Objectives 4 1.2. The Legal Context 4 1.3. Recent Updates to Our Local Plan 5 2. Addressing Inequalities 6 3. Ongoing Role of Non-Pharmaceutical Interventions (NPIs) 7 4. Management of Variants Of Concern (VOCs) 9 5. Testing 12 6. Wastewater Surveillance 15 7. Local Case Tracing and Enhanced Contact Tracing (ECT) 16 8. Enduring Transmission 18 9. Approach to Compliance and Enforcement 19 10. London Coronavirus Response Cell (LCRC) / Local Authority Roles and Responsibilities 20 11. Local, Regional and National Roles 24 12. Cross-border Partnership Working 26 13. Vaccination Programme 27 14. Communications Plan 29 15. The Council’s Recovery Plan 30 16. Governance 31

2 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond Abbreviations

AD Associate Director ECT Enhanced Contact Tracing NHS National Health Service ADPH Association of Directors of EHO Environmental Health Officer NPIs Non-Pharmaceutical Interventions Public Health EPRR Emergency Planning Resilience and OCT Outbreak Control Team ASC Adult Social Care Response PCR Polymerase Chain Reaction ATS Asymptomatic Testing Sites GPs General Practitioners PH Public Health BAME Black Asian and Minority Ethnic HPT Health Protection Team (Public PHE Public Health England Health England) CCG Clinical Commissioning Group PPE Personal Protective Equipment ICEC Islamic Culture and Education CDL Chancellor of Dutchy Lancaster RSP Regulatory Services Partnership Centre CE Chief Executive RT-qPCR Reverse Transcription Quantitative iCERT Interactive Common Exposure CEHO Chief Environmental Health Officer PCR Review Tool CEO Chief Executive Officer RNA Ribonucleic Acid ICS Integrated Care System CFS Community and Faith Sector SARS-CoV-2 Severe Acute Respiratory Syndrome IMT Incident Management Team CILS Community Independent Coronavirus 2 IPC Infection, Prevention and Control Living Service SCG Strategic Coordination Group JBC Joint Biosecurity Centre CMO Chief Medical Officer SOP Standard Operating Procedure JCVI Joint Committee on Vaccination COMF Contain Outbreak Management SoS The Secretary of State and Immunisation Fund LA Local Authority COVID-19 Coronavirus Disease 2019 SPoC Single Point of Contact LAMP Loop-mediated Isothermal CQC Care Quality Commission Amplification STP Sustainable Transformation CT Case Tracing Partnership LCRC London Coronavirus Response Cell CTAS Contact Tracing Advisory Service SWL South West London LFD Lateral Flow Device CTP Community Testing Programme T&T Test and Trace LFT Lateral Flow Test Cx Chancellor of the Exchequer UKHSA United Kingdom Health Security LOMP Local Outbreak Management Plan DASS Director of Adult Social Services Agency LRF Local Resilience Forum DCS Director of Children’s Services VCS Voluntary and Community Sector MECC Make Every Contact Count DHSC Department of Health and Social VOC Variant of Concern MFF Multi Faith Forum Care VUI Variant under Investigation MTU Mobile Testing Unit DPH Director of Public Health WGS Whole Genome Sequencing

3 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 1. Purpose and Objective

The purpose of the Richmond COVID-19 Local emergency preparedness, resilience and response Public Health England to take local action (e.g. Outbreak Management Plan (LOMP) is to set out for health emergencies. At a local level PHE’s testing and treating) to assist the management how we respond to outbreaks of COVID-19 in the health protection teams and field services work of outbreaks under the Health and Social Care borough including new emerging variants and in partnership with the Director of Public Health, Act 2012 coordinate efforts across all stakeholders to protect playing strategic and operational leadership roles • With other responders’ specific responsibilities and keep residents safe. both in the development and implementation to respond to major incidents as part of the Civil of the LOMP and in the identification and This plan is a collaborative effort developed locally Contingencies Act 2004 management of outbreaks. across the council describing our interface with • In the context of COVID-19 there is also the various levels of the national NHS Test and Trace The Local Director of Public Health is responsible Coronavirus Act 2020 and Service, with the regional service led by Public for putting in place borough-based measures to • In the Health Protection (Coronavirus, Health England’s London Coronavirus Response identify and contain outbreaks and protect the Restrictions) (England) (No. 3) Regulations 2020. Cell (LCRC). It also details our governance public’s health, including producing a LOMP and This underpinning context gives Local Authorities arrangements with roles and responsibilities for establishing a COVID-19 Health Protection Board. (CEO, Public Health and Environmental Health) and stakeholder engagement. This is outlined as a responsibility in the Contain Public Health England the primary responsibility Framework, supported by the Association of Communication and engagement with residents for the delivery and management of Public Health Directors of Public Health1. and stakeholders will be key to the successful actions to be taken in relation to outbreaks of delivery of our plan. 1.2 The Legal Context: communicable disease (through local health protection partnerships) and local memoranda of 1.1 Objectives: The Legal Context for managing outbreaks of understanding. These arrangements are clarified communicable disease which present a risk to the The newly configured UK Health Security Agency in the 2013 guidance: Health Protection in Local health of the public requiring urgent investigation (UKHSA) will combine key elements of Public Government. and management sits: Health England (PHE) with the joint Biosecurity The Director of Public Health has and retains Centre (JBC) and NHS Test and Trace. The UKHSA • With Public Health England under the Health and primary responsibility for the health of their is mandated to fulfil the Secretary of State’s duty to Social Care Act 2012 communities. This responsibility includes assurance protect the public’s health from infectious diseases, • With Directors of Public Health under the Health that there are robust arrangements in place to working with the NHS, local government and other and Social Care Act 2012 protect the health of local communities, and that partners. This includes providing surveillance; • With Chief Environmental Health Officers under these arrangements are effectively implemented. specialist services, such as diagnostic and reference the Public Health (Control of Disease) Act 1984 Effective development and deployment of the microbiology; investigation and management of • With NHS Clinical Commissioning Groups to LOMP relies on the Public Health expertise of the outbreaks of infectious diseases; ensuring effective collaborate with Directors of Public Health and local Director of Public Health.

1.Department of Health and Social Care. (2021). COVID-19 Contain framework: a guide for local decision makers. [Last accessed 13/05/2021].Available here: https://www.gov.uk/government/publications/containing-and-managing- local-coronavirus-covid-19-outbreaks/covid-19-contain-framework-a-guide-for-local-decision-makers#local-outbreak-management-plans Association of Directors of Public Health (2020). Explainer: Local Outbreak Control Plans. [Last accessed 13/05/2021]. Available here: https://www.adph.org.uk/ 2020/06/explainer-local-outbreak-plans/

4 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

1.3 Recent Updates to Our Local Plan: easement there will be need to contain local • Comprehensive support for local settings to outbreaks, requiring strong and comprehensive respond to clusters and outbreaks with sector Publication of the Government’s Roadmap out of local capabilities. reopening, ensuring COVID-19 secure and national lockdown2,3, the accompanying refresh guideline compliance. of the Contain Framework and an increasing Effective local outbreak management during focus on Variants of Concern (VOCs) highlight lockdown easement is vital, requiring both national the importance of updating local plans. Updates and local infrastructure and capability. This A Self Isolation Support pilot scheme is currently to the plan will reflect recent landscape changes, includes: underway in 9 locations across England, mainly incorporate learnings from the past nine months • Continued delivery of Test, Trace and Isolation in areas of high disease prevalence, to encourage and enable a strong position for local management systems to rapidly identify local infections, people to comply with self-isolation requirements in the next phase of our COVID-19 response. The with governmental support encouraging self- if indicated. This includes providing alternative plan has also been updated to reflect the pan- isolation. accommodation, language communications London approaches to outbreak control. • Utilisation of insight, intelligence and surveillance support and social care support. Richmond is not currently one of the areas involved in the pilot but The roadmap out of lockdown and the to understand the source and spread of local infections, allowing effective intervention to we can use learning from other areas that do have importance of local outbreak control: reduce spread. a pilot scheme. Locally in Richmond there is an The success of the vaccination rollout, alongside • Local case tracing and other local interventions initiative to provide payments for those required falling infections and hospitalisations, is paving the such as COVID-19 Marshalls, door knocking and to self-isolate or who are parents/guardians of way for the safe and gradual lifting of restrictions. enhanced contact tracing capabilities. children needing to self-isolate and therefore who Vaccines will mean that fewer people will get • Accessible asymptomatic testing, encouraging cannot work as a result. For more information COVID-19 and that those who do are far less likely both targeted and wider population access to please click here. to go to hospital or die. However, it is important to rapidly identify local infections. remember that not all those offered the vaccine • Rapid identification and control of VOCs through will take it up. Moreover, although highly effective, surveillance and deployment of effectively not all those vaccinated will be 100% protected and targeted surge testing. like all viruses COVID-19 can mutate. As a result, it • Continued engagement with local communities is vital that local outbreak management plans are to encourage testing access, compliance with strengthened with this new context in mind, this guidance and embed good habits and safe iteration of the plan considers that with lockdown behaviours that minimise transmission.

2. Commencing at the start of January 2021. Gov. (2021). Prime Minister announces national lockdown. Available at: https://www.gov.uk/government/news/prime-minister-announces-national-lockdown [Last accessed 03/03/2021]

3. Gov. (2021). COVID-19 Response – Spring 2021. Available at: https://www.gov.uk/government/publications/covid-19-response-spring-2021 [Last accessed 03/03/2021]..

5 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 2. Addressing Inequalities

Following the release of the PHE report on the • Oversee the refresh of the Mayor’s Health to develop an action plan to mitigate any further disproportionate impact of COVID-19 in June Inequalities Strategy Implementation Plan widening of inequalities in 2021/22, focusing 2020, particularly amongst Black, Asian and • Promote and support collaboration and action on five themes. The themes will be aligned with Minority Ethnic (BAME) communities, the Local at neighbourhood, borough and ICS (Integrated partner organisations priorities for the London Authority (LA) has responded in several ways. Care System)/STP (Sustainable Transformation Health Equity Delivery Group, and development Partnership) levels and delivery of actions will be reported to the Local level • Put in place enabling work identified by local London Health Equity Group. Examples of the local response for partnerships as helpful to their joint work Richmond include: • Provide visible systems leadership and advocacy • Engaging with local communities on COVID-19 on health equity issues for Londoners. vaccine uptake in a culturally sensitive way through social media, webinars, community The Health Equity Group has a wide membership champions and health care professionals, and translated communications led by the including health and care partners, voluntary and communications team community sector, and faith groups. • Racial Equality Network COVID-19 Vaccine Event Emerging priorities across London include: • Richmond Healthwatch COVID-19 vaccine Event • Improved access to vaccination data between • Richmond Council Staff COVID-19 NHS and local authorities to help inform Vaccine event understanding of vaccine access and hesitancy • Behavioural insights research on attitudes as the NHS vaccination programme continues to towards the COVID-19 vaccines, questions rollout with additional priority cohorts. and fears among diverse communities across • Recovery planning and understanding the wider London (South West London based work) impacts post second wave in responding to health inequalities. In February 2021, the Association of Directors of Regional level (pan-London) Public Health (ADPH) London released a position In August 2020, the London Health Equity Group statement in supporting BAME communities was formed to provide leadership and coordination during and beyond the COVID-19 pandemic. This to ensure that health equity is central to all London statement highlights racism as a public health issue, level partnership transition and recovery strategies given the immediate and structural factors that and the London Vision. The aim of the group is to: have impacted ethnic minorities, with intentions

6 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 3. Ongoing Role of Non-Pharmaceutical Interventions (NPIs)

Non-pharmaceutical interventions (NPIs) are branding and reference points. Local settings, • Minimise the number of different people you actions that people and communities can take such as workplaces, shops, hospitality venues and meet and the duration of meetings, if possible. to help slow down the spread of viruses such as community centres will be encouraged to promote • Let fresh air in. COVID-19. Such community mitigation strategies the use of NPIs using these materials. • Download the NHS Test & Trace app. include the use of face masks, regular hand The Roadmap outlines the ‘Safe Behaviours’, which • Get a test immediately if you have symptoms. washing, social distancing, meeting outdoors and reflect the recommended NPIs, as follows: • Self-isolate if you have symptoms, have tested adequate indoor ventilation. NPIs will continue to positive, or had contact with someone with • Wash hands frequently, for at least 20 seconds. play a significant role in preventing the spread of COVID-19. infection. Ongoing NPIs will be implemented and • Wear a face covering in enclosed environments, The diagram below illustrates the role of NPIs recommended, depending on the current national to cover both the nose and mouth. at three levels; universal use, use when there is restrictions and guidance. This will include creating • Maintain space with anyone outside your community transmission and use in the event of local messages based on the national guidance household or bubble. widespread transmission. and infection prevention control measures in • Meet with others outdoors where possible. relation to the importance of infection control through social distancing, use of face masks and regular hand washing. The chosen mix of NPIs should differ based on the local transmission situation. In the case of enduring transmission, NPIs will also be recommended and included in planning [see section on Enduring Transmission]. NPIs have played a critical role in reducing transmission rates and the impact of COVID-19. NPI will continue to be the main public health tool against SARS-CoV-2 alongside the delivery of the vaccination programme. Our approach to NPIs will align with the national recommendations in the Government’s Roadmap. The approach will draw on campaign material and resources produced by Public Health England’s Campaign Resource Centre. The Communications team may localise this information with local

7 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

1. What every one of us can do

Physical Distancing Strict hand Respiratory Appropriate use of face masks, Stay at home if you have COVID-19 hygiene etiquette in areas where physical distancing compatible symptoms is not possible

2. Possible actions when there is community spread

If you had direct contact Ideally, meet with the same people, Limit the size of gatherings, Work from home Regular cleaning of frequantly with a COVID-19 case, stay at home whether family friends eventually close selected where possible touched surfaces and objects and self monitor or co-workers businesses

3. Considerations in the event of widespread transmission

Ensure appropriate ventilation Stay-at-home policy Population-wide testing strategies Considering closure of schools and of indoor spaces in local settings with high incidence educational settings

8 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 4. Management of Variants Of Concern (VOCs)

Mutations and variants of the COVID-19 virus can what further interventions and actions are be locally led. This will be informed by the data present a significant risk. As well as potentially necessary to contain the variant. and risk assessment, current epidemiology, being more transmissible and leading to more All local authorities need to be prepared to quickly knowledge of the local community and grounded severe clinical consequences for individuals, mobilise a suite of appropriate measures if a VOC in health protection principles and specialist health mutations also present the possibility for COVID-19 is identified in their respective boroughs, including protection advice. Plans will need to be flexible and variants to more effectively bypass naturally local “surge” testing, and complemented by action adaptable to different circumstances, such as the acquired immunity and/or reduce the effectiveness to trace contacts and isolate cases as part of a geography, communities or settings in scope. of current vaccines and therapeutics. wider strategy to control overall transmission. The planned local response to a VOCs will need to Local Authorities play a key role in the investigation, Following the identification of a VOC, PHE be reviewed and supported by PHE National VOC management and control of COVID-19 variants London’s Coronavirus Response Cell (LCRC) will Bronze to ensure the response is appropriate to designated as VOCs. This is achieved through conduct the initial investigation to gather additional the assessed risk and, critically, that the national support from and partnership working with, PHE information, complete a minimum data set and support required for implementation of the plan and NHS Test and Trace at regional and national establish whether there are epidemiological links (e.g. whole genome sequencing, surge PCR levels. The overarching purpose is to restrict the to countries of concern. Those VOCs without an testing) can be mobilised within available national widespread growth of VOCs in the population by: epidemiological link will require wider investigation capacity. • Detecting, tracing and isolating cases to drive and response, and this will be determined jointly Richmond Council will work in conjunction with down overall community transmission, and between the Local Authority, on the advice of the partners such as PHE and the Department of DPH, and PHE London’s Health Protection Team. • Case finding additional VOC cases through Health and Social Care (DHSC) to rapidly develop whole genome sequencing to help assess the The combination, scale and focus of the tools and mobilise plans to detect and contain VOCs. risk of community transmission and determine deployed to investigate and control VOCs will

Variants of Concern (VOC) Investigation and Management

1 2 3 4 VOC identified by PHE London’s If no travel or other National VOC POSSIBLE RESPONSES the NationaI Variant Health Protection epidemiological Bronze agrees to • Whole Genome Sequencing Taskforce Team undertakes links can be recommendations • Surge testing around the index case initial investigation established, an IMT and • Surge testing based on contract tracing of case(s) is convened with implementations • Whole Borough Interventions as necessary the LA to determine appropriate actions

9 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond Variants of Concern (VOCs) Investigation and Management Guide to Determining Public Health Action – Range of Approaches

Whole Genome Sequencing • Define and agree coverage/scope of PCR positives for WGS (over & above routine 5% surveillance) including pillar 1, (WGS) and time period • Data led e.g. small area/geography around VOC case; setting specific; whole borough • Contingent on national capacity • Explore leveraging local hospital and academic sequencing capabilities

Increase symptomatic • Consider increasing symptomatic testing capacity via additional MTU deployment, increased or PCR testing changed opening hours • Enhanced or increased local communications to encourage and ensure people get tested. • Start or potentially increase the local booking arrangements for LTS sites

Targeted surge • Determine target population, geography or setting symptomatic PCR testing • Determine best operational method(s) for targeted surge testing e.g.: • Door drop model (Council, VCS or other trusted delivery partner, commercial partner) • Collect and drop model, roving model • Asymptomatic Testing Site (ATS) (swapping in PCR for LFDs or including supplementary PCR tests for positives) • Surge of up to 5000 asymptomatic tests • MTUs deployed for asymptomatic testing, not on the national portal, for walk up and booked via local system

Rapid and enhanced • Immediate tracing response to positive cases from the defined area/population i.e. tracing begins on entry of positive contact tracing case to CTAS (Contact Tracing Advisory Service) /the trace process • A dedicated team within NHS Trace contacts all positive cases from the defined area, using tailored scripting • LA’s Local Case Tracing (CT) Partnership service works alongside national VOC Trace cell • Re-enforcement of isolation and public health advice to all cases and contacts • Consider using enhanced contact tracing to identify and investigate potential transmission events/clusters as part of wider outbreak control

10 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

Support for isolation • Package of self-isolation support to meet practical and emotional/well-being support needs of cases and contacts • Self-isolation payments and discretionary support for those in financial need • Consider enhanced welfare support/follow up calls and other enhancements

NPIs • Post national restrictions/lockdown, consider need for targeted, local NPIs/restrictions as part of VOC control approach • Reinforce Covid-secure and IPC measures in key settings

Monitoring and evaluation • Evaluation framework in place to assess impact of local measures, inform future VOC response and outbreak control more generally. Requires data on sequencing results to be made available to the Local Authority (LA) and Incident Management Team (IMT) in a timely way, to assist with any real-time amendments to the approach, or to inform programme extension and support overall evaluation

Communications and • Locally led plan for culturally competent communications and community engagement engagement • Coordination of announcements and clear messages about purpose and restrictions in place during implementation of local variant control measures/surge activities • Ensure alignment of national communications with local communications • Managing the need to inform the public about VOCs without driving negative behavioural or psycho-social outcomes • Harness existing community assets, networks and trusted messengers e.g. community champions • Specific considerations include: an inbound helpline; a postcode checker on Council website

11 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 5. Testing

Responding to the COVID-19 pandemic requires programmes that should be noted within the Local: Locally, residents can access information on an effective and proactive programme of testing, context of local outbreak response include: where symptomatic and asymptomatic testing is contact tracing, and self-isolation to break chains available on the Local Authority website. Symptomatic PCR testing for: of transmission. Partnership between national, Note that attendance for symptomatic testing regional, and local bodies is vital to ensure a co- • Symptomatic testing sites (detailed further requires booking via the Government national ordinated coherent response. The local leadership below) booking system or NHS 119 for those who cannot of the Director of Public Health is key in its • Testing for NHS, Care Homes and Adult Social use the online system. effectiveness. Care staff • Home testing kits ordered via the Government’s The initial testing focus has been on surveillance national booking system and diagnosis of symptomatic cases, using Symptomatic and asymptomatic testing • Testing for prisons Polymerase Chain Reaction (PCR) laboratory approaches locally: • Workplace testing tests that take 24 – 48 hours. More recently, the • Symptomatic testing: importance of asymptomatic testing has come Asymptomatic Lateral Flow Device (LFD) testing: Local Testing Sites – These are designed for access to the fore, using Lateral Flow Devices (LFDs), • Workplaces - Register to order free lateral flow on foot or via motorbike/bicycle only and NOT by providing rapid test results. Overall, testing is coronavirus tests for your employees - GOV.UK public transport or taxi, to serve more vulnerable a key component of all LOMPs, allowing an (www.gov.uk) people who may only be able to access a test site understanding of where infections are emerging • Testing for schools by walking locally or require a more in-depth and and detecting asymptomatic infections. Testing • Testing for prisons guided approach in taking a test. also contributes to ongoing surveillance, including • Testing for Day Care Centres - PCR testing for identification for vaccine-evasive disease and new Mobile Testing Units (MTUs) –MTUs are part of the day care centres in England strains. Government’s national infrastructure for COVID-19 • Home testing deliver – accessible via the online testing, with the aim of expanding the reach of National: Nationally the testing landscape has national service testing across the UK. MTUs offer agile temporary changed dramatically during the development Some of the above programmes are delivered with testing capabilities that can be set up quickly to of the pandemic, with a mixture of nationally, Local Authority support. serve communities as required. regionally and locally run initiatives as well as symptomatic and asymptomatic testing and Regional: The regional testing site is at The above testing is accessible for symptomatic targeted pilots. The combination of these Twickenham Rugby Stadium. Testing requires individuals via the Government national booking programmes supports effective and early booking via the Government national booking system or NHS 119 for those who cannot use the identification of the virus in the general population system or NHS 119 for those who cannot use the online system. Testing is via appointment only. as well as targeted groups at higher risk of online system. exposure to the virus. The predominant national

12 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

• Asymptomatic Testing: so that their contacts can be traced, supporting especially deprived communities who may It is estimated that up to a third of individuals who them to isolate and preventing transmission to not access other conventional NHS services. test positive for coronavirus have no symptoms others. Testing is delivered using lateral flow This is due to their geographical reach, clinical and can therefore unknowingly spread the virus. diagnostic technology that allows results within infrastructure and expertise, long opening hours, 30 minutes without the use of a laboratory. and the trust and support of residents. Delivering Locally asymptomatic testing is accessible via Identifying infectious individuals early and isolating testing through pharmacy settings also presents the local Community Testing Programme, the them can significantly reduce transmission of a more sustainable model for continued testing programme seeks to rapidly expand access to the virus and break transmission chains. LFDs delivery. asymptomatic testing to the wider population. are being adopted internationally to reduce the Further work is underway to deliver Collaborative Other complimentary programmes are run prevalence of the virus. nationally, such as the workplace programme, Testing, working with underserved communities. Currently community testing is being delivered where employers can register to establish their For information on local symptomatic and through asymptomatic testing sites, community own local testing provision. asymptomatic testing visit the Local Authority collection points as well as local pharmacies. As a website. The Community Testing Programme (CTP) was health, social and a community asset with strong launched by national government in December links to the communities they serve, pharmacy The following diagram illustrates the London 2020, to enable local authorities with high teams are well placed to play an important role in testing overview. prevalence of COVID-19 to work in partnership ensuring access to testing for local communities, with the UK government to accelerate a reduction in prevalence by identifying asymptomatic cases through local testing. It works alongside other forms of symptomatic and asymptomatic testing led by national government and has a powerful role to play in protecting the public’s safety and wellbeing, particularly by providing testing to critical local services and hard to reach communities based on local knowledge and prioritisation. Community Testing using rapid lateral flow devices can help identify people who are infected and potentially infectious but asymptomatic and unaware that they might be spreading the disease,

13 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

London COVID-19 Testing Overview

Aims and Purpose of Testing • To find people, who have the virus, trace their contacts and ensure both self-isolate to prevent onward spread • Surveillance, including identification for vaccine-evasive disease and new strains • To investigate and manage outbreaks • To enable safer re-opening of the economy

Pillar 1 (NHS Settings) Pillar 2 (Mass Population/Community) Pillar 2 (Mass Population/Community PCR swab testing and LFD antigen testing in PHE Mass symptomatic PCR swab testing (RT-qPCR) Asymptomatic rapid antigen testing (Lateral and NHS labs (RT-qPCR, LAMP & quicker testing and asymptomatic VOC surge testing Flow Device tests)

• Symptomatic patients that arrive in a • 5 Drive-through Regional Test sites • LFD tests delivered through asymptomatic hospital setting • 29 MTUs available across London for routine testing sites • Asymptomatic patients to support infection testing and surge capacity deployment • Whole student population in higher education prevention & control e.g elective care, • 84 LTS across 32 Boroughs institutions inpatient care, mental health, maternity and • Home Testing Kits • National pilots/ programmes discharge planning • Regular whole care home asymptomatic • Workplaces • Symptomatic NHS frontline staff and in an testing: weekly for staff, every 4 weeks for • Schools outbreak situation and household members residents • Adult Social Care: • Routine testing of asymptomatic NHS staff and • CQC-registered domiciliary care provider - visitors contractors weekly staff testing - visiting professionals • Intermittent testing of non-symptomatic NHS • Rapid response LFD testing following care staff e.g. as part of SIREN study4 home outbreaks • Domiciliary care • NHS staff • Private sector testing • Pilots

4 https://snapsurvey.phe.org.uk/siren/

14 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 6. Wastewater Surveillance

The Joint Biosecurity Centre (JBC), working with Although viral concentrations cannot not yet be • Surveillance includes daily SARS-CoV-2 Thames Water, has been conducting wastewater directly converted into population prevalence, Ribonucleic Acid (RNA) concentrations sampling for SARS-CoV-2 at approximately 30 sites trends over time and comparisons in results detection. Key considerations include trend and around London since mid-December 2020 and is between sites can provide insight into the level of detection. It is important to note that still being developed. relative levels of COVID-19 circulating in the a one-off high reading can be misleading due to sampling problems, but consistent trends in population. The size of the catchment areas of the change and when comparing to other areas sampling sites will vary, and this needs to be borne should alert to higher levels. in mind when interpreting results. • The JBC also reports level of detection in a map as well as change in detection. Surveillance includes mapping changes in RNA concentrations and the size of catchment area. Mapping shows location of the sampling sites and the size of catchment areas. Currently there is pilot work to use wastewater samples to support surge testing for detection and control of VOCs, through genomic sequencing of wastewater samples. However this this is work in progress and is currently, focussed on Bristol. There are eight sewage treatment centres in London. Whilst there are no treatment centres in Richmond the borough is covered by the three centres listed below: • Mogden • Crossness • Hogsmill

A time-series view of sewage treatment sites covering Richmond from 1st August 2020 to 29th May 2021

15 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 7. Local Case Tracing and Enhanced Contact Tracing

In Richmond, the local tracing services are spends the next 24 hours attempting to contact Enhanced contact tracing for cases of COVID-19 is designed to enhance case tracing and increase the the case before it is forwarded to the local a systematic process of using information collected rate of follow up and completion from the national borough-based Case Tracing team. from cases during the contact tracing interviews NHS Test and Trace service. Since the launch of • The local service will utilise local systems to to identify clusters of cases and activities/settings local case tracing, the follow up of cases is higher make contact with the individual directly. where transmission may have occurred. This than the London average. • This is outlined in the Local Contact Tracing intelligence is combined with local sources of Partnerships diagram. • The national NHS Test and Trace team allows information known to Local Authority and health protection teams to assess whether investigation eight hours following confirmation of a positive Local Contact Tracing Partnerships case to encourage cases to complete their own may be needed to determine whether public health contact data on a web portal. Implementation of a local enhanced contact actions may be needed in these settings to prevent • After this, the national NHS Test and Trace team tracing service is currently being considered. further transmission.

LA Escalation Digital Journey Invite sent for Activities / Contacts Process Flow complete Contact made within autocomplete regictered in NHS T&T 24 Hours and/or Invite to the YES Activities/ contacts Digital Journey Yes - No action 10 Call attempts registered in NHS T&T

Positive Case enters Case made available Digital Journey NO Call Agent contacts Success? NHS T&T to call agent complete? Case

Case transferred to LA Under 18’s go straight into Contact Centre Takes 8 hours off the journey Can take up to 24 Hours for NO - they are not invited on the journey to the Local Authority case to reach LA

MAXIMUM 24 HOURS LESS THAN 96 HOURS WITH LA

In the new process: • The Index Case record is made available to the • Call agents will be required to check if the Index • If coreact is not made within 24 hours and/or 10 National Contact Centre at the same time as the Case has completed the digital journey before call attempts the Index Case is transferred to the first invite is sent for the Digital Journey contacting the case. Local Authority.

16 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

The 5 Stages of Enhanced Contact Tracing and Bespoke Support

1 DETECT 2 ALERT 3 INVESTIGATE 4 CONTROL 5 REVIEW

NHS Test and PHE, HPT and LA Further Control measures Ongoing review Trace and PHE review intelligence investigation are implemented and monitoring for provide a suite and triage to of potential and continuously 28 days after last of intelligence determine next outbreaks to reviewed as case. reports to help steps required, inform further informed identify potential prioritising control measures. by ongoing outbreaks in your potential local investigation. area. outbreaks.

• Improved Common • Toolkit • National Resource • Regular touchpoint • Capability and capacity Exposure Reports - Local Based Contact meetings and building • Training to interpret Tracers Communications • Postcode Incidence reports • National Resource Reports • National Resource • National Resource - Local Based Contact • Toolkit training - Local Based Health - Local Based Contact Tracers • iCERT Professionals Tracers • Mobile Testing Units • Postcode push - Home Channel

17 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 8. Enduring Transmission

Enduring transmission is defined by high rates • Flexing of capacity around communications, powers where events or settings were of COVID-19 that remain above the national engagement (e.g. activity of Covid Marshalls), considered a risk to public health average for long period of time. Acting on enforcement and testing to concentrate on • Engagement through LFD testing, asymptomatic enduring transmission is critical to help reduce the area testing with communities or in geographical the disproportionate impact of COVID-19 on • Identification of and work with key settings in the areas. This will include collaborative testing under-served communities, that are already at area, across community and voluntary sector, through a faith group or minority group that greatest risk of the burden of ill health due to local businesses, and statutory settings might not be engaged in mainstream testing offer. Faith settings are used and run by the COVID-19. Whilst promoting uptake of the vaccine • Consideration of enhanced activity around community to engage in testing. should have a positive impact in tackling enduring contact tracing and support in isolation transmission, other steps will need to be taken to • Consideration of more active use of local reduce the risk. It is important to consider the factors which may contribute to enduring transmission and monitor these to anticipate any geographical areas or communities in which transmission may be sustained for long periods. For example, monitoring the extent to which communities and population groups are engaging in asymptomatic and symptomatic testing, using NPIs and taking up vaccination offers. Above and beyond community outbreaks, it is also possible that enduring transmission will be identified within either a particular geographical area, or a particular cultural community, within Richmond. This would consist of persistently high rates of COVID-19, in contrast to other areas, and resistant to wider-spread restrictions and other NPIs. • The approach taken in this scenario would build on the approach to community outbreaks, and would likely involve some or all of:

18 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 9. Approach to Compliance and Enforcement

The Regulatory Services Partnership team (RSP) • putting in place appropriate controls prepare, if extra staff are needed to be mobilised takes the lead in carrying out enforcement. The • training staff so they adhere to COVID-19 control in the case of a local outbreak. RSP team comprises Environmental Health Officers measures • Regular meetings and/or operations with and Food Safety Managers. RSP works closely • complying with government and industry the police or other Local Authorities and with local businesses to ensure they are operating guidance to operate safely stakeholders. in a COVID-19 secure manner, are compliant • declare that they will keep up to date with that • Close working with national and regional with the current guidance and have conducted guidance and advice. agencies to further understand the powers that we have to impose local or regional measures to the necessary risk assessments. It also supports The business will then be sent a ‘COVID-19 businesses to manage outbreaks. RSP will work in contain a significant local outbreak (e.g. school safe’ poster to display in their premises and closures etc). partnership with all external stakeholders including will be promoted in our list of COVID-19-safe There is an agreement in London between the businesses, business forums, community groups, businesses to help generate a culture of COVID-19 Metropolitan Police and Local Authorities on the and members of the public to seek compliance compliance in our business community and enforcement for the law. The police will lead and with Covid-19 regulations. RSP, Public Health and provide reassurance for customers using these regulate on matters that directly involve restrictions the wider council use a range of methods such as businesses. providing up-to-date information on our website, on members of the public and gatherings or business newsletters, engagement through COVID The council’s overall approach to Enforcement in wearing of face masks. The Local Authority will Marshalls or Enforcement Officers. COVID-19-management is to: lead on restrictions of businesses and in rare occasions restriction on infected individuals on Local communications have been distributed to • Initially seek compliance with COVID-19 law by Health Protection regulations. businesses to support them in creating COVID-19 education, encouragement, and engagement with individuals and/or businesses. compliant premises. These communications will In general, the police have the power to regulate continue along with pro-active, practical support • Where other prevention measures have failed and enforce all recent COVID-19 law. Local or there is deemed to be an imminent risk, we for businesses, identifying commonly experienced Authorities have a range of new powers relating will use our enforcement powers to prevent the issues in relation to compliance and working with to new COVID-19 Business Restrictions as well spread of infection. businesses to find solutions to ensure that they are as existing powers in Health & Safety, Anti-Social able to operate in a COVID-19 secure way. To prepare Enforcement’s operational response to Behaviour and Public Health law. an outbreak, Public Health and Regulatory Services To be recognised as a COVID-19 safe business, it Partnership work closely and the following are in must declare compliance to a range of measures, place to help with enforcement measures, including: if required: • undertaking a comprehensive COVID-19 • Local procedures and rotas for our risk assessment Environmental Health and Public Health staff to

19 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 10. London Coronavirus Response Cell (LCRC) / Local Authority Roles and Responsibilities

An agreement was set up to provide a framework • The Local Authority will convene an Incident This information is contained within ‘action cards’ for joint working between the PHE London LCRC Management Team (IMT) or Outbreak Control that have been designed for specific situations and the Public Health Teams in the London Local Team (OCT). where an outbreak could occur. This could be a Authorities. The framework supports collaborative Incident Management Team (IMT) restaurant or office, a construction site or a place management of COVID-19 outbreaks, complex of worship. The action cards are designed to be Membership of the IMT will vary according to the settings and community clusters. This partnership downloaded or printed and kept to hand. These nature or circumstances of the outbreak and the enables us to: quick reference guides provide key steps to help incident level. A PHE Health Protection Team staff quickly identify, report and respond to any potential • Have a joint collaborative and co-ordinated member is expected to be involved in all outbreaks. COVID-19 outbreak. A COVID-19 outbreak is more approach to supporting London settings Usually an Environmental Health Officer (EHO), a than one confirmed case of COVID-19. Depending including care homes, extra care housing and Consultant Public Health and a Director of Public on the type of organisation, this may also include supported housing, local hospitals, workplaces, Health will also be required. Additional members ‘possible’ cases of COVID-19. prisons, primary care settings, schools, nurseries will be expected to be involved dependent on the and homeless hostels in managing COVID-19 nature of the outbreak. In some circumstances it In order to deliver an effective outbreak response, outbreaks, reflected in the councils’ LOMPs. may be appropriate for the IMT to consist only of we need to understand the situation. Government • Improve understanding and access to services, PHE staff. guidance provides further information on reduce transmission, protect the vulnerable COVID-19: epidemiological definitions of outbreaks and prevent increased demand on healthcare Case reporting services. and clusters in particular settings to assist with The section below provides information for local actioning an appropriate response in different • Share outbreak information to facilitate organisations regarding reporting of cases. settings. appropriate measures. • Have a Single Point of Contact (SPoC) at the Where to find information on how to report Data and surveillance of cases: cases of COVID-19: LCRC and in each Local Authority (Director Since the start of the pandemic data resources of Public Health or nominated Public Health COVID-19 early outbreak management information and intelligence tools have rapidly developed, Manager) to facilitate data flow, communication has been created to make sure that people who empowering local areas to have a greater and follow-up. run businesses or organisations: understanding of the local epidemiology of • Provide consistent advice to settings and local COVID-19. Public Health Teams. • know how to recognise and report an incident of COVID-19 A number of intelligence tools and products have • are aware of measures local health protection also been produced locally utilising raw data teams may advise in order to contain it provided from central surveillance functions.

20 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

Due to the sensitive nature of some of the data, some of this information is not publicly available. A list of key reports is outlined in the table below, along with links to publicly available data.

Key Reports

Report Data Description Use of data Responsibility Produced by

COVID-19 Situational • Positive/negative tests Production of local sur- Director of Public Health Public Health England Awareness Explorer • Cases veillance analysis and Dashboard • Contact tracing/ dashboards enhanced contact tracing • Vaccination

COVID-19 Local Authority • Daily Surveillance reports Produce daily surveillance Public Health England Public Health England Report Store • Contact tracing for NHS summary for Public Health Test & Trace (weekly and and Councillors daily) • London Daily Surveillance reports • Pillar 1 & 2 exceedance reports

COVID-19 Local Authority • Number of tests and test Included in the daily NHS Digital NHS Digital Dashboard positivity for: surveillance summary - Pillar 2 for Public Health and - Lateral Flow Testing Councillors

Publicly available data is accessible from a number of websites, including; gov.uk, Public Health England Surveillance reports, NHS Digital, NHS website, Office for National Statistics website as well as the Local Authority website.

21 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond Outbreak Identification & Response

5. Measure Impact 1. Tools • Baseline & benefits realisation • PowerBI integrated reports • Build out the operational and and analytics data flows analysis processes Tools • Toolkit- standard operating • Agree monitoring metrics for procedure CE reports COVI D-19 cluster detection • NHS T&T App - using Alerts to and response 01 warn and advise • Develop reporting platforms • Operational Playbook for post 02 ECT actions based a set of key Regional/ principles 4. Resource Support Measure Local Impact • iCERT- Interactive Common Models Outbreak Planning Exposure Review Tool • Identify agile resourcing models to support end-to-end Identiﬁcation 05 2. Regional/Local Planning ECT process • Capability & capacity building & Response • HPTs & LAs co-design ECT including provision of training operating plan/s • National resource • Increase usage of or effectiveness of using reports, Resource 03 tools & resource Support Models 04 Communication 3. Communication • ECT Explainer • Regular touchpoint meetings • Coordinated ‘Newsletter’ approach across T&T • Develop a suite of Communications utilising appropriate delivery platforms

22 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond Local Authority and LCRC Health Protection Team Roles

Local Authority LCRC Health Protection Team

Case and contact • Receive notifications of cases via national test and trace route • Receive notifications of cases via clinical leads / local authority investigation • Investigate and manage cases and contacts as per local SOPs leads if meet the criteria as agreed in national test and trace management • Escalate to LCRC/HPT if meets criteria as agreed in national test protocols and trace protocols • Investigate and manage high risk cases and contacts as • Provide support packages as required per local SOPs

VOCs (or other cases of • Investigate and manage VOC/VUI etc cases and contacts— at • Investigate and manage initially VOC/VUI etc cases and contacts concern) present those lost to follow up • Liaise with LA contact tracing for help with no contact cases • Establish and lead IMT to investigate end manage VOCs/VUIs • Investigate and manage any identified settings cases and clusters with enhanced case and contact tracing, and • Advise and support LA IMT to investigate and manage VOCs/ targeted testing (community or setting focussed) including VUIs cases and clusters with enhanced case and contact tracing, surge testing and targeted testing (community or setting focussed) including surge testing

Enhanced contact • Investigate, identify priority clusters • Overview of cluster identification and management tracing (Cluster) • Manage clusters as per relevant settings SOPs • Overview management of priority settings investigation and • Chair IMTs if required • Attend IMTs if required management

Settings (care homes • Receive notification of cases and clusters via a number of • Receive notification of cases and clusters via a number of workplaces, schools, different routes different routes ports, prisons, • Investigate and manage cases and clusters in settings • Investigate and manage cases and dusters in high homeless etc) • Provide advice and support around contact tracing, isolation, priority settings infection control practices, COVID safe environments and testing • Review and update resources etc including written resources • Provide advice and support around contact tracing, isolation, • Chair IMTs if required infection control practices, COVID safe environments and testing • Develop and provide communications to stakeholders etc including written resources. • Liaise with CCG, GPs and other healthcare providers to provide • Attend IMT if required ongoing healthcare support to setting • Develop and provide communications to stakeholders • Liaise with CCG, GPs and other healthcare providers to provide ongoing healthcare support to setting

23 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 11. Local, Regional and National Roles

The following diagram provides a summary of local, regional, and national roles. Level Place-based leadership Public health leadership LOCAL LA CEO in partnership with DPH and PHE HPT to: DPH with the PHE HPT together to: a. Sign off the Outbreak Management Plan led by the DPH a. Produce and update the Outbreak Management Plan and engage b. Bring in wider statutory duties of the LA (e.g. DASS. DCS) and multi- partners (DPH Lead) agency intelligence as needed b. Review the data on testing and tracing and vaccine uptake data c. Hold the Member-Led COVID-19 Engagement Board (or other c. Manage specific outbreaks through the outbreak management chosen local structure) teams including rapid deployment of testing d. Provide local intelligence to and from LA and PHE to inform tracing activity e. DPH Convenes DPH-Led COVID-19 Health Protection Board (a regular meeting that looks at the outbreak management and epidemiological trends in the place ) f. Ensure links to LRF/SCG REGIONAL Regional team (PHE, JBC, T&T. London Councils and ADPH lead PHE Regional Director with the ADPH Regional lead together a. Support localities when required on outbreaks or specific cases or a. Oversight of the all contain activity, epidemiology and health enduring transmission or substantial cross-boundary protection issues across the region including vaccine uptake b. Engage NHS Regional Director and ICSs b. Prioritisation decisions on focus for PHE resource with LAs c. Link with Combined Authorities and LRF/SCGs or sub regions d. Have an overview of risks issues and pressures across the region c. Sector-led improvement to share improvement and learning especially cross-boundary issues d. Liaison with the national level

NATIONAL Contain SRO and PHE/JBC Director of Health Protection PHE/JBC Director of Health Protection (including engagement a. National oversight for wider place with CMO) b. Link into Joint Biosecurity Centre especially on the wider intelligence a. National oversight identifying sector specific and cross-regional and data sources issues that need to be considered b. Specialist scientific issues e.g. Genome Sequencing c. Epidemiological data feed and specialist advice into JBC

24 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond Regional and National Command Structures to Support Outbreak Management

25 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

12. Cross-border Partnership Working

The pandemic has initiated, strengthened, deliver a tri-borough operation across Richmond, group is to establish close working relationships or accelerated collaboration between Public Wandsworth and Merton. This has previously with IPC colleagues within South West London Health and other Council directorates, as well helped in the pandemic response that has required and to discuss issues that cross borders, including as with the NHS, voluntary sector, community working with neighbouring boroughs, for example care home providers, HMOs, asylum seeker groups and other stakeholders. The coming with workplaces and education settings. We accommodation providers, schools, domiciliary year provides a significant opportunity to build have also been able to gather learnings from care, homeless community. The Consortium will on that collaboration to influence and promote neighbouring boroughs in particular circumstances also be used to share best practice and the latest Public Health population priorities to become to inform our preparedness and response. For IPC guidance. everyone’s priorities. Public Health and the Council example, when the initial identification and directorates will continue to work with key partners management of VOC in Merton occurred. across South West London and regionally. The council’s Infection, Prevention and Control More specific cross border working related to (IPC) Leads chair a fortnightly South West London managing and preventing outbreaks, our existing IPC Consortium, which includes IPC leads from all Regulatory Services Partnership team already South West London boroughs. The purpose of this

26 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 13. Vaccination Programme

The NHS has overall responsibility for roll-out of the The key aims of the communication plan are as evaluation of the Vaccination Champions is vaccines and communications with eligible groups. follows: currently being considered. The Local Authority works with NHS South West • Informing and engaging our wide range of An Immunisation Steering Group chaired by London Clinical Commissioning Group (CCG) to local audiences, some of whom are historically the Director of Public Health provides system support arrangements for vaccination including for resistant to vaccines. leadership and oversight on vaccination example, the identification of mass vaccination sites. • Reducing health inequalities by making sure the programmes locally. This group includes The Joint Committee on Vaccination and right people get the right information in a way representatives from NHS England, Public Health Immunisation (JCVI) recommended priority groups that is accessible to all. England, SWL CCG, Primary Care, and Community for vaccinations which were published early in • Tackling myths and misinformation in a robust, Provider trusts. December 2020. The vaccination programme is joined-up and timely way. The Local Authority is regularly monitoring vaccine being delivered in phases, according to priority • Building public trust in the safety of the vaccine data and reviewing uptake amongst eligible groups. groups. Groups are prioritised based on the among our communities and providing facts in The Local Authority’s role is to respond to low prevention of mortality and the maintenance of the a simple way that enable residents to make their uptake and work with NHS to improve uptake. For health and social care systems. Current vaccine own choices in an informed way. example, this would include local engagement uptake counts nationally, regionally and locally can • Maximise the vaccine uptake in Richmond upon work with target groups to understand concerns be viewed at Statistics » COVID-19 Vaccinations Thames and among health and social care and challenge myths about the vaccines. (england.nhs.uk). staff working in the borough using trusted local voices to reassure and provide facts so that There are draft plans to formulate a South West As vaccine availability increases, the Local Authority people can make an informed choice. London ICS Immunisation Board for both influenza will continue to work with SWL CCG to identify • Leading on access and logistics for the mass and Covid-19 in July 2021 and Richmond will be groups where there is poor uptake and more vaccination centre at The Stoop, including active player in this wider geographical group. targeted work is needed. The role of the Local directions, site logistics and counter terrorism Authority is also to assist with mobilising vaccines prevention messaging. in residential care homes, supporting the practical Overall existing areas of joint working with the delivery and monitoring uptake amongst residents Clinical Commissioning Group include top line and staff. messages to increase confidence and trust in the The Local Authority Communication Team vaccine, community engagement activities, and is part of a collaborative South West London managing expectations about delivery. A network Communication group that is working together on of Covid-19 Community Vaccination Champions reaching the priority groups for vaccination with has been recruited for the borough and are helping key messages. us to successfully deliver the vaccine. Meaningful

27 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond Tackling Vaccine Hesitancy and Inequalities: A Overarching London Approach Built on 4 Pillars

Aspect Data and evidence Addressing hesitancy Practical aspects of Monitoring, evaluation and vaccination system leadership

Issues to Data: Best use of available data to Hesitancy higher in: Under 25 year Other aspects affecting vaccination Evaluation: Systematic, academically consider understand where the inequalities olds, BAME groups (particularly, uptake of minority groups: rigorous service evaluation that is are, to support local and pan-London black ethnic groups) and less affluent Accessibility/familiarity of the setting. agile, answers the essential questions action and interventions. Londoners. Invitation & appointment booking and feeds back into the system. Evidence: Work is rooted in the Health and care professionals: process Measures of success: Clearly evidence, including behavioural Current rates are lower Vaccine site location. defined. science and from other vaccination comparatively. Opening hours / time of work System Leadership: Join up and pro-programmes. Culturally competent community 58% of those in UK answered ‘No oversight across the system, across Lessons learnt: Identifying and engagement: Essential, locally led, to the question ‘Is it easy to get the test-trace- isolate-vaccinate sharing good practice from other regionally enabled. a vaccine? (Global institute of journey and tackling inequalities from countries, regions and boroughs. Behavioural insights: Understanding Innovation) COVID-19 more generally. models of vaccination behaviours, Potential for drop off for second including role of stigma vaccine: As seen in other vaccines

Next Data: Track and share data on Coordinated and targeted Adapting programme delivery: Evaluation: Evaluation of local/ steps vaccine hesitancy/acceptance and programmes: Reaching specific Understand barriers to access for STP interventions/approaches, with vaccine uptake (rolling equity audit). communities. Current focus on minority and vulnerable populations academic support. Integrate: Integrate vaccination data BAME, health and care professionals and feed into and refine NHS Listen and learn: Use range of fora with surveillance and T&T data, to and inclusion health. programme delivery. and networks to engage, listen and inform outbreak control / response Sharing resources and assets: Trailing: Emphasise and support share good practice and understand Insights: Facilitate the collection Maintain an easy access repository healthcare staff in their role as a partners’ support needs. and sharing of insights from across of local, regional and national trusted source of health information Horizon scan/plan ahead: For London. resources that are sensitive to local for key population groups. groups likely to have low uptake, Evidence: Synthesise the evidence communities. Impact of vaccination on thinking also of messaging for on barriers, enablers and what works. Network and support London behaviours: Monitor impact of second vaccine. Quality assure: Provide PH input/ partners: Across orginisations vaccination rollout on social Celebrate success: Keep momentum advice to ensure communications/ to make connections, support distancing and adherence to other and promote further action. interventions are grounded in workstreams. NPIs. Develop clear communications Extending success: Use these evidence. Develop a bureau of professional and other strategies. opportunities/relationships for wider Agile system: Ongoing gathering of speakers programmes to reduce inequalities evidence/learning from the system. Consider other models. MECC more generally.

28 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 14. Communications Plan

Richmond Council’s Communications team lead Events planning on local communication planning, using Public Richmond council also provide support for those Health COVID-19 resources. The Communications who wish to plan events, to ensure that events team will develop key communications messages are permissible within the current guidance and, if to support outbreak control including: permitted, are delivered in a COVID secure manner • Ensuring residents know what NHS T&T is and with infection control measures. A dedicated email how to access a test. address for local event planning has been created • Identifying symptoms of COVID-19. (eventsplanning@richmondandwandsworth. • Providing information on what to do if asked to gov.uk). self-isolate, how to access support if needed, and the importance of complying with advice given as well as how to avoid fraud. • Support the outbreak management theme leads in managing individual and bespoke outbreaks across various settings. • Key messages for specialist settings e.g. schools, care homes and high-risk businesses. • Align national and regional key messages at local level. To use communication platforms to reassure community concerns, provide relevant information to residents, elected councillors/ members and community groups in the event of an outbreak.

29 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 15. The Council’s Recovery Plan

The Government has outlined a roadmap for recovery, which includes key dates between March and June 2021. Over this time period, steps will be taken to gradually ease restrictions (subject to review) with the final dates resulting in no legal limits on social contact. The council will ensure that these dates and restrictions are clearly communicated to residents. As new guidance emerges, information, advice and guidance will be given at key points of the roadmap, i.e. when changes come into effect. The pandemic has highlighted and worsened existing health inequalities and this needs to be considered in the context of Recovery and Prevention. There is a wide range of recovery priorities at national, regional and local level. The Public Health response is hugely affected by external factors including national developments on COVID-19 restrictions, and developments in the outbreak response such as testing, contact tracing, and updates to infection prevention and control guidance. The national road map out of lockdown will be a key consideration to the phasing of a local to ensure that recovery work leads to a future in integration highlights the importance of issues such Public Health road map but not exclusively held to which Richmond is an even better community in as Mental Health and Healthy Weight. These issues that timetable alone. The national road map is also which to live, work and study. are also highlighted within the 9 Recovery Missions, subject to change. of the London Councils’ recovery programme. Elements of the refreshed Public Health Service COVID-19 recovery has been defined as a key plan will align with existing Health and Care priority for the council. The aim of this priority Plan and Public Health Prevention priorities now is to support residents, businesses and staff with highlighted through the impact of COVID-19. The the impact of the COVID-19 pandemic, including Government’s White Paper on Health and Care providing guidance, services and support, and

30 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond 16. Governance

The governance arrangement involves 4 key to help reduce the spread of coronavirus and groups which are set out in the below support local public health. Local Outbreak Control Planning Working Group oversees the use of Funding arrangements this funding to ensure resources are deployed The Contain Outbreak Management Fund (COMF) appropriately in accordance with the needs of provides funding to local authorities in England outbreak management.

Group Membership Purpose Accountable to

Local Authority Adult Social Services and Public Health Develop Local Outbreak Management Plans Local Authority Contact Tracing Environmental Health Services Gold Working Group Communications Children’s Services Achieving for Children Local Outbreak Leader of the Council, Lead Members (Adult Political and partner oversight of strategic response Health and Engagement Board Social Care and Health) Provide political ownership and public-facing engagement and Wellbeing Board Cross-party Members, Director of Public communication for outbreak response Health, CCG Rep, Director of Adult Social Care Directors of Children’s Services, Head of Communications Head of Community and Partnerships Strategic Multi-agency representation, including PH, Borough Resilience Forum; supports and co-ordinates with local Local Authority Co-ordinating NHS (incl. CCG, GP Confed) EPRR, ASC, CFS, groups to support the delivery of outbreak plans Gold Group and communications

31 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

COVID-19 AD representatives from across Council Responsible for determining Council’s overall management, policy Health and Protection Board Directorates and CCG and strategy and achieving strategic objectives; delivering swift Wellbeing Board resource deployment (Integrated into the Richmond and Provide assurance that there are safe, effective and well-tested Wandsworth Public plans in place to protect the health of local population during Health Board) COVID-19 Provide infection control expertise Lead development and delivery of local plans Link directly to regional PHE teams

32 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

Richmond COVID-19 Outbreak Control Governance Arrangements

London Gold

Health and Wellbeing Board Local Authority Gold

Local Outbreak Richmond and Wandsworth Local Authority Contact Tracing Strategic Coordination Group Engagement Board Public Health Board Working Group (Borough Resilience Forum)

COVID-19 Protection Board* Operational Incident *Integrated into the PH Board Management Teams

Public Health COVID-19 Response Team

Local Outbreak Control Planning Working Group

33 COVID-19 LOCAL OUTBREAK CONTROL PLAN London Borough of Richmond

DOCUMENT INFORMATION AND VERSION CONTROL

TITLE RICHMOND COVID -19 LOCAL OUTBREAK MANAGEMENT PLAN PREPARED FOR Richmond and Wandsworth’s Director of Public Health, Shannon Katiyo PREPARED BY The Public Health Team LAST UPDATED MAY 2021 V3 PLAN APPROVAL Local Authority Gold