Northamptonshire COVID-19 Weekly Surveillance Report

• 1,296 Northamptonshire residents have tested positive for COVID-19 in the last week – a small reduction on last week. • However cases locally remain higher than pre-lockdown levels. • The majority of transmission continues to be within and between households.

Data up to 22 November 2020

1 National Restrictions

Northamptonshire residents must follow new National guidance until midnight on 1 December.

Key guidance includes: • Only leave home for food, medical reasons, exercise, education or work (if you cannot work from home) • You MUST work from home if you can • Avoid travel unless essential • Schools and essential shops to remain open • Remember: Wash hands, cover face, make space

For a full list of what you can and cannot do, please visit: https://www.gov.uk/guidance/new-national-restrictions-from- 5-november For local guidance and FAQs, visit: https://www.northamptonshire.gov.uk/coronavirus- updates/Pages/coronavirus-advice-and-faqs.aspx

2 Your Actions Make a Difference!

1. We are still in lockdown until midnight on 1 December. When lockdown ends Northamptonshire will be in Tier 2 which is officially high on the three tier alert system and our position remains precarious. Lockdown restrictions may start to ease regarding certain activities but now more than ever; just because we can do something doesn’t mean we should. We must not be COVID-complacent and it is paramount that we continue to take measures to ensure ourselves and our loved ones are protected from the virus. If we all work together on this we can exit to a lower tier with all the benefits that brings. 2. Book your flu jabs now. We are urging all pregnant women and those with long term conditions to have the flu jab as soon as possible. We want to protect our NHS services at this critical time by ensuring all eligible residents are protected against the flu before we can roll out the flu jab to the over 50s (an additional group this year) and effectively implement a robust and effective COVID-19 vaccination programme. 3. If you can’t minimise your contact with the over 60s, due to caring or childcare responsibilities, then you must minimise your contact elsewhere. We urgently need to reduce coronavirus transmission to older age groups who have greater risk of severe illness and hospital admission. Bed capacity at our hospitals is already continuing to rise. At the moment non urgent and elective surgeries are continuing but if this trend continues they will have to stop. We are therefore asking our older residents to remain alert and to reduce their contact with others wherever possible.

3 Total and Weekly Summary A total of 13,594 positive cases have been identified in Northamptonshire to date. Of this number, 1,296 were identified in the last week, 16 to 22 November 2020. This graph shows the total number of people who have tested positive for COVID-19 in Northamptonshire each week since 31st August 2020. There has been an overall increasing trend over the last two months with cases rising significantly since the end of September. The number of cases in the last week have decreased compared to the previous two weeks, however case volumes remain high and there were more than twice as many cases in the last week compared to the first week of October. Average daily case figures are almost as high as the weekly totals seen during September. The latest week’s figures are likely to increase further as data for the most recent days are subject to reporting delays.

* Please note that Public Health England have recently updated their methodology to link cases to the address entered at the point of ordering the test rather than patient GP registered addresses. Data has been amended retrospectively, therefore historic figures may not match previous weeks’ reports.

4 Recent Cases by Age and Gender

This graph shows the number of positive test results for COVID-19 in Northamptonshire over the last 28 days by gender and by ten-year age band. Overall, more women than men tested positive for COVID- 19 in the last 28 days. The age groups with the most positive tests in males were 50 to 59 year olds, and in females they were 40 to 49 year olds. Case numbers are currently highest amongst working age adults. Cases are continuing to increase in the over 60s. This is of particular concern as these age groups tend to be at greater risk of more severe disease and observed hospital admission.

5 Total Cases by District and Borough

Cases in week This table shows the total number of people who Total cases to Change from Area 16 Nov to 22 have tested positive for COVID-19 up to 22 22 Nov 2020 previous week Nov 2020 November 2020 in each of Northamptonshire’s seven districts and boroughs. Northamptonshire 13,594 1,296  Northamptonshire and all districts and boroughs  Corby 1156 118 have seen a decrease in cases compared to the Daventry 1205 102  previous week. However, Northamptonshire’s total cases in the last week are over 6 times East Northamptonshire 1532 118  higher than the weekly average seen between 31 Kettering 1761 143  August and 27 September. Northampton 5,243 505  Please note that extreme caution must be applied South Northamptonshire 1392 191  when viewing week on week changes. To see the Wellingborough 1305 119  overall changes in areas in context please see slides 11, 12 and 13.

6 Rate of Weekly Lab Confirmed Cases This graph includes all testing data. It shows that Northamptonshire’s rate of cases in the last seven days is below the England average, however the gap between Northamptonshire average and England average is narrower than it was in October.

With the exception of Northampton and South Northamptonshire, all districts and boroughs have weekly total rates below the England average. Case rates are currently on a decreasing trend in all districts and boroughs except for Corby and Wellingborough, where rates have increased in recent days.

Northampton currently has the highest weekly rate of cases in the county, followed closely by South Northamptonshire.

* These are 7-day rolling total numbers of cases as a rate per 100,000 population – this is done to even out the fluctuations we see in testing volumes on weekdays vs weekends. Source: coronavirus.data.gov.uk.

7 Rate of Weekly Lab Confirmed Cases in Ages 60+

This graph includes testing data for people aged 60+. It shows that the rate of confirmed cases for people aged 60+ in Northamptonshire has increased since the end of October.

Corby has seen a significant increase in its case rate in ages 60+ over the last two weeks and currently has the highest rate in the county by a large margin.

There has also been an increase in case rate in ages 60+ in South Northamptonshire, which is now the second highest in the county.

* These are 7-day rolling total numbers of cases as a rate per 100,000 population – this is done to even out the fluctuations we see in testing volumes on weekdays vs weekends.

8 Rates of Cases by District and Borough

Rate per Compared to Compared to The data in this table shows us what the total and Cumulative rate 100,000 13 county rate 13 England rate 13 most recent week’s positive COVID-19 case numbers Area per 100,000 to Nov to 19 Nov Nov to 19 Nov Nov to 19 Nov 19 Nov 2020 for our districts and boroughs would look like if each 2020 2020 2020 area had the exact same population size (100,000).

Northamptonshire 1,746 185.7 - Sig lower This helps us to compare geographic areas with Corby 1,562 181.4 Similar Sig lower different sized populations more accurately.

Daventry 1,347 124.5 Sig lower Sig lower With the exception of Northampton and South East Northamptonshire 1,564 123.8 Sig lower Sig lower Northamptonshire, district and borough infection Kettering 1,687 162.1 Similar Sig lower rates per 100,000 population for the most recent week are significantly lower when compared to the Northampton 2,261 233.3 Sig higher Similar national average. However the rates for all districts South Northamptonshire 1,395 230.7 Sig higher Similar and boroughs are above 100 cases per 100,000 population as a weekly average. Wellingborough 1,597 171.9 Similar Sig lower

Source: coronavirus.data.gov.uk Overall, Northamptonshire’s rate of cases in the most recent week is significantly lower than the *Please note that the word sig means ‘significant’ is a statistical term which simply means that England average, but this is due to a significant the research is valid. increase in the England rate and therefore must be viewed in this context.

9 Education Status

These charts show recent trends in the percentage of schools open, children attending and COVID-19 related absences in both staff and pupils in Northamptonshire. The vast majority of schools have been open or partially open over the last three weeks however attendance levels have been on a downward trend since the beginning of November. COVID-19 related absences amongst both staff and pupils have been increasing since the beginning of November. During the last week, nearly 1 in 10 pupils have been absent for COVID- 19 related reasons. Details around outbreaks and exposures in education settings by district can be found on slide 14.

The University of Northampton reported 5 cases in the week 16-22 November.

10 Cases by Community – Last 28 Days

The chart shows the local communities within Northamptonshire where COVID-19 infections over the last 28 days are highest.

Knowing the areas with the highest case numbers in the last 28 days help us to prioritise and focus our support locally.

11 Case Rates by Community – Last 28 Days per 100,000 population

These graphics show what positive COVID- 19 case numbers over the last 28 days would look like if each local community had the exact same size population (100,000).

The map illustrates the 28-day infection rate per 100,000 population across the whole county.

* Please note that the numbers shown on this page represent the best possible estimate we can make from a wider range of numbers, because there is always a margin of error when calculating cases per 100,000 population – particularly where actual case numbers are small.

12 Change in Case Rates by Community – Fortnightly per 100,000 population If each community had the exact same size population (100,000) in Northamptonshire, this graphic shows how COVID-19 case numbers in the last 14 days would have changed in each community compared to the previous 14 days.

The 15 areas with the greatest increases in case rates are listed next to the map.

Areas with the greatest increases in rates of infection show us where we need to prioritise and focus our support locally.

Please note that the categories of the map have changed since last week to show greater definition.

13 Summary of Outbreaks and Exposures 23/11/2020

In the last 28 days Corby Daventry East Northants Kettering Northampton South Northants Wellingborough County total Case total Outbreaks 2 8 6 10 26 12 3 67 595 Care home/service 1 1 2 3 4 5 16 164 Outbreak Childcare (two or more cases linked Workplace 2 1 2 7 1 13 89 by place and time to that setting) Education 1 4 3 3 11 6 3 31 306 Hospital/hospice 2 4 6 23 Other 1 1 13 In the last 7 days Clusters 1 1 1 1 1 5 17 Cluster Care home/service (two or more cases Childcare associated with that Workplace 1 1 1 setting but not “connected by time and Education 1 1 1 1 4 16 place” to that setting) Hospital/hospice Other In the last 7 days Exposures 1 2 1 2 10 4 2 22 29 Exposure Care home/service 1 3 1 5 7 (single case where there Childcare 1 1 2 2 has been (or potentially Workplace 1 1 3 been) exposure to Education 2 1 6 4 1 14 17 contacts in that setting) Hospital/hospice Other

Total active situations 94 641 • Please note that this summary covers all situations classified as ‘active’. An active situation has had at least 1 positive case within the previous 28 days. • Although outbreaks have increased this week and are related to a particular setting - it is important to note that the majority of cases are due to community household transmission. • University cases are included in the Education category. 14 Winter Flu - Protecting the Immune System Winter Flu immunisation uptake up to to end of week 46 (15 Nov 2020) This data represents 78.3% of GP practices uploading their data for week 46. Please note that individuals can appear in more than one cohort, e.g. pregnant and in risk category.

Number of further Total Number eligible Number of immunisations Target Group immunisations required to Target % people given meet target Over 65 106,900 78,605 1,570 75% Under 65 at risk 71,272 29,032 24,422 75% Pregnant Women 4,284 1,138 2,075 75% 2 and 3 year olds 17,835 7,697 5,679 75%

The table below shows that in 2020/21 flu uptake has improved in all eligible categories compared to the same period in 2019/20 with the exception of pregnant women, which shows a slight reduction.

Total Combined At Risk STP Year 65 and over Population 6months to All Pregnant Women All Aged 2- 3 under 65 years

Northamptonshire STP 2020/21 73.5% 40.7% 26.6% 43.2% Northamptonshire STP 2019/20 62.7% 29.5% 28.4% 9.8% Northamptonshire STP Change +10.8% +11.2% -1.8% +33.4%

15 Public Health Measures

• Public Health Northamptonshire, Environmental Health departments within District and Borough Councils, Northamptonshire County Council and Northants Police have, and will, use enforcement powers where there is non-compliance in relation to COVID-19 Regulations. • The Health Protection (Coronavirus, Restrictions) (England) (No. 4) Regulations 2020 came into force on the 5 November 2020 and amongst a number of new provisions impose restrictions on a variety of businesses within our local communities. • There are a number of well established forums within Northamptonshire to discuss our approach and consider the implications of these new Regulations. • A number of protocols are being developed and shared across all relevant enforcing authorities so that we can provide a consistent approach across this County. • We will continue to engage, explain and encourage within our community to ensure the new provisions are implemented to support public health with the aim of reducing the transmission rate of COVID-19. • Notwithstanding this approach, there are a number of existing provisions including wearing face coverings in certain settings; gatherings and a failure to self-isolate when required to do so, which will result in the use of proportionate enforcement powers aimed at protecting public health.

16 We Are All In This Together

• To find out more information about local testing sites visit: https://www.northamptonshire.gov.uk/coronavirus- updates/Pages/coronavirus-testing-in-northamptonshire.aspx. • Tests can be booked online at nhs.uk/coronavirus or by calling 119. Home testing kits can also be ordered subject to availability. • It is vital that when you leave the house to be tested you must go straight to the testing centre and return home immediately to self- isolate until you get your results. • Advice on how to access a COVID-19 test can be found here: https://www.gov.uk/guidance/coronavirus-covid-19-getting- tested.

17 Partners Working on the COVID-19 Response PHE – Public Health England An executive agency of the Department of Health and Social Care (DHSC) which is the expert national public health agency which fulfils the Secretary of State for Health and Social Care’s statutory duty to protect health and address inequalities, and executes his power to promote the health and wellbeing of the nation. We work with the Midlands PHE Office.

Local Public Health Teams Part of Local Authorities (Upper tier and unitary) since 2013, led by Directors of Public Health with a number of specific statutory responsibilities, including health protection and local control of infectious diseases including immunisation and related functions.

Joint Biosecurity Centre (JBC) The JBC aims to provide evidence-based, independent analysis, assessment and advice to inform local and national decision-making in response to COVID-19 outbreaks. This includes: • helping to inform action on testing, contact tracing and local outbreak management in England • informing an assessment of the risks to UK public health from inbound international travel • advising on the COVID-19 alert level • acting as the main point of liaison between Local Authorities and the Chief Medical Officer and Secretary of State.

Environmental Health Officers Work within District and Borough Local Authorities and are responsible for monitoring and enforcing health and hygiene legislation. They are working closely with Public Health Northamptonshire on COVID-19 workplace outbreaks, with the COVID-19 Schools Cell and Northamptonshire County Council’s Test and Trace service.

18 Government Help, Guidance and Fines

• Financial support is now available for eligible individuals who have to self-isolate for up to 14 days. Details of financial support can be found here.

• Those who do not follow Test and Trace guidance, or those who breach self-isolation, will be fined.