REPORT OF HEALTH AND HEALING ADVOCATE –
Dr Christine Anne Macleod. August 2020.
I am nearing the end of my second term as Health and
Healing Advocate with the Eastern Synod. Since May 2020, because of the
COVID-19 pandemic, I have been recalled to work as a Consultant in Health
Protection with Public Health England. I had finished studying at Glasgow
University for the Diploma in Hygiene and Tropical Medicine at Glasgow
University in April 2020 and so became eligible for this post, still holding my
GMC registration and being on the Specialist register for Public Health.
During this work I became involved in the production of the
internal documentation of the Public Health Management of COVID-19 in a place
of worship as I was representing the East of England.
Since 10th August 2020 there is enhanced recording of settings exposures
including documentation of places of worship in the history of individuals with
COVID-19. Also, there are co-incidence reports by postcode. Our own church for
example has Wetherspoons, a hotel and our church all in the same postcode. Some
churches have a unique postcode.
When a setting is identified the Local Authority may
inspect the premises to ensure that they are COVID-19 secure. Individual contact
tracing is done by the track and Trace system which has three Levels. Level 1
is Public Health England. This is by telephone enquiry. Three local authorities
in East are also in the “lost to follow up” pilot study, following up people locally
who fail to respond to Track and Trace.
I have been impressed by the Synod office ability to keep
up to date with the government guidance and to keep local churches briefed.
Our own church has a service of worship on 23rd
August 2020 and I did the foyer duty taking a note of attendees for the
purposes of track and trace.
In the event of somebody being in the church with a
positive COVID-19 test, there are definitions of contacts. Therefore, social
distancing is important. Two metres is important for various reasons.
Direct close contacts are direct face to face contact with
a case for any length of time, including being coughed on or talked to. This
will also include exposure within 1 metre for 1 minute or longer.
Proximity contacts are extended close contact (within 1 –
2m for more than 15 minutes) with a case
Contacts also include those who travelled in a small
vehicle with a case or bigger van/transport where social distancing was not
maintained.
Confirmed cases are those people with a laboratory positive
case of COVID-19 with or without symptoms.
A suspected case is somebody with a new continuous cough or
high temperature or a loss of, or change in, normal sense of taste or smell
(anosmia).
Therefore, we ask that people with symptoms do not attend.
Each day the Eastern Field epidemiology service produces a
report by lower tier local authority on the incidence of new cases, the numbers
of cases in the last 14 days, and any exceedances in terms of unexpected rise
in cases. Reviews with explanations are shared with the Director of Public Health
teams, with local follow up. We often hear on the news when outbreaks occur in
factories and pubs etc. So, there is a system for surveillance and public
health intervention.
An outbreak in a place of worship is defined as two or more
confirmed cases of COVID-19 among individuals associated with the place of
worship with onset dates within 14 days,
AND ONE OF:
· Identified
direct exposure between at least two of the confirmed cases in that place of
worship (e.g. within 2 metres for over 15 minutes) during the infectious period
of the index case OR
· Absence
of alternative source of infection outside the setting for initially identified
cases.
When an individual is being followed up by Track and Trace,
they will be asked to identify their contacts and can let them know. However,
the contacts are followed up by track and trace through their contact numbers.
Where a place of worship is identified the church will be asked if they are
willing to share their information to help Track and Trace.
In the event of a place of worship becoming involved, there
is a public health action checklist. This checks against the guidance that has
been issued to make places of worship COVID-19 secure.
To help with such a situation there are template letters to
go out to those identified as close contact advising them to self-isolate for a
period of 14 days and when the last date of isolation will be, along with
advice. There is also a “warn and inform” template letter to attendees who were
there but do not need to take extra precautions, along with advice.
I had an antibody test through work recently and this was
negative implying that I have not had COVID-19. However, I now keep a diary as
in the event of contacting COVID-19 the period of infectivity is 48 hours
before symptoms until 10 days afterwards. With enhanced tracing questions are
now asked up to 10 days before symptoms, and I would find it hard to recall
where I had been.
We are now recruiting more staff into the Health Protection
Team as we also must prepare for seasonal flu and to be staffed adequately in
the event of a second spike of COVID-19.
Life has certainly become more restricted, and I have the
kit for home working, but do have to go into the offices at Fulbourn in Cambridge
periodically as we continue to induct new staff.
Please remember all the staff who are now also involved in
the reconfiguration into the National Institute for Health Protection while
they continue to staff 24/7 rotas protecting the public’s health. Their rotas
are extremely busy. Remember also patients who need to apply for hardship funds
to allow them to self-isolate and also handle job insecurity.
Christine MacLeod
26th August 2020.
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