The purpose of this report is to present the 2020 Director of Public Health (DPH) annual report and to seek the support of the Health and Wellbeing Board in implementing the recommendations.  The report identifies key areas for action to tackle some of the societal impacts of COVID-19.

Rebecca Howell-Jones, acting director of public health, introduced the annual report, the principal points of the presentation included:

1.         Course of the pandemic to date: at least 3% of the population in Herefordshire had tested positive for COVID-19 but the true number of infections would have been much higher; the pattern was generally the same as that seen across the country, albeit with some lag in terms of rising trends and with lower case rates between each wave; a peak in July 2020 was linked to a specific outbreak; and attention was drawn to the graph on ‘weekly number of COVID-19 related registered deaths in Herefordshire’ which reflected the shift in the location of deaths from care homes in the first wave to hospital in the second wave.

2.         Impact of COVID-19: in addition to the effects of the virus itself (severe disease, long COVID, and deaths), there were also short and long term effects associated with the control measures (including economic, physical and mental wellbeing, healthcare seeking behaviours, and education impacts).

3.         Wider impacts on health and wellbeing: attention was drawn to a table ‘Health effects of social distancing measures and actions to mitigate them’ by The BMJ and it was commented that the wider impacts were likely to contribute to morbidity and mortality in the county in the future; and all services and sectors in the system were asked to consider the breadth of the impacts and what could be done to mitigate the risks.

4.         Living with COVID, keeping Herefordshire’s most vulnerable safe: clinically extremely vulnerable people (3% of the population had been on the ‘shield’ list in 2020) had been asked to stay at home and isolate for extended periods of time; the clinically vulnerable (1 in 3 residents) had also been asked to undertake protection measures; the people most affected by the disease included the elderly (93% of deaths had been in the 65+ population) and the staff and residents of care homes; and there was a national picture of the virus disproportionately affecting the most deprived or BAME groups but it was not clear from the data currently to confirm whether the same had been experienced locally.

5.         Economic and financial: the higher numbers of small businesses (90% employed less than 10 people) and self-employed workers (17% were self-employed, compared to 10% nationally) potentially increased vulnerabilities in the local economy; the restrictions around COVID and the implications of Brexit were likely to have impacts for the seasonal workforce; the full extent of the impacts on job losses and incomes were not yet known; and food and fuel poverty had increased nationally, and the proportion of pupils eligible for free school meals had also increased locally.

6.         Wider impacts, health and social: there had been impacts on health behaviours, with people in the most deprived areas being more likely to be affected, resulting in higher levels of risk (such as obesity, smoking and alcohol harm); and mental wellbeing was a major issue, Mind had declared  ...  view the full minutes text for item 16