COVID-19 First Wave - Somerset's Response

Preventing and controlling infection

In order to reduce the risk of the virus spreading, the Accident and Emergency departments at Yeovil and Musgrove Park hospitals both split their services into COVID-19 and non-COVID-19 sections. In social care, a new 37-bed ‘pop-up’ care home was set up at Hendford Court in Yeovil for COVID-19 patients unable to return home, particularly on discharge from hospital. The Corona Helpline was set up by Somerset’s County and District councils to provide information and advice on council services and practical support during the epidemic and received nearly 7,000 calls by the end of June.

Personal Protective Equipment (PPE) was regularly distributed to over 800 health, care and education providers, including visors and eye protection donated by local businesses. Infection prevention and control training was provided by NHS Somerset and Public Health England to care homes and schools, and a webinar held by Somerset Public Health gave information and guidance for local business on preventing COVID-19 and how to respond to cases.

Managing the outbreak and testing

There have been mobile testing sites in Taunton at Silk Mills Park and Ride and Taunton Racecourse, as well as access for Somerset residents to sites outside the county. There were 44,874 of these ‘Pillar 2’ tests, for the general population, down to the end of July 2020. ‘Pillar 1’ tests – for those in clinical need and NHS and care staff – are undertaken and reported on a different basis, but for rough comparison approximately 11,000 such tests were undertaken in the month of July.

COVID-19 is often described as a ‘disease of clusters’, and 70 outbreaks – linked cases in a shared location – were managed by the NHS, County Council and PHE down to the end of July. The NHS and Council formed joint teams to rapidly set up systems to deliver testing, PPE, Infection Prevention and Control, and support to Care homes during the first wave of the pandemic.

As numbers began to decline in the summer, the initial response was superseded by the ‘Local Outbreak Management Plan’, launched on 30th June 2020. This set up the systems to monitor outbreaks and to take advantage of the greater capacity to test, trace and isolate people testing positive for COVID-19 that was not present at the start of the pandemic.

Use of health services

Use of GP and hospital services in Somerset fell dramatically after lockdown. A&E attendance and urgent referrals for suspected cancer in Somerset were 60% lower in April than at the start of the year, reflecting national trends. Routine surgery, cancer screening programmes and NHS health checks were suspended. These changes are likely to lead to an increase in late diagnosis of cancer and other long-term conditions such as diabetes, when treatment is more difficult.

Figure 4: Trends in hospital activity in Somerset May 2019 - May 2020

Voluntary and Community Responses

At the community level, small scale voluntary and charitable action was immediate and focused. Somerset’s 60 village, community and carer agents from the Community Council for Somerset assisted 40,000 vulnerable people with over 53,000 activities including distribution of food parcels and prescriptions, and the voluntary sector organisation Spark Somerset launched Corona Helpers, recruiting and matching 1,300 volunteers with 103 local COVID-19 response groups. The Somerset Activity and Sports Partnership supported over 36,000 children, families and older adults with ‘live’ projects and online guidance to help them maintain physical activity. The Somerset Coronavirus appeal, organized by the Somerset Community Foundation, raised over £1 million and provided more than 180 grants to local organisations.

MIND Somerset extended its Helpline to be 24 hours per day, seven days per week, receiving over 5000 calls in three months. Local authority and NHS Somerset Facebook and Twitter posts received 13,800 hits related to mental health communications, and reflecting the rising death rates, additional bereavement services were stood up in May.

Nationally, the Trussell Trust saw an 89% increase in food bank parcels given in April 20 compared to the previous year. One food bank in Somerset, the Lord’s Larder, reported demand nearly tripling between February and March. The Lord’s Larder have seen particularly high demand in households with children. Other groups disproportionately affected include those who were self-employed or had reduced income due to furlough, and families with a long-term condition. Locally, partners have worked together to develop a strategy to maintain supplies to food banks and to families in need.

Children supported by Lord's Larder food bank (Lord's Larder)

Rough sleepers were prioritised by central government early in the pandemic and through the ‘Everyone In’ intervention, provided with emergency accommodation. In Somerset, 160 rough sleepers were accommodated. By mid-July, 62 of these rough sleepers had moved into permanent accommodation. Rough sleepers are likely to have poorer physical and mental health than the general population. This cohort is additionally vulnerable to COVID-19 because of underlying health conditions, inability to access sanitation facilities and inability to self-isolate. The response included blood borne virus screening and treatment via Arc’s Health Link Worker. Approximately 40% showed signs of current or past hepatitis C infection and two thirds received treatment.

Physical Activity and Social Distancing

The need to maintain physical distancing has affected many aspects of our lives but has led to a few opportunities to encourage physical activity in new ways. This has included a £120,000 scheme for new pedestrianisation, cycle routes and one-way walkways in town centres including Taunton and Yeovil.

Figure 2: Pedestrianisation and social distancing in Taunton as shops reopened

With gyms and other sports facilities closed for an extended period, many providers of services have looked at new ways to help people using the internet; this included online support and advice for physical activity provided by Somerset Activity and Sports Partnership (SASP).

Lifestyle in Lockdown

Lockdown had both positive and negative impacts on lifestyle. In terms of diet, more people reported heathier eating habits. However, consumption of unhealthy snacks also increased. The economic impact led to a steep rise in food insecurity increasing reliance on food banks.

At a national level, a third of adults increased exercise and drank less. Another third drank more and exercised less. Lockdown was an incentive for some, particularly those aged under 30, to stop smoking. A reduction of up to 60% in Somerset traffic is likely to have contributed to an increase in outdoor activity. Walking and cycling were at an all-time high and an increase in online exercise classes provided benefit to many.

Uptake of physical activity was not equal. Groups who were less active before lockdown, including people on low incomes, those with disabilities, women, older age groups and some black and other minority ethnic groups, still found it difficult.

Shielded Patient List Activity Survey

Research carried out by Somerset Activity and Sports Partnership (SASP), in partnership with Somerset CCG at the end of lockdown in July 2020, aimed to examine the effects of the pandemic on those that were shielding and their ability and motivations to be physically active.

Please follow this link: https://www.sasp.co.uk/shielded-list-survey

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Did you know?

In 2014 14.9% of Somerset households were estimated to be in fuel poverty. - Fuel poverty