‘We have done it once, we can do it again’

Interview with Debs Harkins, Director of Public Health, Calderdale Council

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This is part of a series of interviews with public health directors, published on 21 October 2020.

Calderdale had relatively low rates of infections all the way through lockdown, but that began to change as restrictions eased. By the start of August, the area found itself in the top 10 areas for the most infections per 100,000.

Director of Public Health Debs Harkins said: “It has meant we have been working hard to reduce transmission of the virus at a time when most areas had very low levels of infection – so I think our experience could be quite useful as we approach the next few months.”

‘We went out door-to-door’

Central to Calderdale’s approach has been partnership working with the community. The council works closely with a network of voluntary sector bodies across the borough known as community anchors.

These anchors have provided the cornerstone of the work that has been done with the community. It has focused on the largest town in the area, Halifax, which had the highest rates over the summer.

“In some parts we were seeing 400 cases per 100,000 people. It was really high and was concentrated in Halifax. We knew we had to work with the community to tackle the problem. With the help of our community anchors and neighbourhood teams we identified a number of Covid community champions.

“We had members of the public, voluntary sector employees and councillors – they went out and spoke to people in the neighbourhoods they lived and worked in. They knocked on doors and explained to people that there were high rates of infection. But it was about listening as well as raising awareness.

“For example, we set up a local testing centre and a lot of thought went into where it should go. The community felt it was important that it was in a neutral venue.

“There is a bit of stigma around the virus and it is easy for certain parts of the community to blame others.”

‘People need support to self-isolate’

Alongside the testing centre, the council set up a support hub. It means anyone who is self-isolating because of a positive test can ask for help with things such as getting food or medicine. It can be accessed online or via the phone.

“It is so important to provide people with help to isolate. The big thing that was missing was financial help and that is why I am so delighted the government is now offering the £500 support.

“We have also taken other steps. We’ve worked with local taxi drivers – encouraged them to wear masks, given them stickers asking passengers to wear them and we are offering testing as well. Our licensing committee supported this by requiring drivers to wear masks. We are now starting something similar with shopkeepers. We know people who do these public facing roles are more likely to come into contact with the virus.”

The approach worked. Infection rates in Halifax were falling by the start of September. “I’m not naïve enough to think it will stay like that. We are now seeing the second wave come and all parts of the borough are seeing positive cases so we are beginning to look at ways we can take the approach we have used in Halifax out across the borough.

“We won’t be able to do it as intensively, but we can certainly apply the principles we have learnt. One thing we want to do more of in particular is engage our primary care colleagues.

“I am already talking to GPs about the important messages we need to get out to vulnerable groups now cases are going up. We know a lot more about who exactly is at risk so for example we will be encouraging people with diabetes and heart disease to adhere to their medicines and get their management of their disease under control.”

Calderdale’s success with local contact tracing

Ms Harkins is also proud of the work that has been done to set up a local contact tracing system. The service went live in the middle of August and operates 9.30amm to 7pm during the week and from 10am to 4pm on weekends.

The service is staffed by 20 people drawn form the council and wider community, providing a wide range of expertise. Currently around 80 per cent of cases passed down by the national team because they cannot reach them are reached by the local team and asked to self-isolate.

“It has been working really well. People are much more likely to respond to someone calling from their local area than a national call centre. There are lots of things we have learnt though. For example, we are now working with the acute trust to help identify those patients who are in hospital.

“We have found ourselves in situations where we are trying to trace someone who is quite ill in hospital and we have contacted their family and they have been quite upset. We are learning so much all the time.”

The public needs positive messages too

Another element Ms Harkins wants to change is the approach to communication with the public. Calderdale, along with Bradford and Kirklees and now Leeds, are all areas where extra restrictions are in place.

“Across West Yorkshire, we want to move towards some more positive messaging. People naturally want to do things. See people they care about. If you keep telling them they can’t do this, or they can’t do that, the risk is some start to ignore you.

“We want to reframe it - to point out the things that can be done. We are going to be living with these restrictions for a number of months it looks like – and we have to give people hope and something more positive to think about.

“I am very apprehensive what the next few months will bring. We are all tired, but we will find the energy we need. We have done this once, we can do it again.”