Covid advice

Summary

A request was made for all Covid-19 advice considered by the Council of Ministers regarding border controls, testing, and lockdowns, resulting in the partial release of a confidential paper from December 2020.

Key Facts

• The Cabinet Office released a confidential Council of Ministers paper dated 3 December 2020 regarding border frameworks and testing.
• The paper sought approval to move to '3A of Borders Framework' and reinstate the Guernsey Airbridge.
• Risk assessments were conducted based on UK prevalence rates, factoring in a 4-fold under-reporting estimate.
• Calculations estimated that 16.5 to 28.4 infected travellers might enter the Island per month depending on regional prevalence.
• The response noted that the decision to relax restrictions depends on the government's risk appetite amidst winter healthcare challenges.

Data Disclosed

• 165 per 100,000
• 600-700 people entering per week
• 16.5 infected travellers per month
• 0.15 infected travellers released after 14 days isolation
• 0.33 infected travellers released after 10 days isolation
• 216 per 100,000
• 147 per 100,000
• 246 per 100,000
• 250 per 100,000
• 1000 per 100,000
• 28.4 infected travellers per month
• 0.28 infected travellers released after 14 days isolation
• 0.57 infected travellers released after 10 days isolation
• 3 December 2020
• 1 January 2021
• 14 December 2020

Original Request

I seek the publication of all relevant advice received and considered by the Council of Ministers on the topic of Covid-19 including the situation in the UK and Republic of Ireland, face coverings/masks in public, risk of spread to the Isle of Man, quarantining arriving residents and the circuit breaker lockdown between December 1 and January 14.

Data Tables (47)

Full Response Text

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Council of Ministers Paper No. 2020/523

Paper for Council of Ministers
Routine Business

Department/Board/Office Cabinet Office
Chief Officers Will Greenhow Responsible Officers Henrietta Ewart, Kathryn Magson, Ste Stanley Cut ups to be sent to Henrietta Ewart, Kathryn Magson, Ste Stanley Date of Council Meeting
3 December 2020

Title 3A of Borders Framework, Day 1 and 10 Testing & Guernsey Airbridge

*Collective Responsibility: (Mandatory field, please choose an option)

Matter of National Importance *Which of the 3 Government Strategic Objectives does this proposal comply with?

Not Applicable Which of the Council of Ministers Sub- Committees has considered this proposal?

Not applicable The proposal relates only to the Department’s core or statutory responsibilities

Not Applicable

Has appropriate internal and/or public consultation taken place? Internal Are there any resource/personnel implications? No Has Treasury concurrence been obtained where necessary? Not applicable Is the Department acting within its legal powers or has legal advice been obtained? (If yes confirm and provide evidence within the paper) Not applicable Are there any inter-Departmental implications?
Yes If yes, which other Departments are involved?
DHSC What is the intention of this paper?
Seek Approval Primary Legislation: Has Council Legislation Subcommittee approved the inclusion of the proposed Bill on the Legislative Programme. If Yes please give decision date:
No Major Policy Proposal/Primary Legislation:
Have you completed an Impact Assessment? If yes please attach a copy as an Appendix to the paper. Choose an item. Have you taken appropriate Corporate Communications Service advice?
Not applicable Does this initiative/announcement have a communications plan?
Not applicable Purpose of the Paper:

1. To provide an update on the current IOM and UK COVID-19 situation;
2. To seek Council’s direction on whether Council to move to 3A of the Borders Framework ahead of Christmas;
3. To provide a proposed implementation plan for a move to provide a Day 1 and Day 10 testing pathway for entrants to the Island and their households;
4. To seek Council’s approval on whether it wishes to reinstate the Guernsey Air-bridge and if so from what date.

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Assessing Risk

The average prevalence rate in the UK is currently 165 per 100,000 however this varies region by region as shown by the following table:

The following table calculates estimated risk based on the UK prevalence rate, the number of travellers per week and the different risk mitigation provided by possible isolation requirements. The UK Office for National Statistics data from England indicates a 4 fold under-reporting of the actual prevalence. This is factored into the figures in the table to provide a more accurate estimate. It should be noted that these calculations are heavily caveated – they are based on modelling which draws on data that is far from perfect however they offer a way of estimating risk based on reasonable ‘best-guess’ assumptions.

The number of individuals entering the Island has remained relatively consistent with around 600-700 people entering per week. If this number is used to calculate estimated residual risk, it results in the following:

 700 individuals per week  UK published prevalence rate 150, UK actual prevalence rate 600  Likely infected travellers per month – 16.5  Infected travellers released after 14 days isolation, per month – 0.15  Infected travellers released after 10 days isolation, per month – 0.33

Looking at the regional prevalence rate, and in particular the North West, the rate is 216 per 100,000 with Liverpool being 147 and Manchester 246. Many of those travelling to the Island will be embarking in the North West. If a rate of 250 per 100,000 is used, it results in the following:

 700 individuals per week  UK published prevalence rate 250, UK actual prevalence rate 1000  Likely infected travellers per month – 28.4  Infected travellers released after 14 days isolation, per month – 0.28  Infected travellers released after 10 days isolation, per month – 0.57 Confidential Page 8 of 19

Conclusions

The decision to relax border restrictions is complex and ultimately depends on risk appetite. Whilst there are signs of progress in the UK, particularly following the recent lockdown in England, transmission levels remain high and the situation is fluid.

The Island is experiencing the usual winter healthcare challenges compounded by the UK COVID-19 situation, demand for staffing and additional staffing required to nurse those isolating in hospital.

There is of course the impact on individuals who are unable to see family, particularly during the upcoming festive season. Clearly this will bring its own challenges such as mental health.

Taking all of these factors into account, it is the view of officers that it is not an appropriate point to relax border restrictions due to the risk of importing the virus and the subsequent chance that this could lead to seeding into the community.

Recommendation 2 –

a) Council is asked to determine whether to move to Level 3A before Christmas 2020, and; b) If it is determined to move to 3A before Christmas 3A, what the implementation date will be.

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Extending self-isolation of household members where a positive case is confirmed

Current procedure, illustrated at figure 1 below, based on Public Health England guidance, is for the remaining members of the household of a confirmed positive case is to self-isolate themselves for 14 days. Where a member of that household goes on to develop COVID-19 perhaps a few days after the first case, then their clock is reset and they begin 14 days afresh. Where a member of the same household remains virus free then current procedure allows for them to leave their period of self-isolation whether or not other members of the household continue to display symptoms.

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Figure 1

Within DHSC, the Clinical Advisory Group (CAG) are yet to consider the day 1 and day 10 pathway but will revert with their views on Wednesday 9th December. However it should be noted that members of the DHSC have been involved in the development of this pathway. Operationally DHSC can confirm that the current swabbing capacity can respond to the increased demand of a day 1 and day 10 pathway based on the current level of entry certificates. The CAG do support the propose change in secondary contacts self-isolation.

Conclusions

Recommendation 3 - Council is asked to agree the proposed implementation plan for a move to provide a Day 1 and Day 10 testing pathway for entrants to the Island and their households and that this is implemented in January 2021.

Recommendation 4 - Council is asked to consider whether to extend household self- isolation requirements to households of high risk exposure close contacts.

Recommendation 5 – Council is asked to consider whether to change current procedures and to extend the self-isolation requirements of a household of a confirmed case to 14 days from the last confirmed case within that household in appropriate circumstances.

1 European Centre for Disease Prevention and Control. Contact tracing: public health management of persons, including healthcare workers, who have had contact with COVID-19 cases in the European Union – third update, 18 November 2020. Stockholm: ECDC; 2020

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Part D – Consideration of whether to reinstate the Guernsey Air-bridge and if so from what date

Discussions with local operators indicate that reinstating the air bridge is commercially attractive but there may be more caution from Aurigny following the recent suspension. It is unlikely that commercial flights would be offered until the first week of February which is half-term in each jurisdiction.

The Director of Public Health has regular discussions with her counterpart in Guernsey and both are assured that the Guernsey cluster is now resolved with no evidence of further community transmission and that the cluster recently seen here has not led to community reseeding. Both DsPH are therefore able to support re-opening of the air bridge from a public health perspective. This decision is also supported by senior officers in the DHSC including Medical Director, Director of Nursing and CEO.

Conclusions

Given that both jurisdictions have no community transmission, a move to reinstate the air bridge could be justified.

In terms of timing, whilst commercial flights would be unlikely to commence until the New Year, it is possible to put in place the necessary Direction from the Chief Secretary to reinstate the air-bridge and administrative aspects. This could be done within the next week if Council determines to re-establish the air bridge. Even without commercial flights operating, non-commercial flights would be able to use the air-bridge.

It is suggested that if Council determines that the air-bridge should be reinstated, this should be done from early January 2021.

Recommendation 6 – Council is asked to determine whether to reinstate the Guernsey Air-bridge and if so from what date.

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Decisions Required:

The following decisions are sought from Council:

Recommendation 1 – Council is asked to note the data dashboard provided at Appendix 1 and the DHSC winter pressures set out within this paper.

Recommendation 2 –
c) Council is asked to determine whether to move to Level 3A before Christmas 2020, and; d) If it is determined to move to 3A before Christmas 3A, what the implementation date will be.

Recommendation 3 - Council is asked to agree the proposed implementation plan for a move to provide a Day 1 and Day 10 testing pathway for entrants to the Island and their households and that this is implemented in January 2021.

Recommendation 4 - Council is asked to consider whether to extend household self- isolation requirements to households of high risk exposure close contacts.

Recommendation 5 – Council is asked to consider whether to change current procedures and to extend the self-isolation requirements of a household of a confirmed case to 14 days from the last confirmed case within that household in appropriate circumstances.

Recommendation 6 – Council is asked to determine whether to reinstate the Guernsey Air-bridge and if so from what date.

Will Greenhow Cabinet Office 2 December 2020

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Appendix 1 – Public Health Dashboard

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Confidential Paper No. 2020/570

Paper for Council of Ministers Routine Business

Department Cabinet Office Chief Officer Will Greenhow Responsible Departmental Officer Steven Stanley Cut ups to be sent to Henrietta Ewart, Kathryn Magson, Kevin Willson, Mark Lewin Date of Council Meeting
21st December 2020 – Urgent Meeting 4pm-5pm Title COVID19 Borders Review

Collective Responsibility: (Mandatory field, please choose an option)

Matter of National Importance Which of the 3 Government Strategic Objectives does this proposal comply with?

Not Applicable Which of the Council of Ministers Sub- Committees has considered this proposal?

Not applicable The proposal relates only to the Department’s core or statutory responsibilities

Core

Has appropriate internal and/or public consultation taken place? Internal Are there any resource/personnel implications? Yes Has Treasury concurrence been obtained where necessary? Not applicable Is the Department acting within its legal powers or has legal advice been obtained? (If yes confirm and provide evidence within the paper) Yes Are there any inter-Departmental implications?
Yes If yes, which other Departments are involved?
DHSC, Cabo, DHA What is the intention of this paper?
Seek Direction Have you taken appropriate Corporate Communications Service advice?
Yes Does this initiative/announcement have a communications plan?
Yes Purpose of the Paper:
To update Council on the emerging situation in the UK and consider a review of the current Borders position and mitigations to protect the Island.

Confidential

1. Recent Developments Over the last few days there have been notable UK developments surrounding the pandemic with notable changes including :

 A new variant of the virus is now the predominant one in the UK (estimated 61% of infections);  It has a propensity for up to 70% more transmissible and carries a higher R number than the previous version (est 3.3 – 3.9 vs 3);  As a result the UK position has been significantly revised with a new Tier 4 introduced akin to local lockdown and previous plans for a 5 day Christmas relaxation have been significantly reduced to 1 day, with reductions in number of households;  The devolved administrations have also announced reviewed and strengthened restrictions, and the UK Health Secretary, Matt Hancock, is on record warning “This new virus is out of control”.

As a consequence many countries have considered their border position with the UK and with almost immediate effect implemented restrictions including:  Over 30 countries have suspended UK arrivals across Europe, Canada, India and Hong Kong;  France has shut its border with the UK for an initial 48 hour period including all manned logistics;  Even within the Common Travel Area, Ireland is purpoted to be considering imposing travel restrictions for ferries and flights from the UK.

Against this backdrop and global concern, the Isle of Man remains without domestic restrictions and therefore is at a higher risk of significant community transmission occur

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