Agenda item

To understand the current position and the impact of long Covid-19 in Buckinghamshire

Dr Jane O’Grady, Director of Public Health, Buckinghamshire Council.

Neil Macdonald, Chief Executive Officer, Buckinghamshire Healthcare NHS Trust.

Dr Jane O’Grady, Director of Public Health, Buckinghamshire Council (BC), provided a presentation appended to the minutes.  Dr O’Grady stated that, so far, Buckinghamshire had had over 73,000 cases of Covid-19 and over 1,280 deaths; the cumulative case rate per 100,000 was lower than England but higher than the cumulative case rate in the South East.  Death rates had been lower than England and the South East average.  A map showed the number of cases per 100,000 in Buckinghamshire which were particularly high in the south of Buckinghamshire, Aylesbury and High Wycombe town centre areas.  Over the previous week Dr O’Grady highlighted a hot spot in the Wing/Bierton area which largely reflected the cases in school aged children and the parental age group.  Case rate graphs were shown for the different age groups for 0-18 year olds; there had been a peak which then dropped due to half term; there was a lag in the data and the case rates in school age children were rising again.  The adult age range graph showed much lower case rates than children in schools due to the vaccine take up; however, the 19-29 age bracket had started to rise again.  At the start of the pandemic, higher rates were seen in those living in deprived areas and front facing roles; however, in the latest week the trend had reversed and was now higher in the least deprived groups as the main place of the epidemic was in school age children who took it home to their parents.

New hospital admissions had decreased slightly and the number of hospital inpatients had plateaued.

A slide provided the number of deaths from Covid-19 during waves one and two; there had been 10 Covid-19 related deaths in Buckinghamshire during the last week which showed that the vaccine was preventing serious consequences and Covid-19 related deaths. The majority of adults had received two doses of the vaccine but there were approximately 60,000 unvaccinated residents who could end up in hospital.  Dr O’Grady urged everyone to have their first and second dose and also the booster dose which had shown to be very effective.  Inequalities in vaccine uptake were being addressed through outreach clinics to encourage vaccine take up. 

Dr O’Grady advised that the Office for National Statistics estimate 1.7% of the population had or had had long Covid-19 with one in five suffering significant limitation in their daily activities.

The Vice-Chairman, Neil Macdonald, added that a specialist hospital base for long Covid-19 had seen approximately 550 referrals between January and October 2021 and there were currently approximately 10-15 referrals per week.  It offered a combination of physicians, physios and psychologists.  Demographics attending were similar to the national demographic; mainly females in their 50’s; there was also a dominant pattern of people with a high body mass index (BMI) and pre-existing significant mental health issues.  There was no defined treatment for long Covid-19 apart from rehabilitation. BHT was participating in the ongoing research and it was expected that there would be a large demand for services and an online rehabilitation cohorts had been launched which would be able to treat large numbers of people.  The key benefits were to validate their concerns and to reassure and signpost patients to other services. N Macdonald stressed that the understanding of the long term impact of long Covid-19 was still at an early stage.

The following key points were raised in discussion:

• The number of people being referred with long Covid-19 was the ‘tip of the iceberg’; there was a large number who were experiencing protracted recovery which impacted the workforce.  The impact needed to be considered from a workforce and health service point of view.  The Chairman added that signposting was available to BC employees.
• Children and young people were also suffering from long Covid-19.  They generally had a milder illness but a significant proportion had debilitating long covid symptoms. 
• Dr O’Grady stressed that being vaccinated significantly reduced the risk of getting long Covid-19; there was also avoidable risk factors such as a high BMI or smoking.

The need for communications regarding references and resources was highlighted. N Macdonald referred to the webpage entitled ‘Your Covid Recovery’.