COVID-19 communications: Living with COVID-19: local clusters and outbreak control

As this next phase of the pandemic develops, it has become increasingly clear that local government will play a pivotal role in controlling the spread of the virus through effective local cluster and outbreak control.

As this next phase of the pandemic develops, it has become increasingly clear that local government will play a pivotal role in controlling the spread of the virus through effective local cluster and outbreak control.

Alongside high-profile cases such as Leicester and Blackburn with Darwen, councils up and down the country are taking rapid, data driven, measures to identify local infections clusters and outbreaks at a very early stage and intervening to prevent them worsening.

Communications and engagement are a vital part of this process, potentially the most important part, and the relationship between public health teams and communications teams is fundamentally important. Essentially, for the purposes of local outbreak control, the functions must operate as one team.

Know your areas of risk and watch your data

Communications leaders and health communications leads should have as good a knowledge of emerging health data as public health teams, and should ensure that they are in receipt of this data on a regular basis. It is also important to work with public health colleagues to pool local knowledge and assess areas, settings and communities of risk in your local area and ensure that you have a bespoke communications plan for any high risk areas, alongside your template outbreak communications plan.

Ensure that you are scenario planning, both with your public health teams, and within your communications teams. How would you deal with an outbreak in a local factory or primary school? Who would your stakeholders be, locally, regionally, and nationally? How well do you know the setting and its communities? What channels would you need to use and how quickly could you access them?

Establish your channels and partnerships in advance

When it comes to local outbreak comms, speed is absolutely of the essence. Having an effective and accurate knowledge of and easy access to local, and hyper-local, information channels is vital to enable a rapid communications response. Most councils have excellent digital channels, but with substantial gaps in their reach, especially amongst vulnerable groups. Door to door distribution in affected areas is powerful and reaches everyone. Many councils no longer have easy access to such channels, especially if they don’t produce a regular print publication.

Setting up contracts for ad hoc deliveries with local distributors in advance of any local incidence of COVID could be one solution, or working with other council teams, such as estate cleaners, to see if they can deliver hyper-locally could be another. Most GPs surgeries have the ability to text all patients on their roll. Work with your local CCG or GPs’ Confederation to ensure that you have knowledge of practice boundaries and easy access to those systems.

Ensure that your relationships with key community leaders, the voluntary sector, businesses, and other stakeholders are strong, current, and easy to mobilise. 

Community cohesion

When a cluster or outbreak arises in a particular community or setting, there is a real risk of communities or businesses becoming stigmatised. The fear of this carries a risk of outbreaks being concealed. Councils have a very important role to play in managing community relations and community cohesion, and reassurance of effective groups. This will involve very careful messaging, engagement with local media and stakeholders, active management of misinformation on local online forums, and building a reputation for becoming the repository of reliable and trustworthy information on the local COVID-19 situation.

Test and Trace

The NHS Test and Trace system is a vital tool in the battle against Covid-19 and councils have an important role to play in maximising public understanding of and engagement with the system. Research in London shows that whilst most people have heard of Test and Trace, many have very little understanding of what it involves. YouGov research for the Greater London Authority (GLA) in June 2020 showed that 46 per cent of Londoners would not know how to access a COVID test and that BAME Londoners and over 65s would be least likely to know. Insight from a number of boroughs showed a high level of distrust from residents in sharing data through the system and that could lead to an unwillingness to engage with it.

This was particularly true of younger people and some minority communities. London is launching a citywide ‘Keep London Safe’ campaign, focusing in the first phase on clear messaging on how to get a test, and in the second phase on building awareness of and trust in the contact tracing system. Councils should carry out local insight work to inform communications, and understand specific local barriers to engagement and local areas should consider developing their own collateral to support and enhance the national messaging.

Case study: Hackney Council

Hackney’s suburb of Stamford Hill is home to Europe’s largest Charedi Orthodox Jewish population, estimated to be nearly 30,000 people living in the North East of the borough, with an additional 3,000 Charedi households over the border in Haringey. Charedi communities live a highly communal and religiously observant life, having no access to television or mainstream media, and very limited digital access.

It is not always easy to engage with them on public health messaging, and it was clear in the early stages of the pandemic that Charedi communities in Israel and New York were being hit hard by COVID. Hackney Council and its health partners moved fast to establish a highly effective partnership with the community, focusing on healthcare, communications and engagement, and humanitarian assistance. This was crucial in those early weeks as the community moved into one of its most important annual festivals, the Passover holidays, in which communal worship and intergenerational family celebrations are widely observed.

The partnership forged in early lockdown has continued to strengthen and grow. This allowed the Council to respond rapidly when infection data began to indicate small numbers of linked household clusters of Covid. Hackney immediately activated a communications programme, including getting leaflets into 20,000 homes in Hackney and Haringey within three to four days, advertising and editorial in community media, texts from local GPs practices, and a short film featuring the community ambulance service Hatzola to be shared on  local WhatsApp networks. As throughout the pandemic, key community leaders were used to help shape and nuance the messaging to ensure that it had the right tone and was culturally competent.

Although the confirmed positive numbers are still small, there is a low level of awareness of testing in the community. There was also significant anecdotal community intelligence that infection levels were higher than testing had revealed. Hackney worked with the Department of Health and Social Care (DHSC) to deploy a Mobile Testing Unit(MTU) into the community, using a local Jewish school site identified by the Borough Emergency Control Centre. Many community members welcomed the MTU but rumours began to circulate through community WhatsApp groups that testing would lead to local lockdown and the closure of schools and synagogues, and encouraging people to boycott the MTU. The council’s established relationships with local religious and community sector leaders helped us to reassure people and ensured that the site was well communicated into residents. On it’s first day of operation, it ran nearly at capacity, with around 75 per cent of those being tested being from the Charedi community.

City and Hackney Public Health Intelligence Team is developing a data dashboard that will play an important role in helping to identify these highly localised clusters at an early stage.

The data management software used to build the dashboard will allow for timely data refresh and a range of analyses including but not limited to trends over time, recent trends, geospatial as well as analyses by such characteristics like age and sex. Once more detailed data becomes available, inequality analyses looking at differences in testing uptake, and case detection, as well as contact tracing outcomes by ethnicity and occupation will be performed. The results from these analyses will help to inform local action and set strategic priorities around service delivery. Any detection of significant emerging trends will enable the council to shape a rapid community response, with effective communications at its heart.