This week saw the return of politicians to Tynwald and the first in person committee hearing as the Social Affairs policy Review Committee heard evidence on the decision making that led to our third lockdown. With the stage set, let’s meet the players.
Julie Edge MHK (chair)
Martyn Perkins MHK
Peter Greenhill MLC
Hearing the evidence of:
Education Minister Dr Alex Allinson
Health Minister David Ashford
Chief Secretary Will Greenhow
DESC ceo Graham Kinrade
DHSC interim ceo Kathryn Magson
Director of Public Health Dr Henrietta Ewart
This summary should not be seen or read as a verbatim transcript of the committee hearing, the full sitting can be heard here.
Julie Edge – Hi everyone, please make sure your phones are on silent and let’s get on with the show, we’re meeting face to face AND IT’S LIVE.
First lockdown was March to June 2021, then we had a second one in January 2021 and our third one finished just yesterday. We’re focussing on the decisions that led to Lockdown 3.0.
We’re very concerned that the Chief Minister confirmed on Jan 9 that the Kent strain was circulating. There were cases in schools on Feb 19. In your written evidence, you gave conflicting answers as to when the virus was in schools, which is right?
Dr Allinson – Our situation has been very different to the UK and we haven’t had the same waves they’re experiencing. However this year we had a single point of entry with one person leading to an outbreak.
We had cases in schools on Feb 26, which were not believed to be related to the Steam Packet case. One of them was someone who worked in a school and contact tracing said it was low risk as there was no obvious link to school students or teachers as they worked outside of school hours.
March 1 a student at SNHS, we had a direct link and we had to decide what to do and we announced the closure of schools the following day.
Julie Edge – On the contact tracing for Feb 19, there was concern around a school bus and that was given out as a location of risk. The Steam Packet UK crew case was announced on Feb 11 and the Manx based crew was Feb 18.
Dr Allinson – Index case was linked to a later date. The UK based member of crew was picked up in the UK but produced concern for us. You’ve asked about the BBC article in response to the island based crew member testing positive. There were then 15 further cases across three households. All this happened during half term when contact tracing looked at the index case and their children, they found that the only time they could have mixed was outside of school. As a precautionary measure we issued locations such as the school bus but at that point there was no evidence of a risk to that school.
Julie Edge – Dr Ewart, schools opened on feb 1 and we contact traced until feb 12. They were only open 10 days prior to half term, did it not ring alarm bells that we were tracking back to Feb 12?
Dr Allinson – We take advice in terms of risk, there is a difference between alarm bells and risk and that is based on the evidence at the time. You talk about the January outbreak, that was very different, we could trace that back to a particular scenario. The risk profile of this did evolve during the course of the outbreak but originally it seemed it was confined to close households. There was extensive contact tracing and info made available to the public. The tracing team does a very good job.
Julie Edge – So you knew in Jan it was the Kent variant?
Dr Ewart – No. We know we’ve had cases of it on island since November/December and links were made to the Patient Transfer. The January outbreak wasn’t the Kent variant, it was another one.
Dr Allinson – We know the risk from travelling has been significant. But the January outbreak was not Kent but we had to assume any outbreak here was. In some ways we were fortunate it wasn’t and that probably was why we had a relatively low number of cases but we were almost certain it would come here.
Julie Edge – So you assumed it was Kent, what was the January variant?
Dr Ewart – We’ll publish it.
Julie Edge – Was genomic sequencing carried out on the school cases?
Dr Ewart – Yes first 2/3rds of positive cases in this outbreak was sent for testing. They all show they link to the index case.
Dr Allinson – Last year genomics was useful as it was from different sources of entry but this time it was a single index so we knew where it came from anyway. We have to rely on the tracing team and genomics often won’t give answers we need.
Julie Edge – Contact tracing, it was half term. The school also said there was a positive case in the school.
Dr Allinson – They said it was their school community, which is different between being in the school itself. The most likely spread was on the Saturday after schools had finished. There was no evidence of an outbreak in the school.
Julie Edge – How far did contact tracing go on that student with the school and who decided what was done?
Dr Allinson – The team acts on the advice of the European Centre for Disease Prevention and Control. It isn’t an exact science. But it looks at close contacts, mixing of households and going back three or four days to see when there is possible spread. Coronavirus has varying incubation periods and Kent is particularly difficult as so many people have no symptoms. All close contacts were checked and they came back negative.
Julie Edge – So contact tracing was done correctly?
Dr Allinson – Yes. All the relevant people were contacted and asked to isolate, test and trace.
Julie Edge – From a public health point of view, the norovirus advice is to stay away for 48 hours, but the advice for Covid doesn’t seem to have been clear.
Dr Allinson – Norovirus advice is based on symptomatic cases, it is different to Covid and particularly the Kent variant. But we have clearly communicated what people do if they have symptoms.
Julie Edge – Mr Kinrade, were you involved in the tracing and decision making with schools?
Dr Allinson answered instead – Again, the positive case was Feb 13. There was no communication with the head teacher before then. We contacted the head teacher when we knew there was a case but our department doesn’t get involved in contact tracing which is a public health matter.
Julie Edge – In hindsight, with regards to your department and members, contact tracing has a straightforward process to follow.
Dr Allinson – It isn’t straightforward. Staff wouldn’t be involved in diagnosing norovirus and equally they wouldn’t be doing that with Covid, they are employed to teach, not to be doctors.
Peter Greenhill – What does the school do for contact tracing?
Dr Allinson – They explain what the student has been doing, who they’ve been near etc.
Dr Ewart – There are two purposes to contact tracing, stopping forward transmission and to see where they caught it from.
Julie Edge – Going back to the case in the school which you said was out of hours workers. How did you establish they hadn’t been in contact with students and teachers?
Dr Allinson – How did I as minister do that?
Julie Edge – You have responsibility for schools.
Dr Allinson – The case of the person working at Bemahague raised concerns with track and trace and they looked at the risk they posed to the school. They hadn’t been in school for a number of days and were a low risk contact who had not come into contact with students or staff.
Julie Edge – CoMin decided not to bring in a lockdown the weekend but then you did on the following Tuesday. Mr Greenhow what was actually recorded that weekend? And will you share those minutes?
Will Greenhow – Yes I’ll share them.
Martyn Perkins – Why was a voluntary closure decided on?
David Ashford – We took a precaution because of the big events that were happening but remember the tests we had concerns over came back negative. We got the message out as soon as possible and advised people to make a choice and many of those events were cancelled. There was no way we could have brought direction measures in time for that evening.
Dr Allinson – We had an urgent meeting at 11am with nine high risk contacts, six results back negative and the Chief Minister gave a speech mid afternoon which said we had cases that couldn’t be linked and advised people to stay at home.
Julie Edge – It was possible to do a direction for venues and locations, why didn’t you?
David Ashford – I honestly don’t think we could have done it in time. It was important to get the message out there and that’s what we did.
Martyn Perkins – You knew there was a possibility of a new lockdown, couldn’t we have had the legislation ready to go?
David Ashford – You can technically just shut everything down. But given what we knew, we decided to tell people to make their own choices. We had no evidence of wider spread and we have to remember the context. On Sunday we had people, and Tynwald members, telling us we’d got it wrong and shouldn’t have said anything.
Dr Allinson – Getting legislation out isn’t just signing a piece of paper, so an advisory message was issued. If we had gone into lockdown then we’d have to have undone it if it came back negative so we issued advice.
David Ashford – As the Attorney General has said, you also need to give reasonable notice to businesses. We didn’t have the time to do that in a way because that could have risked prosecutions if they hadn’t heard.
Peter Greenhill – Did any events go ahead?
Dr Allinson – None of the big events did. I know the Palace Hotel closed as I was kicked out of my room. Some of the pubs and small events carried on and that unfortunately led to some other cases.
Julie Edge – Is it possible to know how many cases came from the Saturday and was any consideration given to business insurance over a closure order?
Dr Allinson – Treasury have looked at a financial package for that weekend.
David Ashford – An awful lot of businesses also can’t claim due to the pandemic clause in their policies.
Dr Allinson – You mentioned the Sunday press conference. We still weren’t clear how those cases arose. And we did warn a lockdown may yet happen.
Julie Edge – Who decided to make an announcement at 11.20pm saying only one school year at SNHS had to isolate?
Dr Allinson – That was a judgement made on the evidence that came forward. The decision to go into lockdown was made on Monday evening and the lockdown came into force 12.01am Wednesday morning. On the Monday we were dealing with the first positive case within the schools. The decision to isolate one year group was made on the basis of advice form contact tracing.
Julie Edge – Was that decision reached by head teachers?
Dr Allinson – No CoMin made that decision and I completely agreed with it.
Julie Edge – So it was Lockdown 3 by this stage, I would expect that some procedures were in place, do you think it was the wrong decision not to shut that school down?
Dr Allinson – We have very clear procedures which were drawn up last year and published online last year. We have to calculate the risk and on this occasion we had one case in a very large school. We isolated the school year and the following day all the schools were closed. It was the right decision at the time. Hindsight is a wonderful thing.
Peter Greenhill – Hypothetically if the same circumstances came up again, would you act in the same way?
Dr Allinson – Yes. We can’t just close the island down everytime we get a case. As we move forward, we have to accept the risk. I would not close all schools based on one case.
Julie Edge – Would you close one school down?
Dr Allinson – In hindsight there was an outbreak at Behmague but there was at many schools because we had widespread community spread.
Julie Edge – Not sure the public would agree, you had a member of staff and a student testing positive.
Dr Allinson – A member of staff who had not come into contact with teachers or students and a student who had a case that the evidence said was not spread in school.
Julie Edge – So I class an employee as part of the school community, but you don’t.
Dr Allinson – Yes I do but they were low risk.
Julie Edge – You’re confident the member of staff and the student are not two cases within the school community?
Dr Allinson – I am confident in the work of contact tracing.
David Ashford – Each outbreak is unique, we can have guides as much as we like but we have to respond to the evidence. We must make sure we don’t overreact or underreact. The speed at which we isolated the whole year group as soon as we had the evidence was actually quite good.
Julie Edge – It is quite clear that there will be no policy change within education.
Dr Allinson – I didn’t say that. We are doing a debrief on how we responded and looking at the plans we drew up last year. We have to take appropriate action based on when cases happen both in terms of pupils but also the wider community.
David Ashford – We have to start living with Covid. This week we will have 60% of the population having had a vaccine. Spanish Flu was around until the 1950s so we have to move to a mitigation phase.
Dr Allinson – If you look where we are now compared to last year, we have on island testing, we have vaccines and knowledge about how to deal with the virus. The response from the community has excelled what we’d hoped for.
Julie Edge – You kept hub schools open, who recommended that?
Dr Allinson – We didn’t have hub schools. In lockdown 1 and 2 we had hubs, this time we left schools open for the vulnerable students and essential worker children. This was done to facilitate the protection of the vulnerable children on the advice of head teachers.
Julie Edge – You knew it was the Kent Variant but you still had the vulnerable children going into their school so what was different so that all other students had to be out schools.
Dr Allinson – There is a difference between vulnerable children and those with a health vulnerability. We’re talking about people who may be on various registers, the looked after children, those sorts of things. We took the advice of Public Health and made a plan to get the smallest number of children, who definitely need to be in school, to be there in the best way. We brought in a whole range of mitigations but you can never reduce the risk entirely. It was because of the wider community spread that we had to close the schools and the childcare services down completely.
David Ashford – When you talk about vulnerable children, routine is very important and like me you’re very passionate about children’s mental health so any change to their routine is difficult and the DESC deserve praise for trying to keep things as normal as possible for them.
Julie Edge – Let’s move on. With regards to state of readiness for a lockdown. If there were unexplained cases today, how long would it take to lockdown?
David Ashford – We could do it the same day.
Dr Allinson – All these variants act differently but the way to respond to them is the same.
Julie Edge – Vaccination programme, not a lot of detail about if they help with the new variants?
David Ashford – In relation to the variants, it is difficult to determine as in a lab setting, it is different to real world tests. The vaccines still protect people from the worst of the virus, what you need is real world examples. Israel has shown different results to the lab trials. We are in the top 10 in the world for vaccines rollout.
Dr Allinson – Politicians need to be careful around statements on the success of vaccines and how they respond to the variants. So it is important that statements don’t undermine the rollout.
Dr Ewart – There are various elements which vaccines may or not have an impact on and the trials looked at symptomatic infection and the risk of serious illness etc. What they didn’t look at was transmissibility. It is possible to get a vaccine that may prevent you becoming seriously unwell, but you could still become ill and miss some days from work.
Dr Allinson – But don’t forget there is work being done on a booster programme.
Julie Edge – The South African variant has moved up north and is in Manchester. How are we going to keep public confidence in the programme?
David Ashford – The vaccine doesn’t stop you catching the virus, we have to be clear about that. But what matters is when someone catches Covid and the evidence seems to be at the moment that even when you have those different variants such as the Brazil one, it still seems to protect against serious illness. The risk from vaccination is minute compared to the risk from Covid. I’ve had Pfizer, the Chief has had AZ, so between us we’ve had the two.
Dr Allinson – Most of the cases of the SA variant are travel related, which is why the traffic light system is being introduced. The surge testing being done in areas such as Lewisham is to see if there is community spread which could be concerning.
Dr Ewart – The community aspect of the new South African variant cases found in South London show spread from before the quarantine hotel system was in the UK, but they are now stopping that.
Julie Edge – Have we had a case on the island?
Dr Ewart We have had a South African variant on island before the UK had the traffic light system but they had travelled to the island from Africa and it was an isolated case which didn’t spread. They also hadn’t travelled from South Africa so may not have been picked up in the UK hotel quarantine system.
Dr Allinson – We also need to work this out as we move forward. At the moment, if you live on the island but come from South Africa, you would have to isolate in the UK and then again when you get to the island. Is that fair? Well that’s a matter for debate. Is it the safest option? Well right now it probably is but we will have to work around that in the future.
Martyn Perkins – You should be congratulated on the rollout, the public have a very positive view on how it has gone. Just for the record, why didn’t they go to the police etc earlier?
David Ashford – The vaccine is about preventing death, not to stop people catching it. We considered it for phase two but by then it would have slowed down the rollout. We are now at the point where all adults under the age of 30 are being asked to register online and it would have caused significant problems if we had started to pick people out. I get why the Chief Constable wanted it for his officers but it wouldn’t have made much difference with the number of officers who ended up being off recently.
Julie Edge – Will you be reviewing the members of the gold, silver and bronze command structures? There seems to be a lot of repetition across these structures. It stuck out that the national infrastructure group didn’t have anyone from education for example.
Dr Allinson – In March last year I was asked by the Chief Minister to join the national strategy group to work with gold common to degenerate plans for education. I can’t recall how many meetings there were but I was in all of them and was involved with planning our response. After that it was less vital for me to be part of that group but there is an ability to bring in people to that group. The group often has to make decisions in real time and you may have breakout groups but at the end of the day they need as much info as possible at short notice to make decisions.
Will Greenhow – We will review the membership of it like we would with every situation that plays out, we will review how it has worked and what it dealt with.
Julie Edge – With some groups, it seemed that people weren’t aware of how decisions were made. The Home Affairs silver group for example didn’t have a member of DESC despite looking at key national infrastructure.
Dr Allinson – Yes but they aren’t absolute, they work together and share work. We need to be carely that at the time of an outbreak that the people are spending all their time in meetings, it’s how we run services and business that is the challenge and I think the structure has managed that challenge very well.
Martyn Perkins – Elephant in the room is our borders and that is key to how we get out. Are you all happy there has been enough input into this?
Dr Allinson – When we finish this evidence session, there is a session for members which will explain the various measures for an exit framework and we hope that it will bring the input with that. There are some people who want the borders open tomorrow with no restrictions and there are others who want them closed even more and we have to find a balance with that and seek Tynwald support.
David Ashford – There has been a lot of input into it from across gov. We do have to recognise there is a section of our community that will be very worried about no matter what we do. We will move in stages but this document has had more input in than any document I have known.
Julie Edge – What happened to the point by point rebuttal of Dr Glover’s PAC evidence?
David Ashford – We’ve now got the chance to speak to PAC and we will be doing that instead.