Members will be aware that health inequalities existed in Bradford District before COVID-19.  The impact of COVID-19 has shone a light on inequalities in terms of poor outcomes relating to deprivation and ethnicity. 

The Director of Public Health will present a report, Document “C” which describes health inequalities, provides national and local data on health inequalities in relation to COVID-19, and discusses what actions have been taken to date and actions which are planned.

Recommended –

That the report be noted.

(Kathryn Ingold - 01274 437041)

Members were aware that health inequalities existed in Bradford District before COVID-19, however, the impact of COVID-19 had shone a light on inequalities in terms of poor outcomes relating to deprivation and ethnicity. 

The Director of Public Health presented a report, Document “C” which illustrated health inequalities in the District, provided national and local data on health inequalities in relation to outcomes relating to deprivation and ethnicity and discussed what actions had been taken to date and actions which were planned.

The Leader of Council, whilst acknowledging the measures outlined in Document “C”, stressed the necessity for structural inequalities in the city to be solved; she reported her belief that living in poverty limited life choices and that health inequality was the most important issue of the time.

Information included in the report revealed that all deaths would identify COVID-19 as the cause of death if life was lost within 28 days of a COVID-19 diagnosis and the rationale for that decision was questioned.  The Director, Bradford Institute for Health Research, explained that this was to provide international standardisation as previously a number of countries had been recording deaths differently. 

A Member referred to data suggesting that the South Asian population death rates were similar to Caucasian deaths and it was confirmed that was the case.  Data revealed that the risk of transmission was greater among people living in crowded places or those in low paid work.  Some blood groups had been identified as having a very small genetic component but the greatest risks were environmental factors. 

Increases in positive test results were questioned with one Member suggesting that decisions to lock down communities should be based on the number of serious disease as opposed to positive tests.  It was acknowledged that high levels of COVID-19 were being identified in the community as the number of tests increased but stressed that people were still getting seriously ill.  It was explained that more positive cases were being identified amongst young people.  As Bradford had the youngest population in the country the positive test results would be high.  Reductions in serious illness may be due to the effectiveness of social distancing or more herd immunity than was first thought.  It was felt that there were some signs of hope but caution against complacency was advised.

The Director of Public Health confirmed that younger members of the population were statistically more likely to recover but cautioned that they could still pass on disease to other people who may not.  Assurances were provided that the Government did not base lock down decisions on the number of positive tests alone but considered a number of factors. Bradford had a higher positivity rate than the rest of Yorkshire and Humberside and the goal was to reduce the positivity rate to 1 % or below.

A view was expressed that some Government measures were making people unhealthier as their impact on young families, education and the economy was causing intense suffering.

The Leader of Council confirmed that the area was not currently in lock down and explained if that was the case more stringent measures would be in place. She explained that the decision to close sectors of the economy was made by the Government and the Council did not have those legislative powers.  It was felt that insufficient testing had been undertaken at the beginning of the pandemic to understand the correlation between infection and deaths.  The number of deaths occurring in the district together with the distress to family and friends was reported and it was stressed that throughout the pandemic  the focus had always been to preserve life. It was not known how high the rates would have to be to be considered unsafe and whilst wanting to avoid lock down at all costs it was understood that people would not wish to go into the economy if the felt they would not be safe.  The Chair stressed the necessity for public leaders to be speaking with one voice.

The accuracy of self-testing was questioned and Members were advised that all tests in the area were classed as self-tests.  It was acknowledged that there had been some inconclusive results.

A Member suggested that testing people for anti-bodies could provide more useful information than testing for the virus.  In response the Director, Bradford Institute for Health Research, explained that it was not known if people who had contracted the virus could contract it again and that they could still spread the virus to others. A Member questioned that statement and believed anti body testing would have helped the situation in nursing homes where he felt people had been treated badly and that this was not being addressed.  He maintained that anti-bodies would afford protection and would provide an indication of the people who had been affected.

The Director, Bradford Institute for Health Research, acknowledged those points.  He explained that there were a lot of home based anti-body tests which had not been properly evaluated.  More information was required and it was believed that more accurate testing methods would be available shortly. 

A Member questioned how many positive tests had been recorded on people who were asymptomatic.  It was explained that positive tests had been provided from people who were asymptomatic but they often did not have enough of the virus to provide an accurate result and it was preferable to test people with symptoms as more accurate results were provided.    It was confirmed that the majority of asymptomatic patients were young people although it was not certain why that was the case.  Bradford was part of the national immunity studies and it was hoped that the studies would provide more valuable information on in the coming months.

Following questions about the long term effects of the disease it was explained that a number of affects were being seen with people suffering issues including chronic fatigue and palpitations.  National and regional discussions were being held about that issue and Bradford had one of the first long term COVID clinics in the country.

A Member questioned when the infection would be eradicated and she was advised that it was feared that the virus was here to stay. 

The Director of Public Health and the Director, Bradford Institute for Health Research were thanked for their informative report and presentation and Members were assured that health inequality would continue to be included on the Committee’s Work Programme and picked up throughout the year.

Resolved –

That the report be noted.

ACTION: Director of Public Health