Sheffield Covid report says that poor state of city’s health had big impact on outcome

Director of public health Greg Fell has devoted the whole of his annual report on Sheffield’s health for 2023 on analysing the way that the city was hit by the pandemic and what lessons should be learned.

A total of 1,952 people died in the city and there were 13,500 hospital admissions, the report says. One million Covid tests were undertaken at home and at test sites and 210,600 cases were confirmed by testing.

The report says: “The overall story on health for Sheffield is one of stalling (and in some areas declining) life expectancy and healthy life expectancy over the last decade or so. Like almost everywhere else we went into the pandemic in poor shape health wise, and this had a significant bearing on outcomes in the pandemic.”

“People living in the most deprived areas of this city experience both shorter lives and a greater proportion of their lifetime in poor health relative to people in the least deprived neighbourhoods,” the report notes.

“A baby born in Firth Park can expect to live one-third of their shorter life with poor health, with a large proportion of that in working age. A baby born in Carterknowle and Millhouses will live one seventh of a longer life with poor health.”

Preventable

Around 30% of the differences in life expectancy between the richest and poorest areas are due to more people in poorer areas having cardiovascular and respiratory diseases, which are preventable conditions.

The report will come before Sheffield City Council’s health and wellbeing board next Thursday (September 26). The agenda states: “Covid-19 was the most significant emergency since World War Two, and we can be certain that at some point in the future, there will be another pandemic.

“It is important to note that many lost their lives during this pandemic, and that this is still raw for the loved ones left behind.”

The public health report outlines three key points:

• Data saves lives;
• The need to prepare, plan and act on a whole city basis;
• The response to a future pandemic cannot ignore the “structural determinants of how infection spreads and resulting poor outcomes”.

Mr Fell says that he had previously been involved in two planning exercises around what to do in case of a pandemic. “The point of planning exercises is to be prepared. Unfortunately, society did not take heed of the important lessons from these exercises.”

Inequalities

He adds that a pandemic influenza plan for Sheffield stood the city in good stead and informed the measures that were taken.

The report says: “As we later saw, underlying social and economic inequalities badly impacted outcomes from the pandemic. Factors such as overcrowded housing and not being able to afford to isolate really mattered for transmission.

“This did not become apparent until too late. One of my critical bits of learning was that we went into a pandemic with an infectious disease control playbook, but it soon became apparent this was not sufficient.

“We could not control spread with only the traditional tools of health protection which for a respiratory virus were based heavily on a pandemic influenza scenario.

“A whole of society response, considering underlying structural inequalities was necessary. The importance of a trusted message and trusted messenger became particularly apparent early on.”

The city public health team were on high alert from January 2020. The report says: “Sheffield’s first cases came towards the end of February when two passengers from the Diamond Princess cruise ship were transferred to our specialist infectious diseases unit.

Battle

“More cases came, in particular from people travelling home from European February half-term holidays where the virus was spreading rapidly, and it took off from there.”

Mr Fell describes “a long and uphill battle” to get access to all the data needed to assess accurately the position in Sheffield. This took four months to achieve but by summer 2020 weekly reports became available using data from different sources.

He says that the full ‘stay at home’ lockdown saw cases drop significantly and the later rules such as social distancing, table service at licensed premises, travel restrictions and wearing masks continued that trend.

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Numbers began to climb again in September 2020, when people’s desire to ‘get back to normal’ led to more social mixing. Mr Fell says that the return of university students also played a part but was not a key factor.

A rise in cases prompted a second lockdown in November 2020 that ended on December 2.

Mr Fell says that the Covid vaccine introduced in December 2020 “had a limited effect on transmission but a very significant effect on preventing serious illness and death”.

Exposed

The rapid spread of the Alpha variant of Covid in January 2021 led to a third lockdown, when schools were again closed, people were asked to work from home and socialising was restricted.

The report says: “Poorer people were in jobs that could not be done from home, so were more exposed to the virus (and therefore illness and death) on a daily basis. By the time Delta [one of the Covid variants] came around, most eligible people had at least one if not two vaccines.”

Mr Fell says that more people from black and Asian communities died of Covid, mainly because of poverty, inability to work from home, overcrowded living conditions and some vaccine hesitancy.

Average uptake of the vaccine across Sheffield was above 75%, the highest of the core UK cities.

Mr Fell’s report says: “I would like to pay tribute to the people who looked after those who were made ill with Covid-19.

“To those who provided essential support, especially to the most vulnerable. To all people across the whole of the city that kept Sheffield running in some of the most testing years of our lives, we all owe you a debt of gratitude.

“Secondly, I would like to pay my tribute to all those who lost their lives to this illness, and to the loved ones they leave behind.”

He also pays tribute to colleague Louise Brewins, who died unexpectedly in November 2021.