Peterborough’s public health chief reflects on a year of COVID - from January 2020 meetings to the critical point we are now at

Dr Liz Robin has overseen the city’s response to the pandemic over the past 12 months, liaising with health services and community leaders and organisations to ensure Peterborough residents are able to stay as safe as possible.

The first patient with COVID arrived at Peterborough City Hospital on March 16 2020 - but preparations for the pandemic had already been ongoing since January.

Dr Robin said: “Within local authority public health and the local public sector system we kept ourselves aware of developments from quite an early stage.

“I remember we had our first multi-agency meeting about COVID back at the end of January, I was chairing that as director of public health but we were working with and talking to all the different public sector agencies, talking about needing to watch what was happening and keep an eye on this. We were having regular phone calls, and thinking through potential eventualities.

“Even at that stage the links between our local communities in Peterborough and the council, and the help our communities could give us was really important.

“I remember talking to a wonderful Chinese community representative at a really early stage who was talking to friends in Wuhan over social media, and giving me such good intelligence as director of public health about what was going on there, which really helped my thinking.

“There was all the official information, but there was someone able to give me information about what was happening abroad, and I really appreciated that. I think that our communication with all the communities in Peterborough is something that has been happening throughout the past year. It has been a real joint effort - some of the information and intelligence that we have been able to exchange has been really, really helpful to us in public health.”

On Friday, March 20 - just a few days before lockdown was announced (on March 23), Dr Emma Tiffin was due to take part in her regular health spot on BBC Radio Cambridgeshire - and Dr Robin said the programme was a crucial point in being able to get information out to residents across the county.

She said; “I remember writing frenetic emails about what information could we get out to the listeners, as the show has quite a high listenership, and people who have health issues might be listening, and they are a really important group to communicate with.

“By that stage we knew this was serious, I remember writing to Dr Tiffin, saying social distancing is really important, so please can you do a lot about social distancing - I’ve always been really pleased Dr Tiffin did that, as at that point the pandemic was doubling every three days. Getting that information out at that point just a few days before lockdown, that could have had some real benefit.”

While the information local communities in Peterborough were giving to health officials was vital, the council also realised the importance of making sure important messages - such as lockdown rules - reached all residents in the city. As a result, the council were one of the first to produce a range of videos, led by community and faith leaders.

Dr Robin said: “I was putting out a vlog as director of public health explaining the new lockdown rules, but really quickly, and we were possibly the first in the country, we were working with community leaders, and they translated them into the different languages, and did video blogs with what the rules were.

The videos were given to the police and officers had them on their police mobile phones so they could show them to people.”

The videos were then used by councils up and down the country - from Cornwall to Coventry - as authorities tried to keep the pandemic under control.

While in recent weeks and months Peterborough has been near the top of the charts for having the worst case rate in the country, Dr Robin said in general, the city had coped well with the crisis.

She said; “I actually think the city has done really well - we tend to be at the top of the rate chart in the later phases of lockdown. This happened with the first lockdown, we had high cases in May, and then in the November lockdown we didn’t really go down, we just levelled off.

“In this lockdown, other places have seen their rate fall much more quickly and Peterborough hasn’t, and for me that reflects the challenges in Peterborough.

“The city has higher risks than other areas can - a lot of people going out to front line work in sectors which are essential, so they have to carry on in lockdown, some people are in low wage or insecure employment, and there are risks associated with that in terms of having to go out of your home, in terms of needing to travel with others, a number of people living in a household with a number of others, either HMOs or multi generation households, so we have a lot of risk factors in Peterborough.

“Right from the beginning I’ve known that and I think worried that Peterborough would shoot up to really high rates at a time when everyone else was at low rates, or that we would be at the top at a time when rates were high, and we haven’t done that,

“I think community leaders have been brilliant, faith leaders have been exceptional, the vast majority of businesses have worked hard to keep their employees safe.

“I know there has been a level of interest and engagement in Peterborough - an awful lot of people in Peterborough have really contributed and done what they needed to and kept the rates down, and I just think we could have had a much worse time if they hadn’t.

“Every death is a tragedy, but if you look at our mortality rates over whole pandemic, Peterborough is well below the average - partly due to age structure in the city, but with our risk factors you might not expect us to be where we are - our community has pulled together to protect our vulnerable.”

When lockdown began, nobody knew what the next 12 months would hold - but while Dr Robin said she knew the virus would still be here, she was surprised vaccines were already available - and this week, she was pleased to get her first jab,

She said; “I think I knew this virus wouldn’t go away, and I think that all public health people knew this virus would continue because that is what viruses do, they are infectious, it is really hard to get rid of them.

“But I would not have predicted we would have an effective vaccine by now, and we do have a number of effective vaccines, so although it has been very difficult, the way the science has worked with developing the vaccines has been a real positive.”

So far the vaccine roll out across Peterborough - and the rest of the country - has gone well, with thousands of people in the city receiving the jab - and Dr Robin offered her assurance the vaccines are safe.

She said: “When we look at best data we have, which is for our elderly populations, we have seen a good uptake (for the vaccine) across Cambridgeshire and Peterborough - it is just about making sure everybody understands the benefit of vaccination, because people are bound to have their own thoughts about it. Everyone has a different life experience, everyone gets their information from different places. But I’d offer my assurance on safety, I was very pleased to take my Astrazeneca vaccine this week, and took my mother for her second dose a couple of days ago.

“Having said that the vaccine is fantastic, we are at a really important point in all this, because the vaccine takes time to work. For full effectiveness (from the first dose) you need up to three weeks after you have had your vaccine, then for full effectiveness you need two doses.

“At this point where there is quite a lot of protection but by no means full protection yet - a lot of adults have not had the vaccine at all - we need to be so careful, and we mustn’t relax social distancing.

“It is so critical we do what Peterborough has been good at, and continue to observe the rules, go and get a test if you have symptoms.

“We are at this transition point - it will get better but it will take time.”

The praise for frontline key workers has come from all sides over the past 12 months - and Dr Robin was keen to highlight the work of them all - from the medics at Peterborough hospital to food workers.

She said; “Our frontline health workers have been absolutely fantastic, and people at our hospitals have worked so hard, but so many people in Peterborough have gone above and beyond.

“Our NHS workers, our care home workers, the people who are working in supermarkets and the people going out to work in agriculture and food packing, and other high risk industries - all the people are needed to keep us fed and society going, and I want to pay tribute to all the front line workers.”

With rates in Peterborough and across the country now falling, lockdown is set to be relaxed in coming months - but lessons from across the pandemic will be crucial across all areas of public health for years to come.

Dr Robin is set to retire at the end of next month (she had been due to retire in January, but has continued in the role due to the pandemic) but said she was sure there had been a lot of good work that would help in the future. She said; “Before COVID started we had worked on a joint health and wellbeing strategy, with a lot of different measures across the system to support health.

“One issue we were focussed on was healthy weight, obesity, diabetes prevention and heart disease prevention, which is really important in the longer term to Peterborough. This has been a different year, a year where we have focussed on infectious disease and we have had to move our focus away from other important issues.

“What it has done is show what relationships we can build up across public health - going forward we have shown we can work together to prevent illness and deaths from COVID and I hope that those relationships carry on, and we understand communities and businesses organisations have the power.

“COVID is going to go on, but as time goes forward we should be using some of that knowledge and those community links to really push some of heart disease, diabetes and cancer prevention messages.”