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supported through Test Trace Protect to risk assess and manage the cluster orincident to prevent further transmission. This may involve self-isolation of individualcases or class groups, additional infection control measures, handwashing, socialdistancing measures etc. Consideration will be given to layout and separation ofstaff and children, the ages of children and likely adherence to measures. If thecluster has the potential to develop into an incident then an Incident ManagementTeam (IMT) will be established to consider any additional measures, such as classclosures or further testing.5.10Most clusters and incidents will be comprehensively dealt with under thearrangements described above, which allows for investigation and control measuresto be rapidly instituted, including wider testing of identified classes or groups, ifrequired. In rare circumstances, an incident will be so complex it will requiremanagement under the comprehensive formal structures of an Outbreak ControlTeam (OCT).5.11When and how an outbreak should be declared is explained in detail in theCommunicable Disease Outbreak Plan for Wales (2020). This provides a tried andtested approach for the investigation and control of infectious disease.5.12Therefore, clear processes and procedures are in place for the management ofclusters and incidents. In many circumstances these can be managed through theTest Trace Protect programme without necessarily the need for closures ofpremises or wider lockdown restrictions. Similarly, clusters of infection identified inour communities, within family groups for example, may be effectively managedthrough the Test Trace Protect programme without the necessity for wide spreadlockdown restrictions. In the event of a more significant outbreak of infection, robustarrangements are in place for investigation, management and control.5.13In addition to the powers available to Local Authorities, Welsh Ministers have powersunder the Coronavirus Act 2020 to ensure local actions are proportionate andprotect public health. Some powers are reserved to Welsh Ministers and the stepsto determining use of those powers are set out in the National COVID 19 Preventionand Response Plan to be published this month by Welsh Government. Where localdecisions are involved these will use existing Council governance mechanisms asdescribed in paragraph 5.5.6.EQUALITY AND DIVERSITY IMPLICATIONS6.1An Equality Impact Assessment has not been carried out in connection with therecommendations of this report as it concerns the endorsement of a regional planthat is applicable to the entire population of Cwm Taf Morgannwg rather than anychange to existing services or Council policy. Where service changes or specificrestrictions are introduced in response to COVID-19, these will be subject to anEquality Impact Assessment.7.CONSULTATION / INVOLVEMENT

7.1The Cwm Taf Morgannwg COVID-19 Prevention and Response Plan has beendeveloped in partnership between the UHB and three Local Authorities across theregion. Given the limited timescale for its development and urgent requirement toestablish this plan that responds to a major infectious disease incident, it has neitherbeen practical nor appropriate to undertake a wider consultation exercise.8.FINANCIAL IMPLICATION(S)8.1There are no immediate financial implications from the endorsement of the Plan.The wider financial implications of the Council’s response to COVID-19 wereconsidered in the Chief Executive’s report to Cabinet on 28th July 2020.9.LEGAL IMPLICATIONS OR LEGISLATION CONSIDERED9.1There are no legal implications arising from the recommendations in this report.10.LINKS TO THE CORPORATE AND NATIONAL PRIORITIES AND THE WELLBEING OF FUTURE GENERATIONS ACT.10.1This report is fundamentally concerned with protecting the health and well-being ofour population in response to a serious threat to public health. As such, the plancontributes towards all the Council’s corporate priorities and to the Well-beingobjectives set out in Our Cwm Taf.11.CONCLUSION11.1Although the number of cases of COVID-19 are decreasing across Wales and theCounty Borough, there remains a risk of the resurgence of the infection as lockdownrestrictions are eased. It is possible that the Council will need to re-introducerestrictions, close or reduce services or take enforcement action to ensurecompliance with physical distancing or other infection control requirements.11.2The Councils and UHB in Cwm Taf Morgannwg will need to remain vigilant in thecoming weeks and months and respond in a timely and effective manner to anysurveillance information or intelligence that provides evidence of an increased riskfrom COVID-19 in our communities.11.3The Cwm Taf COVID-19 Prevention and Response Plan provides a comprehensiveand robust approach to how the region has responded effectively to the threat fromCOVID-19 and sets out clearly how it will continue to do so.Other Information:Relevant Scrutiny CommitteeOverview & Scrutiny Committee

LOCAL GOVERNMENT ACT 1972AS AMENDED BYTHE LOCAL GOVERNMENT (ACCESS TO INFORMATION) ACT 1985RHONDDA CYNON TAF COUNTY BOROUGH COUNCILREPORT TO ACCOMPANY THE DECISION OF THE LEADER13th AUGUST 2020CWM TAF MORGANNWG COVID-19 PREVENTION AND RESPONSE PLANBackground papers: Cabinet 28th July 2020Officer to contact: Paul Mee, Director – Public Health, Protection & CommunityServices – Tel: 01443 425513

APPENDIX 1CWM TAF MORGANNWG REGIONCOVID-19PREVENTION AND RESPONSE PLANA PARTNERSHIP APPROACHDraft Version 8As at 7th August 20201

CONTENTSMAIN REPORT - SECTIONPAGENO.41.0BACKGROUND2.0OVERALL STRATEGIC AIM53.0OVERARCHING OBJECTIVES54.0OVERSIGHT ARRANGEMENTS55.0PREVENTION66.0MITIGATION AND CONTROL87.0ESCALATION ARRANGEMENTS8.0MANAGEMENTOUTBREAKS9.0WORK STREAMS139.1 STRATEGIC AIM 1 (SA1) – SURVEILLANCE139.2 STRATEGICTESTINGSAMPLING AND169.3 STRATEGIC AIM 3 (SA3) – CONTACT TRACING ANDCASE MANAGEMENT179.4 STRATEGIC AIM 4 (SA4) – RISK COMMUNICATIONAND COMMUNITY ENGAGEMENT199.5 STRATEGIC AIM 5 (SA5) – PROTECT219.6 STRATEGIC AIM 6 (SA6) – COVID-19 MASSVACCINATION2310.0QUALITY AND SAFETY2411.0WORKFORCE AND FINANCE2512.0ISSUES LOG2613.0RISK REGISTER2614.0LESSONS LEARNT LOG26OFAIM10CLUSTERS,2(SA2)2INCIDENTS–AND12

15.0SITUATION REPORTING2616.0IMPLEMENTATION, LEARNING AND REVIEW26APPENDICES1ACTION PLAN (ATTACHED AT THE END OF THE MAIN DOCUMENT)2PROGRAMME OVERSIGHT ARRANGEMENTS3RISK ASSESSMENT TOOL4LOCAL ENHANCED COVID-19 MEASURES5SURVEILLANCE INDICATOR OVERVIEW6COVID-19 TESTING STRATEGY7RISK COMMUNICATION AND COMMUNITY ENGAGEMENTFRAMEWORK8LATEST ESTIMATED PROGRAMME COSTINGS9COVID-19 PREVENTION AND CONTAINMENT PLAN GUIDANCECHECKLIST3

CWM TAF MORGANNWG COVID-19 PREVENTION AND CONTAINMENTPLAN1.0 BACKGROUNDThe Public Health Protection Response Plan developed by Public Health Wales(PHW) on behalf of Welsh Government proposed three key elements:1. Preventing the spread of Coronavirus Disease (COVID-19) through contacttracing and case management.2. Sampling and testing different people in Wales.3. Population surveillance.Subsequent letters and guidance from Welsh Government and Public HealthWales, most recently dated 29th July 2020, set out that effective implementationof an integrated national and local system should be based on six principles asfollows: The primary responsibility is to make the public safe.Build on public health expertise and use a systems approach.Be open with data and insight so everyone can protect themselves andothers.Build consensus between decision-makers to secure trust, confidence andconsent.Follow well-established communicable disease control and emergencymanagement principles.Consider equality, economic, social and health-related impacts of decisions.This plan is the Cwm Taf Morgannwg COVID-19 Prevention and Response Plan,which builds on the above guidance and incorporates the former, approved CwmTaf Morgannwg (CTM) Test-Trace-Protect (TTP) strategic plan, so we retain one,over-arching strategic plan setting out our approach to prevention and response.For continuity purposes, it should be noted that this plan records what has alreadybeen delivered within the CTM TTP programme and importantly, sets out next stepactions.The plan contains a number of key sections (including those set out in the nationalguidance) and is supported by an action plan at Appendix 1.The action plan identifies those actions required by partners across the region tooperationalise the plan. It outlines work in each of the key areas in terms of whathas already been completed and what is planned to be done in the next stage,together with leads identified and deadlines for completion.4

2.0 OVERALL STRATEGIC AIMThe strategic aim for the CTM COVID-19 Test-Trace-Protect programme is:To put in place appropriate systems and capacities to ensure that, followingthe easing of lockdown measures, we do not see a rapid increase in illnessand deaths in our communities due to COVID-19 infection.3.0 OVERARCHING OBJECTIVESOur overarching programme objectives are as follows:1. Protect the health of the population by taking action to prevent and ifotherwise necessary, reduce the transmission of COVID-19.2. Ensure appropriate resources are in place to reduce the burden of COVID19 in CTM through the collective efforts of contact tracing, surveillance,testing and risk communication & community engagement.3. Ensure adequate sampling and testing capacity exists to sample all peopleidentified as possible cases or who present a high risk of transmission tovulnerable persons.4. Ensure local contact tracing teams are adequately resourced and are ableto provide a service across the whole of the CTM area 7 days a week.5. Ensure effective measures are in place for the control of clusters of COVID19 infection in: healthcare settings, other enclosed settings and the widercommunity.6. Ensure activity contributes to national surveillance efforts. In return ensurethat data / information obtained nationally or locally is applied to maximumeffect within CTM.7. Ensure an adequate and whole system approach to the support which maybe required by some people to enable them to successfully self-isolate andensure this support is provided openly and equitably across CTM.8. Test and deliver an end-to-end pathway for the delivery of a Covid-19 MassVaccination Programme within CTM ready for when required.9. Update and satisfy the CTM Chief Executives Group that sufficient resourcesand effective measures are in place and being utilised to control COVID-19in the CTM area.4.0 OVERSIGHT ARRANGEMENTSThe strength of the TTP programme in Wales is its focus on regional and localleadership delivered through robust partnership arrangements. This plan and anyoperational plans that sit beneath it have been endorsed by the Leaders and ChiefExecutives of the public sector organisations in the region.5

It is essential that all organisations are clear on the implications and actionsrequired to prevent the spread of COVID-19. In the unfortunate event that wemay need to implement additional measures, either preventative or in mitigationthat affect our communities, it will be essential that there is strong communityleadership at a local level in the decision making process.The local authorities have a critical role in implementing and enforcing anydecisions to introduce enhanced Covid19 measures or local lockdownarrangements should they be required. These decisions must be based on the bestavailable surveillance and intelligence provided by the UHB and PHW and madeavailable to the respective local authorities on a regular and timely basis.Each local authority will have its own governance arrangements set out in theirconstitution and Leader’s schemes of delegation and functional responsibilities.These set out how and by whom decisions are made. Key strategic decisions suchas the temporary closure of public services in an emergency or the imposition oflocal restrictions would be made by the Leader and their Cabinet, if urgent by wayof an Executive Decision. Other specific enforcement powers such as those underthe Health Protection (Coronavirus Restrictions) (No. 2) (Wales) Regulations 2020are delegated to officers to use in accordance with each Council’s corporateenforcement policies.If there is evidence to suggest that such enhanced measures are required for theprotection of public health the relevant local authority will be made aware as earlyas possible to ensure that any necessary decisions are properly considered andmade in accordance with the Council’s governance arrangements so that thenecessary measures can be appropriately and quickly introduced.The CTM TTP programme oversight arrangements are captured in a documentapproved by the Programme’s Regional Strategic Oversight Group on 9 June 2020.This has been updated to add in two recent, additional work streams and can befound at Appendix 2.Details are also contained on the relationship to the South Wales Local ResilienceForum and partnerships such as the Regional Service Board and two Public ServiceBoards.In essence the programme reports into the Chief Executives of the Health Boardand three Local Authorities, who meet on a regular basis, and is supported by: Regional Strategic Oversight Group – chaired by Professor KelechiNnoaham, Director of Public Health. Regional Tactical Group – Stage 1 chaired by Siôn Lingard, Consultant inPublic Health, Stage 2 to be chaired by an alternate Consultant in PublicHealth.It is important to note that this group also incorporates the role of RegionalResponse Team in managing incidents in COVID-19 clusters, enclosedsettings, & healthcare settings.6

Six Work Streams:o Surveillanceo Sampling and Testingo Contact Tracingo Risk Communications and Community Engagemento Protecto COVID-19 Mass vaccination.This plan consists of oversight of the six work streams and their respective workprogrammes. It acts as a vehicle to bring the work together and allow for oversightof actions, in order to monitor progress, actively review and set new direction asrequired. Further detail on each work stream can be found in section 9.0 below.5.0PREVENTIONOur PopulationThe resident population of Merthyr Tydfil, Rhondda Cynon Taf (RCT) and Bridgendis estimated to be 448,639 (Stats Wales 2020). The population aged over 65years make up 20% of the Cwm Taf Morgannwg population and are projected tohave the largest increase by 2036.Both Life Expectancy at Birth and Healthy Life Expectancy are lower in Cwm TafMorgannwg compared to other Health Board regions and lag behind the Walesaverage in men and women. More specifically, life expectancy at birth in menranges from 77.2 years in Merthyr Tydfil to 77.9 years in Bridgend, and in womenfrom 80.6 years in Merthyr Tydfil to 81.2 years in Bridgend. The degree ofinequalities in health in Cwm Taf Morgannwg is indicated by the fact that basedon data from 2015-2017, a girl born in Bridgend can expect to live 61.3 years ingood health, but would live only 56.5 years in good health if she was born inMerthyr Tydfil – a nearly 5-year gap.Cwm Taf Morgannwg is also likely to see a rise in the number of people livingwith a range of chronic conditions such as diabetes, heart and respiratorydisease as well as cancer and dementia. In addition, over 40% of people aged75 and over in Merthyr Tydfil and RCT live alone. The combination of multiplemorbidity with long term conditions and growing social isolation has an impacton the need people have for health and social care.The major health and wellbeing challenges which the health and care system areworking in partnership with communities to tackle therefore include: Frailty – and associated challenges presented by population ageing.Obesity/overweight – nearly 2/3 of adults in Cwm Taf Morgannwg beingoverweight or obese.Inequalities in health outcomes – as set out above in stark variations betweenpopulations in health life expectancy and life expectancy at birth, partly drivenby relatively higher prevalence in Cwm Taf Morgannwg of socioeconomicdeprivation and lifestyle choices that impact health adversely, such assmoking, poor diets, low physical activity and alcohol misuse.7

Loss of wellbeing (mental health).The importance of continued efforts across our community and public servicespartnerships to address these challenges through prevention has beenemphasised more recently by the evidence of how, both in isolation andcombination, they determine vulnerability to and drive adverse outcomes inCOVID-19.Prevention of COVID-19From the outset, the need to engage locally and provide information to promoteprimary prevention measures for COVID-19 has been an objective of the CTM TTPProgramme. Messages to workplaces, other settings, key workers and the generalpublic have been coordinated through the risk communication and communityengagement work stream (strategic aim 4). A key goal of this work stream is toensure that proper engagement with our communities to ensure we understandtheir perception of COVID-19 risk and the nature, determinants and distributionof knowledge, attitudes and practices related to the disease in those communities.This is fundamental to our approach to prevention and has meant that we havebrought together key communications personnel from local authorities and theHealth Board and sought to use all appropriate media to engage and communicateeffectively.We have been working with key settings – such as large employers or high riskoccupational areas to provide advice and assistance on ensuring primaryprevention measures are promoted. The Risk Profiling undertaken nationally bythe Military Liaison Intelligence Group identified that some of Wales’s largest sitesfor manufacturers are based in our Region. This is in addition to the large meatprocessing plant - Kepak Merthyr – which was the subject of a cluster of cases inMay 2020. Additional risks were identified for two large holiday caravan parkslocated in Porthcawl, Bridgend.Working with the National Health Protection Cell, a risk assessment tool has beendevised to assist Local Authorities in the area to identify key employers and makecontact to assess potential risks associated with the work environment orworkforce characteristics. This is attached at Appendix 3. Using local expertise,Welsh Government guidance and Healthy Working Wales materials, medium andlarge business based locally are being supported in providing a safe place to work.Welsh Government are de

2.1 The Cwm Taf Morgannwg COVID-19 Prev ention & Response Plan is endorsed and; 2.2 The Director of Public Health, Protection & Community Services regularly reviews and updates the Covid-19 Prevention & Respons e Plan to include changes in Welsh Government guidance and to incorporate the lessons learnt in responding to the