Cabinet meeting: 29 July and 2 August 2021

• Rt. Hon. Mark Drakeford MS (Chair)
• Rebecca Evans MS
• Vaughan Gething MS
• Jane Hutt MS
• Julie James MS
• Eluned Morgan MS 
• Jeremy Miles MS
• Mick Antoniw MS

• Julie Morgan MS
• Lynne Neagle MS
• Lee Waters MS

Apologies

• Lesley Griffiths MS (2 August)
• Dawn Bowden MS (2 August)
• Hannah Blythyn MS (2 August)

Officials

• Shan Morgan, Permanent Secretary 
• Des Clifford, Director General Office of the First Minister
• Will Whiteley, Deputy Director Cabinet Division
• Toby Mason, Head of Strategic Communications
• Jane Runeckles, Special Adviser
• Madeleine Brindley, Special Adviser
• Alex Bevan, Special Adviser
• Daniel Butler, Special Adviser
• Ian Butler, Special Adviser
• Kate Edmunds, Special Adviser
• Sara Faye, Special Adviser
• Clare Jenkins, Special Adviser
• Andrew Johnson, Special Adviser
• Mitch Theaker, Special Adviser
• Tom Woodward, Special Adviser
• Catrin Sully, Cabinet Office
• Christopher W Morgan, Cabinet Secretariat (minutes 2 August)
• Damian Roche, Cabinet Secretariat (minutes 29 July)
• Helen Carey, Cabinet Secretariat (2 August)
• Tracey Burke, Director General, Education and Public Services
• Andrew Goodall, Director General, Health (29 July)
• Reg Kilpatrick, Director General, COVID-19 Crisis Coordination
• Andrew Slade, Director General, Economy, Skills and Natural Resources
• Frank Atherton CMO (2 August)
• Chris Jones, Deputy CMO (29 July)
• Andrew Sallows, Delivery Programme Director NHS (2 August)
• Rob Orford, Chief Scientific Adviser Health (29 July)
• Fliss Bennee, Co-Chair TAC
• Liz Lalley, Deputy Director Recovery
• Tom Smithson, COVID-19 Restart (2 August)
• Chris Stevens, COVID-19 Restart and Recovery (29 July)
• Michelle Morgan, COVID-19 Restart and Recovery (29 July)
• Aimee North, Technical Advisory Cell (29 July)
• Laura Andrews, KAS (29 July)
• Chris Roberts, KAS (29 July)
• Brendan Collins, KAS (29 July)
• Helen Lentle, Director Legal Services (29 July)
• Dylan Hughes, First Legislative Counsel
• Jo-Anne Daniels, Director Mental Health, Vulnerable Groups and NHS Governance (29 July)
• Jason Thomas, Director Culture Sport and Tourism
• Neil Buffin, Senior Lawyer
• Terry Kowal, Senior Legislative Counsel (29 July)

Item 1: Review of Coronavirus Restrictions (No.5) Regulations – 5 August – initial discussion 

Public health situation report

1.1 The First Minister asked officials to provide a brief presentation on the overall public health situation in Wales, after reminding Cabinet the restrictions relating to COVID-19 were for the purpose of preventing, protecting against, controlling or providing a public health response to the incidence, spread of infection or contamination. There must be a threat to public health and the restrictions had to be proportionate in what they were intending to achieve.

1.2 It was noted transmission of coronavirus continued to increase in many areas across Wales, although several areas were now reducing or close to stable in terms of weekly change.

1.3 Cases across Wales had increased rapidly since the beginning of June, following a six-month sustained reduction in cases, with an 800% increase from a very low baseline. The cases appeared to mainly occur in younger people, notably those aged 10-29, which suggested vaccination was providing a degree of protection, but there was some evidence of spread to older groups.

1.4 It was reported data from the previous few days had suggested plateauing rates, possibly starting to decline. However, it was too early to suggest the decline was a short lived response to the end of the school term, or whether a more meaningful improvement was being seen.

1.5 Cabinet noted that estimates of infection from the ONS Covid Infection Survey were still awaited, along with further information on whether the reduction reflected a similar decrease in test seeking behaviour amongst younger adults. Fewer tests had been undertaken over the past week and case positivity rates were high.

1.6 COVID-19 pressure on the NHS remained well below levels seen in previous waves, although if cases continued to rise in older age groups, hospital admissions were likely to follow.

1.7 The number of new daily hospital admissions with suspected or confirmed COVID-19 remained close to the lowest levels seen, however there had been a slight increase in the number of beds occupied with COVID-19 related patients in recent weeks from 10 daily to around 20. This was still at the lower end of numbers during the pandemic response and in line with more optimistic scenarios.

1.8 A small increase in patients occupying critical care beds had also been observed, with 19 patients in critical care as of 18:00 on 28 July. This was seven lower than Tuesday 27 July and seven fewer than the previous Wednesday. This equated to a figure 88% lower than the peak experienced in the winter.

1.9 These numbers added pressure to a service attempting to process patients delayed by the pandemic. Overall though, patients presenting with COVID-19 were less sick than during previous waves. Anecdotally, most new patients were not fully vaccinated.

1.10 At present, cases were tracking close to the most likely scenario, as were hospital admissions, however critical care admissions and occupancy were tracking closer to the reasonable worst case, although these were still much lower than previous waves in absolute terms. This discrepancy could reflect altered thresholds for clinical decision making about critical care need.

1.11 The data on deaths continued to be very low and the number of deaths was tracking slightly lower than the most likely scenario. However, the most likely scenario did predict a sustained level of cases between the summer and late autumn, but as with all modelling of the virus, there was uncertainty over this and the Government would consider the most recent data when making decisions on the proportionality of any restrictions.

1.12 In terms of the vaccination programme, as of 22 July, 90.1% of adults in Wales had received their first dose, and 78.8% had received their second dose, which equated to more than 2 million people.

1.13 It was anticipated that 80% of adults would have received their second dose by 29 July. The vaccination programme was working with the intention of offering all adults their second dose by the end of September. Significant efforts were underway to ensure nobody was left behind and Cabinet requested a note on the autumn booster programme, planning for which was underway.

1.14 It was estimated that 85% of adults could be fully vaccinated by week commencing 9 August, subject to people coming forward.

Self-isolation

1.15 The First Minister introduced the next item for discussion, which considered whether to remove the requirement to self-isolate for people who had been fully vaccinated for longer than 14 days. 

1.16 Cabinet previously considered the issue and signalled implementation for 7 August.

1.17 Cabinet considered whether there was merit in bringing forward the planned changes in Wales, based on input from various sectors over their current staffing levels and operational practicalities.

1.18 A number of steps would need to be taken from an operational and legal perspective to have this change ready for 7 August or sooner.

1.19 There was potential for up to 500 TTP staff to be fully integrated with the vaccine checking system by next week, with the remainder of the approximately 1,200 staff following afterwards to ensure the system remained stable.

1.20 Cabinet requested further information for the next meeting about how the more generous Protect offer would work for those harder to reach groups who were often disproportionately impacted by any requirement to isolate and noted the offer might need to be backdated, which was an approach undertaken previously.

1.21 Cabinet discussed the issue of timing and it was noted the considerable pressure public services were facing, including police forces, local authorities, health and social care, hospitality, manufacturing and retail, along with a HGV driver shortage.

1.22 It was noted staff absences across these sectors were due to a number of reasons including self-isolation, other sickness absence, summer leave, recruitment issues, Brexit and furlough, but removing self-isolation as one of the elements would ease the burden on these sectors.

1.23 Having fully considered the balance of harms, Cabinet agreed to remove the requirement to self-isolate for people who were identified as close contacts, if they had been fully vaccinated for at least 14 days. Cabinet agreed the change would be announced before the weekend.

1.24 Cabinet would return to the Coronavirus Control Plan and the issue of whether to move to AL0 at the next meeting.

Item 1: Minutes of previous meetings

1.1 Cymeradwyodd y Cabinet gofnodion y 12, 14 a 15 Gorffennaf / Cabinet approved the minutes of 12, 14 and 15 July.

Item 2: 3 week review of COVID-19 Regulations

2.1 The First Minister introduced the paper, which requested a steer on the current review cycle including proposals to move to Alert Level 0.

2.2 Ministers were again reminded that the restrictions relating to COVID-19 within the Coronavirus Control Plan were for the purpose of preventing, protecting against, controlling or providing a public health response to the incidence, spread of infection or contamination. There must be a threat to public health and the restrictions had to be proportionate in what they were intending to achieve.

2.3 The First Minister invited the Chief Medical Officer to provide the latest advice in respect of the transmission of the virus and the public health situation.

2.4 In general terms the rate of infection was stable, with the seven day average around 144 in every 100,000 of the population, and Local Authorities were reporting that the situation was improving. It was likely that the school holidays had provided a natural firebreak and data from the ONS survey, which was due to be published the following week, would provide more information. Improvements were also being reported in England and Scotland.

2.5 However, there was some concern with the 25% drop in people being tested for the virus, particularly amongst young people.

2.6 In terms of the vaccination programme, over 90% of the adult population had received their first dose with 80% now fully vaccinated. There was evidence that this was having an impact on transmission rates as the seven day average infection rate in the over 60s was around 50 in every 100,000.

2.7 The Delivery Programme Director of the NHS reported that as at 30th July there were currently 171 people occupying hospital beds with COVID-19 related symptoms. 14 of these were suspected and 138 were confirmed cases. Overall the rate of increase in admissions had slowed and the time patients were spending in hospital with the virus had greatly reduced, which was due to the success of the vaccination programme.

2.8 Cabinet noted that the decision to bring forward the removal of the requirement to self-isolate for those who had been fully vaccinated to 7 August had been well received.

2.9 In terms of the recommendations within the paper, Cabinet agreed that the legal limit on the number of people who could meet in private homes, public places or events should be removed. Furthermore, the requirement for reasonable measures should be amended, so each organisation could determine based on the outcome of their specific risk assessment. Ministers also agreed that adult entertainment venues could re-open from 7 August.

2.10 Cabinet confirmed that the regulations should also be amended to remove the explicit requirements to collect contact information and it should become one of the number of reasonable measures that businesses should consider when preparing risk assessments.

2.11 Ministers agreed that the requirement for face coverings in hospitality settings should be removed from 7 August.

2.12 The approach to the development of guidance for Alert Level 0 was noted.

2.13 It was reported that the (principal) The Health Protection (Coronavirus Restrictions) (No. 5) (Wales) (Amendment) Regulations 2021 and the Health Protection (Coronavirus Restrictions) (Functions of Local Authorities) (Wales) Regulations 2020 were due to expire on 27th August and Cabinet agreed that they should be extended by 4 months, with a new expiry date of 31 December 2021.

2.14 On a general point, Cabinet opposed the action of the UK government to incentivise the roll-out of the vaccination programme to young people in England, as there was a concern that this could lead to people delaying their inoculation until such rewards were available. The focus of the vaccination programme in Wales should always be on social responsibility and taking precautions to protect the wider society.

2.15 Cabinet had a wide ranging discussion around the re-opening of night clubs, as there was a concern that such venues had the potential to become ‘super-spreaders’ of the virus, given the characteristics of nightclubs, including number of people in a confined, noisy space.

2.16 However, balanced against the fact that night clubs were already open in England, the potential risk that people instead would hold unregulated house parties, and the need to be consistent with the relaxation of the rules for other premises, Cabinet concluded that such venues could re-open from 7 August, in-line with what had already been signalled. Although, there would be a need to make clear that should the re-opening of night clubs result in an exponential growth of the virus Ministers could reverse this decision.

2.17 Cabinet confirmed the move to Alert Level 0 on 7 August.