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Introduction

The Coronavirus Control Plan for Wales sets out how we will all work together to manage the risks of coronavirus in Wales.

Coronavirus has not gone away and we are likely to see an increase in cases over the autumn and winter as it becomes colder and everyone spends more time indoors.

This plan describes the different stages of the possible spread of coronavirus. It sets out how we will respond in different circumstances. This is a collective effort with everyone having a role to play. From businesses to local government, NHS Wales, Public Health Wales, the Welsh Government and every single one of us playing our part.

What are the different stages?

  1. Prevention
  2. New cases and clusters
  3. Incidents and outbreaks
  4. Local or regional measures
  5. All-Wales measures

Prevention

Prevention is the most important of all these stages. If everyone plays their part to prevent the spread of coronavirus we can keep it suppressed in Wales. If we can suppress the virus, we will not have to introduce wider restrictions or measures that can have such negative impacts on our lives, economy and society.

To do this we must all maintain good practices and encourage others to do the same. The risk factors are now well known, as are the most effective ways of protecting ourselves and others. This means:

  • Avoid or limit contact with others where possible. Work from home where you can. Maintain 2m distance from others. Avoid large gatherings or places where social distancing is not possible, including mixing indoors with others who are not in your family or extended household.
  • Maintain good hygiene. Wash your hands for 20 seconds regularly and especially before touching your face or eating. Soap and water is most effective, but use sanitiser where this is not possible. Sneeze or cough into a tissue and throw it away, and if this is not possible use your elbow.
  • If you have any symptoms, you should self-isolate and seek a test immediately. If you have a positive test, you should cooperate with the Test, Trace, Protect teams to ensure all your close contacts are quickly traced and self-isolate to prevent any further spread of coronavirus.
  • Avoid touching surfaces that are touched regularly by others, for example door handles, particularly indoors. Where this is not possible, wash or disinfect your hands before and after touching surfaces to avoid transferring infection to your nose or mouth.
  • Wear a face covering to protect others as well as yourself when you cannot maintain 2 metres distance. This includes on public transport or in a busy shop. Do not go out if you are unwell with viral symptoms, even with a face covering.
  • Ensure indoor spaces are well ventilated, with good passage of air.
  • Avoid travelling to areas where there are high rates of infection. This might be another country or another part of the UK or Wales. Follow quarantine requirements to self-isolate for 14 days if returning from a country that does not have an exemption

Businesses also have a role to play in making sure they take all reasonable measures to prevent the spread of coronavirus, for customers and staff. The Welsh Government has put in place regulations to help prevent the spread of coronavirus. This includes requirements on businesses, restrictions on meeting others indoors, and the wearing of face coverings on public transport. Local authorities and enforcement officers are working hard to enforce these rules to keep everyone safe. Health boards, local authorities and their partners have Local COVID-19 Prevention and Response Plans to identify and address specific issues in each local area.

New cases and clusters

New cases will happen. This is when a person is infected and tests positive for COVID-19. This is inevitable as people move around the UK or travel overseas and return. If we all play our part to prevent any spread from those new cases, then we should avoid the rapid increase in cases we saw back in March.

A cluster is when there is a group of new cases that are linked. This might be within a household when people living together pass the virus on to each other. It might be linked to a particular workplace. It could be linked to a pub or restaurant. This is likely to be the result of one person infecting a small number of others in that place. The aim is to quickly identify all of those people. Rapid testing and immediate self-isolation can avoid passing the virus on to others.

Our Test, Trace, Protect system helps us to identify new cases quickly. Its effectiveness relies on everyone following the public health advice. In addition to the prevention measures above, this means:

  • If you have any symptoms – even if they are mild – you should self-isolate and seek a test immediately. You need to take a test in the first 5 days you show symptoms. This is when the test works best. You should advise your friends and family that they may have COVID-19 so that they can follow advice from Test, Trace, Protect on self-isolation.
  • Provide information to the contact tracing teams. This means who you have been in contact with and where you have been from 2 days before you started having symptoms.
  • Provide accurate contact details at places you visit, such as pubs and restaurants. This will ensure you can be contacted if there is any risk you may have been in the same place as someone who later tests positive.

Businesses have a role in collecting contact information, particularly where they may be higher risk places. This might include pubs, restaurants, hairdressers, tourist sites, or other places where lots of people visit for more than a very short time. Local and regional Test, Trace, Protect teams will carry out contact tracing and will identify any clusters or complicated cases. They will be supported by Health Boards, local authorities, Public Health Wales and the Welsh Government.

Incidents and outbreaks

When an investigation of a cluster or complicated case suggests that there may be risk of wider transmission of the virus, this is described as an incident. At this point, an Incident Management Team (IMT) is established. The IMT draws together health experts and other responsible bodies to investigate the incident and respond locally.

An Incident Management Team may decide to put in place local measures to prevent further infections in the area. This might include more local testing to find out if there is any further infection outside of the known cases. There may be new local public health advice about what extra precautions to take. Some places linked to cases may be asked to close.

If the Incident Control Team confirm a wider spread of coronavirus in the area, they may declare an outbreak. At this point, an Outbreak Control Team (OCT) is established. This brings together decision makers and health professionals from local authorities and relevant Health Boards, with other members dependent on the nature of the outbreak. The members of the OCT may put in place a range of measures such as more testing, closing businesses or schools, or preventing events.

Local or regional measures

If the measures put in place by Outbreak Control Teams are not successful in preventing the spread of coronavirus the Welsh Government will advise and act. This will be done in consultation with local decision-makers. Measures will be put in place across a locality or region to respond to the specific circumstances of that place and the progression of the virus within it. The response will reflect what we know about the cause of infections in that area. For example, if cases are linked to places of worship or to pubs, those sectors might be closed down temporarily. If it is linked to visitors coming into the area, travel restrictions might be introduced.

There are no hard and fast rules for when local or regional measures might need to be introduced. There are some indicators we will take into account, but any decision will be based on local knowledge and expertise. This will make sure that our action is necessary and proportionate. Indicators changing over time that might indicate action is needed include:

  • A significant and sustained rise in new cases in the community and other disease indicators at a local or regional level
  • A significant increase in the seven-day rolling average of confirmed cases per 100,000 population and sustained increase in the rate of change which is not under control.
  • A high and rising percentage of positive tests and testing rate per 100,000 population, in particular evidence of wider community transmission.
  • A rise in the numbers and locations of incidents (clusters with the potential for onward transmission) that cannot be linked to trends in known areas, locations or settings under control measures.
  • A rise in the number and proportion of new sporadic cases which are not part of an identified cluster or outbreak.

Decisions will not be based on indicators alone. All decisions will be informed by the specific local context and situation on the ground, including advice from local and national health and environmental health professionals.

There are a wide range of things we might do, depending on the specific situation in an area. These might include:

  • Closing businesses and venues where transmission is occurring.
  • Restrictions on movement of people. For example asking people to stay within their local area.
  • Prevent or limit the number of people that can meet indoors or outdoors.
  • Limiting how and when people can use public transport, including limiting the number of people in a vehicle or carriage.
  • Requiring the use of face coverings in a wider range of places.
  • Any other requirements that could prevent further community transmission.

The intention will be to target measures so that we only close down those things that are causing the spread in that area. Any measures we put in place will only last as long as necessary to prevent the spread of coronavirus. We expect to review restrictions at least every two weeks. This is the amount of time it takes for new symptoms to show should others have been infected.

All-Wales measures

If there is evidence of a more widespread rise in cases, we may introduce measures across the whole of Wales. We have learned a great deal from the national lockdown in Wales since March, and the subsequent careful and gradual reopening of our society and economy. We have learned many lessons, which will enable our response to be more tailored and targeted.

We are also learning more each day about the way the virus is transmitted and the conditions under which it can spread. Our Test, Trace, Protect and surveillance systems are giving us a much clearer picture about where and how new cases are emerging. We are learning from other countries and regions that are seeing new outbreaks and how they are managing them. All of this should enable us to avoid the extensive set of lockdown measures that were necessary in March.

In future we can expect adjustments to the existing regulations to reflect the latest national situation. This might involve tightening some restrictions that have been eased, or introducing new measures such as the recent mandating of face coverings on public transport.

The power and responsibility to prevent resurgence of coronavirus is in all our hands. Each citizen of Wales has an important part to play in suppressing transmission and protecting the vulnerable.

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