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Duncan Selbie's Friday message - 28 February 2020

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Dear everyone


An essential part of managing any outbreak of infection is to ensure that the public is confident in our science and that we communicate clearly how that science underpins the actions that we take to control the spread of disease. This is especially so with Covid-19 as new viruses inevitably cause greater concern. There is a particular challenge since the actions we need to take now are different from those which we will need to take if we have widespread transmission of Covid-19 throughout the UK. As I write, this is not a certainty, but the spread of infection in northern Italy and the Canary Islands, as well as in Iran and the Middle East make this more likely, and of course it could happen relatively quickly so we must be prepared.

Our current focus is on containment – identifying anyone who returns to the UK with Covid-19, identify all their contacts who might be at risk, monitor and isolate as necessary and in that way, avoid further spread of infection. Given the developments of the past few days we have further heightened our vigilance and are working with selected hospitals and general practices to test people who have similar symptoms but who have not been to one of the countries of concern. This means we should know when our considerable efforts to contain the spread of Covid-19 need to move into the second phase of our planned response, to delay the spread of the virus if possible into the warmer spring and early summer months.

Whilst the risk for any one of us needing complex medical care will be low, the overall numbers of people with complications of Covid-19 are likely to be a significant challenge for the NHS to manage. This is also why efforts to delay the spread of infection and reduce the intensity of the outbreak are so important. An essential part of managing any outbreak of infection is to ensure that the public is confident in which social distancing measures may work best to achieve this. PHE scientists and public health experts are working alongside other government and university scientists, including behavioural scientists to ensure that the best possible advice is given to the government and the public. This will obviously depend on exactly what circumstances do arise and we are preparing for a range of different scenarios.

Crucially everyone has a part to play by staying at home when unwell and practising good hand hygiene. Catch it, bin it, kill it has never been more relevant.

Marmot Review

Health and wealth are inseparable, and this has again been articulated by Michael Marmot in his 10 year review of his 2010 report Health Equity in England. There are many factors affecting good health including good mental health but the main determinant of health outcome – that is the number of years in good health – remains income. The wealthier you are, the healthier you are, and vice versa. Michael raises a challenge for all of Government, public services and society that inequalities in health are not inevitable and he is of course right in this, and is why the Prime Minister’s commitment to levelling up and tackling geographic inequalities is so important.

Investing in the public’s health makes economic sense and represents outstanding value for money. This means addressing the root causes of poor health through creating more jobs that local people can get, improving educational outcomes and increasing and improving available housing, alongside ensuring that the needs of the most vulnerable, especially children, are met. Everyone has the right to enjoy a healthy life, no matter where they live or who they are.

The Government’s response to the Green Paper on Prevention will be an early opportunity to make inroads on this and you can read about the work PHE has already been doing in Professor John Newton’s blog.

Mental health

And finally, it was a pleasure on Tuesday to open the PHE Public Mental Health Summit in Manchester, which brought together 200 people across the public, private and third sectors with expertise and experience in mental health. Of all health conditions, poor mental health is the one most affected by inequalities, both as a cause and a consequence. Better mental health is one of ten priorities for PHE and more on this when we publish our five year mental health plan in the spring.

Best wishes



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