Liverpool has always been in the vanguard when it comes to medical milestones.
The city was the first, way back in 1847, to appoint a public health officer, then known as the medical officer for health, and now known as the director of public health. Dr William Henry Duncan helped raise the profile of public health, and tackled many of the often fatal health conditions caused by poor sanitation and living conditions.
In 1944 penicillin was first used at Alder Hey Children’s Hospital to save the life of a child with pneumonia.
And in 1959, the city was also one of the first to introduce a population screening programme for tuberculosis in 1959.
Despite much power and funding being centralised in London over more recent decades, responsibility for public health still lies with councils. As I write we are facing our greatest challenge in a century – rolling out a vaccine in the middle of an ongoing pandemic which is again spiralling out of control.
Our colleagues in Whitehall are brilliant at what they do, but they simply do not know our communities as well as we do. I am not criticising them, simply stating the obvious.
We saw our expertise in action during the recent COVID mass testing pilot in Liverpool - which was fully supported by our Department of Health and Social Care colleagues in London - but was designed, driven and managed by partners on the ground here. Our targeted messaging and community outreach encouraged 200,000 people to get tested and identified more than 1,500 people who had COVID-19 but didn’t know it, helping slow transmission and reduce infection rates.
Previous examples of our success include a highly localised, on the ground response to the COVID-19 outbreak in Princes Park and a localised MMR vaccination programme to tackle a measles outbreak in a vulnerable community in the heart of the city.
We have the knowhow through our understanding of the data, through the infrastructure and strategic relationships we have built, as well as expertise in getting messages out to communities and – crucially – encouraging people to act on the information and advice given.
We know that COVID-19 has hit hardest in our most deprived communities, where multiple generations live in close proximity to each other and a large proportion of the population have underlying health conditions.
Almost 1,000 Liverpool residents have died as a result of COVID-19. Many others are suffering the consequences of Long COVID.
And, as we enter a third wave of the virus, which - tragically - looks set to be even worse than the first two, rates of transmission are spiralling out of control again.
That is why we need to act, fast, using our local knowledge, intelligence, and partnerships.
Evidence from rotavirus, measles and influenza vaccines shows lower vaccine uptake in these communities – but these are the areas that need the highest uptake to prevent transmission.
So it is absolutely vital we get the vaccine to people, rather than bringing people to the vaccine.
This means getting it closer to their homes and workplaces, rather than expecting vulnerable people – many who are already on the breadline and struggling to make ends meet – to get a bus or taxi to have their jab.
And this is where councils come in.
We know the best locations to site mobile and pop up clinics, whether it is schools, community centres or existing COVID testing sites.
We know where vulnerable people who need to be vaccinated gather, from homeless shelters to foodbanks.
We know the voices trusted by hard to reach communities, from GPs to community and faith leaders, to bust myths and tackle falsehoods about the vaccine.
Our skills and knowledge in data, intelligence and operations enable us to make a rapid and reliable assessment of vaccine uptake and impact, and would also generate evidence important for informing and encouraging widespread vaccine uptake among disadvantaged populations elsewhere.
We have the knowledge – all we need are the tools to do the job.
With people dying every day, the vaccine rollout really is a matter of life and death, and there is no time to waste.
Matthew Ashton is director of public health at Liverpool City Council
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