There is nothing perfect about the COVID storm now raging over British households. A cruel virus, faltering income, the suffocation of confined living, with worry piled onto worry – heating, feeding the kids, internet access so they don't fall behind, worries about work and relationships

Such has been many people's experience of COVID-19, yet in many of our communities this has combined with existing deep-seated inequalities which are highlighting the growing gulf between the ‘haves' and the ‘have nots'.

Our national strategy is built on the actions of citizens who we need to do the right thing, get tested when they need to, engage with contact tracing, and isolate to prevent spread. This sounds easy, but demands full public engagement. To achieve this, we must understand the challenges which people face. In my opinion, this piece of the jigsaw has largely been neglected.

It is right to focus action on the clinically vulnerable, but what about those who are socially vulnerable? Where is their voice in the national debate?

Councils across the country are well placed to recognise unmet need in their communities and many have stepped up – Gateshead MBC is no different. From the start, our mandate was to do whatever we could to mitigate the COVID-19 threat with a focus on those people who need us most.

Community hubs were set up to support the clinically vulnerable, but we knew this would not be enough.

Long before COVID, we developed an analytical tool known as our Local Index of Need (LiON). Using this we identified residents who were more likely to be experiencing additional challenges so we could connect them to the community hubs established to support the clinically vulnerable. We found there were lots of them. People in our community weren't just clinically vulnerable, they were socially vulnerable.

Our eight hubs have received more than 7,400 urgent requests for help, and more than half of them, for food. We have sent out 12,500 emergency food parcels.

At first, shielding residents came forward with requests for help with practical tasks such as shopping and prescriptions. But our biggest area of urgent need was food. While COVID is not exclusively responsible for this, the virus has exposed a desperate unmet need in a surprising number of vulnerable working families.

We have also seen a dramatic rise in energy enquiries to both our hubs and Citizens Advice Gateshead. Of course, energy is expensive and imagine having to isolate in a cold house. This is a difficult issue for customers and staff who don't understand social tariffs or charitable options. It is a minefield to work through, with long queues on helplines and poorly trained staff.

It is particularly complex for those with payment meters where there is existing debt because when energy companies offer a relief payment this is often deducted from the debt, which is of little practical use.

Citizens Advice Gateshead has seen a 125% increase in Universal Credit enquiries alongside a 74% increase in demand for employment advice, with the most searched words being redundancy, furlough and pay. I fear for local families if the Government withdraws the £20 Universal Credit top-up in March as this will immediately plunge many back into very difficult circumstances, unable to cover their costs.

I had high hopes for the Government's self-isolation payment to help households in need, but the reality has been quite different. Overall, the £500 payments have probably been the hardest grant to administer of all the COVID support. Large numbers of people applied but a staggering 88% found themselves ineligible, at least half due to not having evidence of being told to self-isolate.

The Government's lack of under-standing is also evidenced by its initial guidance which suggested we would see fewer than eight applications a day, with 50% eligible and around 200-250 cases in total. That was certainly not what we saw. We have had ten times as many – 2,709, of which only 332 have been successful.

We understand that responding to crisis, and low-level problem-solving while necessary, does not achieve self-actualisation for the person. It is the creation of relationships, supporting people to feel they have greater control over their lives, helping them to find purpose, connect with friends and family, and feel a sense of place and safety that will change futures. This is what we are striving for as we build back local services.

We are yet to formally evaluate our community support offer, but qualitative feedback so far has been overwhelmingly positive. We have only achieved that by ensuring social vulnerability is treated as proactively as clinical vulnerability.

As isolation support is reviewed, social vulnerability must be fully included so that councils can build on the arrangements already established at a local level and successfully meet the needs of their communities

Alice Wiseman is director of public health at Gateshead MBC

@AliceWiseman11