Every GP practice in Devon will have a vaccination site in operation by the end of the week as the rollout of COVID-19 vaccines gathers pace.

Four more sites will come on board, in addition to the 16 already operational, Dr Paul Johnson, chairman of the Devon Clinical Commissioning Group (CCG), told Thursday's Team Devon Local Outbreak Engagement Board meeting.

The committee also heard that there was a target for all care home residents in Devon to have received the first dose of the vaccine by no later than the end of the month – although the government has subsequently set a January 24 target – and that pharmacies plus two mass vaccination site were also set to be operational once approval is granted.

Dr Johnson said: "I am optimistic that all care homes will be done by the end of the month and we have plans to do that even sooner. We will get people vaccinated as quickly as possible.

"The first stage of vaccinations are not about coming out of lockdown but savings lives. Care homes account for one a third of all death, and you have to vaccinate 20 people to save one life. Another third in those over 80s, and if you are under 50 and no pre-existing health conditions, you have to vaccinated 47,000 people to save one life."

He said that hospitals are vaccinating staff and over 80s who can attend the hospital, and that GP practices have 16 active sites and with four coming on board this week, which will cover every GP practice across the county.

The already active sites include Seaton Hospital, where patients aged over 80 from Seaton, Colyton and Axminster have already been vaccinated.

Dr Johnson warned that the roll-out of the vaccination programme was not a reason to become complacent with social distancing guidelines.

"If you get a vaccine it does not mean you can lower your guard," he said.

Allaying fears over the decision to delay the second dose of the vaccine, Dr Johnson said that after about 10-14 days, patients get about 80 per cent protection from the virus, which doesn't seem to be waning.

He added: "The flu vaccine is only around 60 per cent effective so it is better than that. This doesn't put people at significant risk and doubles the number of people who we can get vaccinated at this first stage."

Sally Slade, director of Integrated Children's Services, added: "We have 282 care homes in Devon and we commenced the first whole homes just before Christmas and before Christmas and New Year, we vaccinated most of the homes with more than 50 residents.

"We are now doing the medium and small sized homes in January which is a big challenge but an effort across the system to work best as possible."

Rapid testing to catch those showing no symptoms

Rapid '30 minute' community testing for key workers and those unable to work from home with no COVID-19 symptoms will soon be available across Devon.

It follows the government announcement on January 10 that it is expanding asymptomatic community testing across the UK to find those who have COVID-19 but do not have symptoms and need to isolate, who may inadvertently be spreading the virus.

Rapid 'lateral flow tests', which provide a result within 30 minutes, will be used and the first testing site will open at County Hall in Exeter towards the end of January, with further sites to open across Devon through February and March.

Steve Brown, Devon's Director of Public Health, told the Team Devon Local Outbreak Engagement Board meeting that the community testing was one the tools they were using to try and find the asymptomatic carriers, take them out of community, and then isolate to break the chain of transmission.

The testing will be focused on people who are out and about – the key workers leaving homes for paid employment or carers – rather than the wider community, and were for people without symptoms. Anyone with symptoms should carry on being tested in the usual fashion.

Mr Brown said: "We are setting up the community testing programme at a fast pace. Once in place, it will provide us with a useful tool for identifying people who are asymptomatic, who otherwise could be spreading the virus without their knowledge. This will help to break the chain of transmission and help slow the spread and protect other people.

"Community testing is trying to identify the one in three who have COVID but no symptoms. This will be focused on people out and about – the key workers leaving homes for paid employment or carers – so we are to try and find the needle in the haystack for those who have COVID, no symptoms, and could pass on to someone vulnerable.

"It will be a significant ask, and will require significant resources, and we expect it to go live at the end of January and then roll out over a six week period. This is a test to find and to identify people who have no symptoms but not a programme where people who are isolating can get back to work."

A negative result will not remove the need to follow existing COVID measures socially and in the workplace, and organisations and employers who have staff and workers who would be eligible for testing are encouraged to register their details.

Critical workers and those in high-risk occupations who still have to attend work, and people who are in contact with vulnerable individuals, such as carers, will be prioritised.

Community testing will complement and not substitute national coronavirus testing – anyone with symptoms should book a free NHS test via the GOV.UK website or by calling 119.

Cllr John Hart, leader of Devon County Council, added: "In the face of this pandemic, we want to do what we can to keep Devon working, and working safely. This will enable key workers, and for example, people who care for vulnerable people, to know that they are doing so as safely as possible."

Large outbreaks within care homes

In the seven day period between January 2 and January 8, a record number of tests were carried out in the Devon County Council area – 31,382 – with 6.3% of them returning a positive reading. About 20 per cent of the positive results have been in care homes.

Mr Brown told the meeting that the cases rates in the over 80s had seen a big increase in recent weeks with some large outbreaks within care homes.

Across the county, the over 80s age range, based on the week of specimens from January 2 to January 8, had an infection rate of 396 per 100,000 population, the highest of any age range, with the 20-39s at 331/100,000, the 40-59s at 270/100,000, the 60-79s at 124/100,000 and the 0-19s at 108/100,000.

Mr Brown said: "We are seeing increasing in outbreaks in care home and have had some significant outbreaks with 70 or 80 per cent of residents or staff testing positive. Some are asymptomatic but some have symptoms and in hospital, and about 20 per cent of Devon's cases are care homes.

"It is important to re-emphasise the stay at home message and to stay at home unless it is essential to go out, but every time you leave the front door, you risk coming into contact with someone who may have COVID and could be a crucial link in chain of transmission."

Simon Chant, Public Health Specialist, added that while Devon's case rates were at the highest they had seen, they were still only a third of the rate of the national average, and there were some positive signs that growth in cases has slowing.

He said: "It needs to be treating with a bit of caution as rates have fluctuated over Christmas so too early to know definitively if the peak has happened, but there are promising signs at the moment.

"But we have seen a big increase in the 80+ cohort where there is a greater likelihood of hospitalisation and more severe outcomes for the age group, and we are seeing outbreaks in care homes again."

At an MSOA level, the areas with the highest infection rates at present are Alphington and Marsh Barton, Cullompton, Ogwell, Mile End and Teigngrace, Exmouth Littleham and South Brent and Cornwood, with Mr Chant saying that some of these areas are where outbreaks in setting and care homes have occurred.

Asked about the presence of the new and more transmissible variant of COVID-19, Mr Brown said that while they do believe it is present in Devon, it is only being found in a relatively low number of cases.

He added: "Only about five per cent of tests are sequenced, and we think it is in Devon, but the numbers relatively low, in around five to 10 per cent of cases. The worry is that if does become the dominant strain, things can escalate quicker, so the public health measures don't change, but we should more of it and be better at doing it."