The first possible signs of a coronavirus outbreak at Banham Poultry were not flagged up by the Norfolk and Norwich University Hospital, the county’s director of public health has said.

Dr Louise Smith said the key lesson to be learned from what happened at the Attleborough meat factory was for the NHS to be alert to cases, which could be signs of outbreaks, presenting in “unexpected ways”.

But she said it was unlikely that the outbreak could have been declared much more than a day before it was.

Responding to the comments, a spokesman for the Norfolk and Norwich University Hospital said the case was alerted to public health within two hours.

The spokesman said: “We have robust infection and control procedures for the identification and isolation of patients with suspected or confirmed Covid-19 and our staff remain alert to the pandemic. All patients are tested when they are admitted to the hospital and all new Covid-19 cases are routinely reported to our Public Health and NHS system colleagues.”

More than 120 workers connected to the factory tested positive for the virus following the outbreak, which started in August and which is now deemed to have been contained.

At a meeting of Norfolk County Council’s scrutiny committee, councillors quizzed public health director Dr Louise Smith about the response to the outbreak.

Dr Smith said the first case was of a worker in the factory’s cutting room who had became unwell at work on August 17.

But she said at around Friday, August 21, public health started to hear “rumours” there might be further cases.

Dr Smith said: “The first rumour we heard was that the hospital had diagnosed somebody and we had to send somebody to ask the Norfolk and Norwich University Hospital if they could give us some more information.

“An admission and diagnosis is very unusual and it hadn’t been automatically flagged by the hospital.

“Over the weekend we had additional people from Banham Poultry attend the N&N hospital. In the process of working out what was happening, I was contacted and asked why we, as public health, had not notified the N&N that we had an outbreak.

“And my answer to that was that actually, it worked the other way round - that it was the diagnoses that were made in the hospital over the weekend that become part of the early indications that we did have an outbreak.”

She said those early cases which went into the N&N did not go in the “normal ways”, so did not present in circumstances which would have led staff to suspect coronavirus, so it was picked up in routine testing.

She said: “I think the main learning point which came out for me is that our local NHS need to remain alert that they may be seeing cases of coronavirus and they may present themselves in unexpected ways.

“And when they do identify cases, they need to have a much lower threshold for notifying the outbreak team about them.

“It’s the early stuff, when you need to know what you’re looking for that you need to remain alert.”

She said it had taken three or four days to get the result of swab test on the first worker who had fallen ill at work, but as the outbreak went on the results were coming within 24 hours.

Mid Norfolk MP George Freeman had been critical over the speed of the response, but Dr Smith told the scrutiny committee she could not see opportunities where they could have declared an outbreak much faster.

She said: “We might have got the rumours of the first case, perhaps 12 to 24 hours earlier, but we still wouldn’t have acted on that.

“It was only when we got the results back on the Monday morning, combined with activity which had happened in the hospital at the weekend, that we had enough evidence that we could have declared this as an outbreak.”

She praised early actions which Banham Poultry took to get close contacts to the initial worker who fell ill to self isolate and get a test as “vital”.

THe N&N has been contacted for comment.