What is the exit route from the Coronavirus paralysis? Normal life is much closer in countries that have embraced the advice of World Health Organisation Director General Dr Tedros Adhanom to “test test test”.
Jeremy Hunt, former Health Secretary www.telegraph.co.uk
What is the exit route from the Coronavirus paralysis? We are told the peak will be in about three weeks. But we are also told that until we have a vaccine, thought to be over a year away, the virus will come back in wave after wave. Normal life seems a long way off. But normal life is much closer in countries that have embraced the advice of World Health Organisation Director General Dr Tedros Adhanom to “test test test”.
The restaurants are open in South Korea. You can go shopping in Taiwan. Offices are open in Singapore. These countries learned the hard way how to deal with a pandemic after the deadly SARS virus. They now show us how we can emerge from lockdown.
Testing provides clarity. Where you find it, you can isolate and contain it. And where you don’t, vital services continue to function. In most of those countries restaurants, malls and office blocks require you to walk through a temperature checker before you enter. They all check international visitors the same way and are astonished we don’t do the same at Heathrow.
The immediate priority is to protect the NHS and ramp up its capacity. Beds, equipment, and ventilators are all vital, but as every health secretary learns fairly quickly, the true capacity of the NHS lies in its staff.
They are the heroes we need to protect – and make sure they can get back to work as quickly as possible if a member of their household has symptoms. Around 10 per cent of the population have a cough or fever at this time of year, taking thousands of NHS workers off the frontline. The government’s commitment to accelerate testing for NHS staff is therefore absolutely right.
But as new tests come on stream we need to go further. Professor Yvonne Doyle, Medical Director of Public Health England, told the Select Committee which I chair on Thursday that the virus can incubate for three to five days before any symptoms. Those are days when doctors and nurses could be infecting their own patients. We need weekly tests for all NHS and care home staff to remove that worry.
As we tool up to do this, you begin to see how mass testing can also show us the way out of this crisis. Social distancing works because it drastically reduces the opportunity for transmission. What was previously an exponential growth in transmission becomes much slower as the curve is flattened. But this only works for as long as it’s in place, and it can’t remain in place forever. But with mass testing, accompanied by rigorous tracing of every person a Covid-19 patient has been in touch with, you can break the chain of transmission.
Of course, with many other countries thinking the same way, there is no magic wand that will suddenly overcome shortages in testing supply chains. The solution is to look to British scientists and manufacturers to put in place tests and the infrastructure we need to process them. Just as we are rising to the challenge with ventilators, we need urgently to do the same for testing.
If we do so, the opportunities are clear. South Korea has tested five times more people per head of population than us – and are reaping the rewards with their new cases now on a downward trend – despite being nearer to China. They are reporting fewer than ten deaths every day.
Closer to home, Germany is leading the way. Two weeks ago they had carried out 167,000 tests, four times more than us. As a result they have identified three times more cases than us – but with fewer than half the number of deaths we have had. There may be differences in reporting, but fundamentally, finding Covid-19 patients earlier means you can get the most vulnerable ones hospital care more quickly. In Germany they are even taking in patients from France and Italy.
We should be under no illusion that the contact tracing that goes alongside testing is resource intensive. Every time somebody tests positive, they need a dedicated contact tracer who works through all their previous interactions to make sure every single one is isolated until they are tested as Covid-free. Why not allocate all the local government officials in planning departments and the civil servants on non-Covid duties to this task?
And as Europe’s tech hub, we should use our skills there, too. In Singapore everyone has been asked to use the TraceTogether App. When you come near someone else with the app it swaps anonymous ID data which is stored in your phone. If you contract the virus, everyone you have been near can be contacted.
Singapore has had just two deaths. It is encrypted and all data destroyed after 21 days. Those worried about the civil liberties implications might reflect that Singaporeans have had their liberties curtailed far less than countries which have had to go into full lockdown.
Mass social distancing should protect the NHS through the peak over the next few weeks, but it’s a blunt instrument with massive economic impact. For the next wave we must use the precision scalpel of mass testing.