“Ministers were warned last year the UK must have a robust plan to deal with a pandemic virus and its potentially catastrophic social and economic consequences in a confidential Cabinet Office briefing leaked to the Guardian.”

“The recommendations within it included the need to stockpile PPE (personal protective equipment), organise advanced purchase agreements for other essential kit, establish procedures for disease surveillance and contact tracing, and draw up plans to manage a surge in excess deaths.”

“Having plans for helping British nationals abroad and repatriating them to the UK was also flagged as a priority.”

Nick Hopkins  www.theguardian.com 

Ministers were warned last year the UK must have a robust plan to deal with a pandemic virus and its potentially catastrophic social and economic consequences in a confidential Cabinet Office briefing leaked to the Guardian.

The detailed document warned that even a mild pandemic could cost tens of thousands of lives, and set out the must-have “capability requirements” to mitigate the risks to the country, as well as the potential damage of not doing so.

It comes as the UK’s hospital death toll from coronavirus heads towards 20,000. Less than a month ago, the medical director at NHS England, Prof Stephen Powis, said the country would “have done very well” to stay below this grim milestone.

Marked “official, sensitive”, the 2019 National Security Risk Assessment (NSRA) was signed off by Sir Patrick Vallance, the government’s chief scientific adviser, as well as a senior national security adviser to the prime minister whom the Guardian has been asked not to name.

The recommendations within it included the need to stockpile PPE (personal protective equipment), organise advanced purchase agreements for other essential kit, establish procedures for disease surveillance and contact tracing, and draw up plans to manage a surge in excess deaths.

Having plans for helping British nationals abroad and repatriating them to the UK was also flagged as a priority.

All of these areas have come under relentless scrutiny since the start of the coronavirus pandemic, with the government accused of being too slow to react to the crisis. It is now under sustained pressure to provide answers about what was done nationally and locally to provide the support that planners have long called for, amid growing fears ministers were “caught out” by the crisis and have been playing catchup ever since.

The Cabinet Office document, which runs to more than 600 pages, not only analysed the risk of a viral flu pandemic but also specifically addressed the potential for a coronavirus outbreak (the earlier Sars and Mers were both coronaviruses), though it regarded this as potentially much less damaging. In reality, the UK is dealing with a hybrid of the two, raising further questions about whether ministers were quick enough to recognise the dangers and were able to rely on whatever preparations were already in place.

Drawing on previous security assessments and health risk registers, the document implicitly warned ministers they could not afford to be complacent. “A novel pandemic virus could be both highly transmissible and highly virulent,” it said. “Therefore, pandemics significantly more serious than the reasonable worst case … are possible.”

The government declined to provide specific details of the preparations that had been made prior to the pandemic, but said it would be unfair to say they were “starting from scratch”, pointing to planning exercises carried out in recent years.

“This is an unprecedented global pandemic and we have taken the right steps at the right time to combat it, guided at all times by the best scientific advice,” a government spokesman said.

“The government has been proactive in implementing lessons learned around pandemic preparedness. This includes being ready with legislative proposals that could rapidly be tailored to what became the Coronavirus Act, plans to strengthen excess death planning, planning for recruitment and deployment of retired staff and volunteers, and guidance for stakeholders and sectors across government.”

But one source with knowledge of the Cabinet Office document said the UK had not properly focused on the pandemic threat, and had been caught flat-footed.

“The really frustrating thing is that there were plans. But over the last few years emergency planning has been focused on political drivers, like Brexit and flooding.

“There was a national plan for dealing with a pandemic that should have been implemented. But who took control of that? And who was responsible for making sure that plans were being made at a local level? The truth is, I am not sure anyone was doing this.”

The source added: “We have been paying for a third-party fire and theft insurance for a pandemic, not a comprehensive one. We have been caught out.”

The shadow Cabinet Office minister, Rachel Reeves, said the revelations were “alarming … and raised serious questions about the government’s planning and preparedness for a coronavirus-style pandemic”.

She demanded her opposite number, Michael Gove, give a statement to parliament on Monday to explain “whether this report was read and what actions were taken”.

The NSRA sets out a series of potential reasonable worst case scenarios (RWCS) for the spread of a flu-like viral pandemic, which emergency planning experts regard as the benchmark for its preparedness in the current crisis.

It also included predictions that offer insights into how planners believe a crisis like this current emergency might evolve.

The document said:

• A pandemic would play out in up to “three waves”, with each wave expected to last 15 weeks … “with the peak weeks occurring at weeks 6 and 7 in each wave”.
• 50% of the population would be infected and experience symptoms of pandemic influenza during the one or more waves. The actual number of people infected would be higher than this, as there would be a number of asymptomatic cases.
• A pandemic of moderate virulence could lead to 65,600 deaths.
• The potential cost to the UK could be £2.35tn.
• Even after the end of the pandemic, it is likely that it would take months or even years for health and social care services to recover.
• There would be significant public outrage over any perceived poor handling of the government’s preparations and response to the emergency.

Whitehall sources concede that turning “plans on the page to real life” was always proving a challenge, but said that in some respects the Brexit planning had helped.

The government spokesman said its response to the emergency had protected lives and businesses: “Our response has ensured that the NHS has been given all the support it needs to ensure everyone requiring treatment has received it, as well as providing protection to businesses and reassurance to workers.”

But political pressure is mounting on the government. On Wednesday, the Labour leader, Sir Keir Starmer, demanded ministers explain why “we were slow into lockdown, slow on testing, slow on protective equipment”.

In an interview with the BBC on Thursday, Dame Deirdre Hine, who produced a report for government on the swine-flu pandemic, said she feared the government had not implemented the plans for a pandemic. “I think they have been complacent,” she said.

A very serious warning for all Owl’s followers:

The maker of Dettol has said its product should not be ingested “under any circumstances” after Donald Trump suggested tests should be carried out to see if COVID-19 patients could be injected with disinfectant.

Ian Collier News reporter news.sky.com 

In a statement, RB said since the US president’s remarks it had been asked if “internal administration of disinfectants” could be used to treat coronavirus patients.

“As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route).

“As with all products, our disinfectant and hygiene products should only be used as intended and in line with usage guidelines. Please read the label and safety information.”

Mr Trump made his remarks after one of his officials gave a presentation on the impacts of bleach and sunlight on coronavirus and how it reacts to different temperatures and surfaces, during Thursday’s White House task force briefing.

news.sky.com /story/coronavirus-trump-under-fire-for-suggesting-disinfectant-as-covid-19-treatment-11977958

“So, supposing we hit the body with a tremendous, whether it’s ultraviolet or just very powerful light, and I think you said that has not been checked but you’re going to test it,” he said.

“And then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way. And I think you said you’re going to test that, too, sounds interesting

“Right, and then I see the disinfectant, it knocks it out in a minute, one minute and is there a way we can do something like that by injection inside or or almost a cleaning, ’cause you see it gets on the lungs and it does a tremendous number on the lungs.

“So it will also be interesting to check that so you’re gonna have to use medical doctors. But it sounds, it sounds interesting to me so we’ll see. But the whole concept of the light, the way it goes in and one minute, that’s – that’s pretty powerful.”

At one point, he turned to Dr Deborah Birx, the co-ordinator of the White House coronavirus task force, and asked her to speak with doctors “to see if there’s any way that you can apply light and heat to cure”.

“Maybe you can, maybe you can’t,” he said: “I’m not a doctor. I am a person that has a good, you know what,” he added while pointing to his head.

The president was already facing criticism for championing hydroxychloroquine as a possible cure for COVID-19, which has been shown to provide no benefit and possibly a higher risk of death.

Doctors immediately warned against the unproven idea, blasting it as “irresponsible” and “dangerous”, and said it could kill people.

.”..there is no official word to explain clearly why the Republic of Ireland, which has followed WHO advice, records a death rate a third lower than that in Northern Ireland, which follows UK advice. Such are the delusions of national character that too many members of the government, from the prime minister down, suffer from. People are dying. It is time to give up on the fantasies of British exceptionalism.”

Editorial  www.theguardian.com 

The Guardian view on following viral science: why did we go it alone?

If there is a simple way of showing how out of step this government is with the rest of the world on coronavirus, it can be found in the gap last week between the five criteria that Dominic Raab said the country must fulfil before the lockdown was lifted and the six tests the World Health Organization set. Missing from Mr Raab’s list was that health system capacities ought to be “in place to detect, test, isolate and treat every case and trace every contact”.

What divides these two approaches is the “science”, which is why claims of following it ring so empty. On one side we have those who believe that testing, tracing and the isolating of infected individuals is needed to defeat coronavirus. In this camp are public health experts such as Anthony Costello of University College London and Jeremy Hunt, the former health secretary.

They have facts on their side. South Korea registered its first 10 deaths of patients with Covid-19 by 25 February, and by following the WHO’s advice Seoul had suppressed the epidemic within 22 days. Prof Costello says that by the time the UK had recorded its first 10 deaths, by 13 March, the government had stopped all testing and contact-tracing in the community. How has that gone? South Korea sees 17 new cases daily, while the UK records 5,000. These numbers convinced the health secretary, Matt Hancock, who on Thursday outlined his “test, track and trace” strategy, which would start “as the new number of cases begins to fall”.

On the other side are those who believed the UK ought to go it alone – with a response determined by mathematical models and control measures while waiting for the silver bullet of a vaccine. In this camp appeared to be Mr Raab, the chief medical officer, Chris Whitty, and his deputy, Jenny Harries, who condescendingly claimed South Korea’s outbreak was atypical and akin to controlling that found in a single care home. Sir Patrick Vallance’s promotion of “some kind of herd immunity” put him, as chief scientific adviser, at odds with public health doctors. The evidence suggests that was also the case for Dominic Cummings, the prime minister’s chief adviser, who has long been entranced by computational modelling “fast enough for epidemic ‘war games’”.

Sir Patrick chairs the Scientific Advisory Group for Emergencies which last month warned that “if interventions that are perceived to be effective [in other countries] are not applied [in the UK]”, then this would increase “the risk of public concern”. Sage recommended “a clear explanation as to why expected interventions are not being implemented”.

Yet there is no official word to explain clearly why the Republic of Ireland, which has followed WHO advice, records a death rate a third lower than that in Northern Ireland, which follows UK advice. Such are the delusions of national character that too many members of the government, from the prime minister down, suffer from. People are dying. It is time to give up on the fantasies of British exceptionalism.

East Devon Reporter eastdevonnews.co.uk 

Residents are being urged to avoid having a spring declutter as recycling centres in East Devon and Exeter will only reopen when ‘it is safe to do so’.  

Nineteen facilities across the county were shut on March 24 after the UK went into coronavirus lockdown.

They include hubs in Exmouth, Sidmouth and Honiton, as well as Exton Road and Pinbrook Road in Exeter.

Devon County Council (DCC) said today it is looking to reopen recycling centres ‘as soon as it is safe to do so and [the]Government guidance permits’.

“Until that time residents are urged to avoid having a spring declutter or undertake home improvements that may create extra waste,” added the authority.

‘Please be patient’

Councillor Andrea Davis, cabinet member for infrastructure, development and waste, added: “It’s understandable that people have more time on their hands and want to keep busy, but it does push extra waste onto already stretched services, especially as recycling centres remain closed.

“We are looking to reopen these facilities as soon as it is safe and government guidance allows.

“Until that time I ask that people to please be patient and store excess waste or wait until restrictions are lifted. It would help keep collection services running smoothly.

“It’s easy to generate more waste and recycling while we’re at home and it’s great to see that most people a continuing to recycle as much as possible and keep waste to manageable levels under difficult circumstances.

“I want to thank everyone for doing their bit and for supporting the crews as they continue the important task of collecting our rubbish and recycling.”

East Devon support for refuse crews

Households across Devon have been thanked for their waste and recycling efforts during the pandemic.

Support for collection crews has included pictures and ‘thank you’ notes left on bins and outbreaks of spontaneous doorstep applause.

East Devon District Council said its refuse collection staff had been ‘cheered’ by a campaign to celebrate their hard work.

“A whole series of posters and messages have greeted the refuse collectors during their deliveries,” added a spokesperson.

“Your cheers for our staff have been much appreciated.”

Waste and recycling tips

DCC has issued the following advice to households:

• Your bin may be collected earlier or later than usual due to collection round changes. Find out what time your bin should go out here to avoid a missed collection;
•  If your car is parked on the street, make sure there is room for a collection vehicle (or emergency service vehicle) to pass;
• Keep hold of clean and wearable textiles and shoes until restrictions are lifted, when charities will urgently need your donations;
  Wash, squash and flatten your recyclables to increase the capacity of your recycling bin, box or bag;
• Start home composting your uncooked food, peelings and garden waste from as little as £13. Buy a compost bin here or build your own from pallets. Alternatively, leave grass cuttings on the lawn to return nutrients to the soil;
• Think about your food waste. Find recipes to effectively use up ingredients via our FREE online recipe book “Have your food and eat it”;
• Residents showing Covid-19 symptoms are advised to store recyclables for 72 hours before placing in the regular recycling container. Any personal waste, such as tissues, need to be double bagged and then stored for 72 hours before being placed in the residual waste bin.

More information is available on the Recycle Devon website.

Daniel Clark  www.devonlive.com

The majority of parks and gardens in East Devon are set to be reopened – but will close again if people don’t use common sense and abide by social distancing guidelines.

East Devon District Council last month decided to close parks to help people abide by social distancing measures following the Government’s lockdown announced.

The council added that the decision was balanced by the fact that East Devon is a rural district with good access to the countryside and open spaces.

But following the statement made by the Secretary of State for Housing, Communities and Local Government on Saturday, April 18, who said: “People need parks. That’s why I have made it clear to councils that all parks must remain open,” the council has reviewed its initial decision.

The cabinet have agreed that the majority of the district’s large or easy to access park sites should be reopened to the public, as soon as possible, but some small sites with restricted access/egress points will remain closed in order to support Government’s social distancing guidance

Cllr Geoff Jung, East Devon’s Portfolio for the Environment, said: “We believe we can safely re-open large parks sites, such as Phear Park in Exmouth, with access points, open borders or space that allow people to easily use the site for exercise while maintaining social distancing.

“We will re-open these sites by removing barriers and closure signage starting Thursday, April 23. It will take us a couple of days to complete this.

“This will mean that the majority of our parks will be open, giving residents ample green spaces within which to exercise responsibly. Social distancing signs will remain in place and we will remind the public to observe these measures.

“If people do not observe social distancing or congregate in our Parks, we may be forced to close them all again.

“So we are putting our trust in our public and asking them to use common sense, follow the two metre social distancing recommendations and generally take responsibility for staying safe.”

A council spokesman added that as it would be difficult for the public to maintain robust social distancing in the following sites, and so as not to increase the risk of viral transmission, these sites are to remain closed.

They are:

• Manor Gardens – Exmouth
• Gunfield Gardens – Exmouth
• Queens Drive Space – Exmouth
• The Glen – Honiton
• Connaught Gardens – Sidmouth
• Blackmore Gardens – Sidmouth
• Seafield Gardens – Seaton
• All play areas
• Outdoor gym equipment
• All skate parks

The spokesman added: “Due to restrictions in East Devon staffing levels, resulting from the virus lockdown, the council will not be able to maintain the parks and gardens to the same high standards as they were before closure.

“However, from a positive environmental perspective, East Devon has already started a programme of actively re-wilding areas, encouraging biodiversity and wildflowers and cutting grass less frequently and this will continue. Those using the parks for exercise can expect to see meadow length grass with access paths cut through it as a more prominent feature.

“The council will only be able to conduct visual walkover inspections of its sites as staff are focussed on maintaining core operations services, self-isolating or restricted from travelling due to health reasons.”

Further guidance on what people should do when accessing East Devon’s parks can be found at: https://eastdevon.gov.uk/parks-gardens-and-recreation/parks-and-gardens/coronavirus-information/

In a previous post discussing exit strategies and some of the strongly held views, Owl said “it might be wise to watch and see what happens in other nations, further down the path. (The USA will be an interesting wild-card to follow).” This now  proves to be the case as Georgia frees up the “land of the free”. An interesting experiment especially given strained Georgia’s starting point. 

Demetri Sevastopulo in Washington and Hannah Murphy in San Francisco April 21 2020 www.ft.com

Georgia and several other southern US states are moving to ease lockdown restrictions as early as this week, as sporadic protests erupt in other states over the strict measures governors have enacted to tackle coronavirus.

Brian Kemp, the Republican governor of Georgia, said residents could visit gyms, hair salons, tattoo parlours and bowling alleys from Friday, and could then start going to movie theatres and restaurants from Monday.

Henry McMaster, South Carolina’s Republican governor, rescinded a ban on residents going to the beach and eased restrictions on retail outlets to let them reopen if they implement social distancing measures. Bill Lee, the Republican governor of Tennessee, said his stay-at-home order would lapse at the end of April.

Mr Kemp was one of the last governors to impose a lockdown and his move makes his state one of the first to ease restrictions. Georgia has not met the criteria outlined by the White House last week when it recommended that a state see a decline in cases for 14 days before starting to reopen.

The move was slammed by two Democrats — Stacey Abrams, the former minority leader in the Georgia legislature, and Keisha Lance Bottom, the Atlanta mayor — who are both possible running mates for Joe Biden, the presumptive Democratic presidential nominee.

Ms Abrams said the decision was “dangerously incompetent”. Ms Lance urged Atlanta residents to continue to stay at home. Mr Kemp came under intense criticism earlier this month when he acknowledged that he had not realised that people who had no symptoms could still be carrying the virus.

The moves to open some states came as Facebook said it would remove pages promoting anti-lockdown protests that did not adhere to social distancing guidelines. The company took the decision as a spate of public rallies opposed to the coronavirus measures continued across the US. 

Facebook said it would take down content organising anti-quarantine protests if they sought to defy social distancing rules in US states. It has already removed content in California, Nebraska and New Jersey, but said events that include clear calls for social distancing would be permitted.

Small protests have erupted sporadically in recent days as a combination of far-right groups and supporters of President Donald Trump have targeted the governors of states, most Democratic-led, with the more severe lockdowns.

Several hundred people protested outside the Pennsylvania state capitol building in Harrisburg on Monday against lockdown measures introduced by Tom Wolf, the Democratic governor. Mr Wolf announced on Monday that the state’s stay-at-home order would be extended until May 8. 

Some of the protesters have been emboldened by Mr Trump, who last week urged followers in a tweet to “liberate” Michigan, Minnesota and Virginia — all states with Democratic governors, such as Pennsylvania.

On Sunday Mr Trump refused to condemn the protesters despite the fact that many are not practising the social distancing guidelines that his own administration has recommended should remain in effect for now.

Mr Trump said they were “great people” who had “cabin fever” and that they had the right to protest, particularly because some of the governors, including Gretchen Whitmer in Michigan, had gone too far.

As it enforces its policy, Facebook said it had contacted state officials to better understand the scope of their orders related to social distancing.

The social media company is battling to crack down on the false information and conspiracy theories related to coronavirus that are rapidly spreading on the platform. It also announced a new tool last week that informs users if they have interacted with dangerous Covid-19 misinformation on the platform.

At the same time, Facebook risks charges of censorship if it is seen to prevent political discourse — at a time when it already faces accusations of anticonservative bias. 

In Pennsylvania on Monday cars and trucks honked their horns as protesters, some holding placards that backed Mr Trump, waved American flags and called on Mr Wolf to ease stay-at-home restrictions.

The lockdown has been especially devastating to Pennsylvania’s economy, in part because Mr Wolf moved earlier than most governors to order the closure of non-essential businesses in his state to curb coronavirus. 

Pennsylvania has recorded almost 34,000 cases of Covid-19, the fourth-highest total in the country. The number of people who have died has hit 1,348, giving the rust-belt state, the fifth-highest death toll in the US.

Larry Hogan, the Republican governor of Maryland, who chairs the National Governors Association, questioned why Mr Trump was encouraging dangerous behaviour against the advice of his health experts. Last week Mr Trump introduced a plan to reopen the country that urged states to start resuming normal activity only after a 14-day drop in cases.

Mr Hogan on Sunday told the television news channel CNN that many of the states where the protests were occurring, including Maryland, had not yet hit that target.

“To encourage people to go protest the plan that you just made recommendations . . . just doesn’t make any sense,” Mr Hogan said.

“The understudy prime minister is exposing many of the structural flaws that characterise Boris Johnson’s government.” We also have an Opposition Leader who can forensically hold the Government to account. 

Editorial www.theguardian.com

Dominic Raab’s tenure as Brexit secretary in 2018 was short and fruitless. He negotiated nothing in Brussels and resigned in protest, as if the failure was not his own. It is worth recalling that record now because Mr Raab has temporarily risen to the highest office, which is higher than his capabilities should allow.

Acting as prime minister during Boris Johnson’s illness is an unenviable task. The stand-in did not take decisions he must now defend, and has no executive authority to fix mistakes. Mr Johnson’s absence can be felt as drift and incoherence, expressed most potently in confusion over coronavirus testing and supplies of vital medical equipment.

Keir Starmer raised both subjects in his Commons debut as Labour leader on Wednesday. On both fronts he exposed the void where Mr Raab must have wished he had answers. The foreign secretary floundered most under questioning on testing, where the rate lags far behind what would be necessary to hit the target of 100,000 per day by the end of this month. He attempted a sleight of hand, defending the government’s record in terms of elevated testing capacity, an easier metric and not what had initially been pledged. Mr Starmer’s efficiency in identifying and dismissing that trick bodes well for when it is Mr Johnson at the despatch box and not his understudy.

On equipment supplies, Mr Raab’s defence was propped up by two flimsy planks: first, that no country is managing without difficulty; second, that every decision has been taken in accordance with the best available scientific advice. If there was ever merit in those claims it has worn thin from overuse by ministers evading responsibility for the lethal consequences of their actions – and inaction. It is disingenuous and improbable to suggest that ministers have followed a technocratic template, impeded only by logistical challenges beyond their control. Political prejudice infiltrates most decisions in government and Mr Johnson’s Downing Street is one of the most ideologically driven, politically cynical administrations in British history. It is likely that medical expertise was heeded, given that no one in the cabinet had relevant qualifications, but the equivalent skills deficit in other areas has never stopped the prime minister from having a strong opinion and acting on it before. Brexit is a case in point, where decisions of national importance were routinely taken in disregard of advice from people with professional expertise in the relevant fields.

It is plausible that the scale of the coronavirus threat forced ministers to set ideology aside. The Treasury response demonstrates that much in its swift abandonment of orthodox Conservative fiscal policy. But it is also feasible that Mr Johnson and his team took longer than necessary to climb out of some ideological trenches because they had dug themselves in so deep. That lag might help clear up confusion surrounding an EU procurement scheme for medical equipment, which Britain either joined or did not join for reasons that mysteriously vary depending on whether it is a civil servant, a minister or Brussels accounting for events.

On Tuesday, a senior foreign office official told a parliamentary committee that the decision not to participate had been political. Hours later he “clarified” to the contrary, but his written retraction contained no clarification of facts. The truth will surely emerge one day, probably in front of a public inquiry.

Meanwhile, the episode reinforces the impression of a government that was ill prepared for a crisis that demanded competence more than rhetorical bluster, and is failing now to get sufficient grip and undo damage done. Partly that is a symptom of over-centralisation and reliance on the individual authority of the prime minister, whose focus is necessarily elsewhere. But capable ministers and a resilient administration would be compensating better for Mr Johnson’s absence. That they are not, that the whole system seems obviously adrift, running on bluster and improvisation, testifies to flaws. Mr Raab is obviously out of his depth. Sadly, it seems his painfully shrunken stature is an accurate measure of the government he currently leads.

The development of a smartphone app to help identify infection contacts (now being tested by RAF personnel) has long been trailed. This article suggests that similar preparations have not been made to conduct the low tech, but tried and tested, solution the rest of us have seen coming for week.

Charlie Cooper and Ashleigh Furlong www.politico.eu 

LONDON — Doctors and public health experts warn the U.K. faces significant logistical hurdles if it plans to use mass coronavirus testing and contact tracing to help ease its lockdown.

This comes as Health Secretary Matt Hancock set out the government’s plans to roll out an army of 18,000 contact tracers in a matter of weeks. “This test, tract and trace will be vital to stop a second peak of the virus,” he said, during the daily press conference on Thursday.

Britain initially attempted to test those suspected of having the virus and trace their contacts early in the epidemic but then abandoned the approach, with health experts saying mass testing was “not appropriate” for the U.K.

Hancock has since pushed to rapidly increase the U.K.’s testing capacity, which currently stands at just under half of the target of 100,000 tests a day by the end of the month.

However, while welcoming the shift in strategy experts warned that the U.K. is starting from a low baseline to deliver on the plan, following a period in which public health budgets have been cut by over £700 million in real terms between 2015-17 and 2019-20.

Those drafted in will also, experts said, have to have full criminal records checks in place and require at least some training to effectively conduct the necessary telephone conversations required of a contact tracer.

“The challenge of all of this is that we’ve had a decade of cuts to public health,” said Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine. “And the question is whether we can deliver this and I suspect that has been a consideration of the very beginning.”

“We shouldn’t underestimate how complicated it is,” he added. “We need to be quite careful about getting this right.”

Importance of safeguarding

Of the initial 18,000 people drafted in to help, over 3,000 will be clinicians and public health specialists. Civil servants and local government officials are also set to be called on to help,, according to the Times. The newspaper reported the government hopes to have the scheme up and running by May 7, with Hancock saying that the contact tracers would be trained “over the coming weeks.”

While much emphasis has been placed by government on the development of a new contact-tracing app by the “NHSX” tech innovation unit, experts say that simple manpower is also key to the strategy.

However, one retired public health doctor, who worked in health protection but asked not to be named, warned that the skilled environmental health officers trained to carry out such work were in short supply. “They have absolutely decimated public health in local authorities,” said the doctor.

If new recruits from the ranks of national and local government officials, or even volunteers, are to be used, they will also require training for the task of contact tracing, said Gary McFarlane, the Chartered Institute of Environmental Health’s Northern Ireland director.

“You can make this sound very simplistic, but in reality, it’s actually quite complex, he said. “The critical thing here is the answers that are actually given, because the answers need to inform where the questioning needs to go. It’s about following an investigative path.”

However, the public health doctor disagreed. “It’s not rocket science,” the doctor said, explaining that a contact tracer simply needs to take a contact through their average day, finding out who they have seen and where they went.

But that doesn’t mean the process will be straightforward, with both McKee and the public health doctor raising issues around safeguarding. This could require all contact tracers to have Disclosure and Barring Service (DBS) checks, which highlights if someone has a criminal record and usually take four weeks or more. A similar requirement is already in place for volunteers working with the most vulnerable within the NHS’s new volunteer service.

“You must not let people loose on contact tracing who have not been appropriately vetted,” the public health doctor said. “It will just open the floodgates for potential abusers to volunteer and find their way into kids’ networks and vulnerable people’s networks.”

Government officials have been contacted for comment.

‘Alternative’ to full lockdown

According to public health experts, community testing, contact tracing and isolating is one of, if not the most, effective strategy governments could deploy to control the coronavirus epidemic; a “community shield” that could avert the need for repeat lockdowns, according to Anthony Costello, a former World Health Organization director of mother, child and adolescent health.

“We allowed the epidemic to surge by stopping a national strategy for community case finding, testing, contact tracing and isolation on March 12 and still haven’t restarted it,” he told POLITICO. “This virus will come back within weeks of lifting the lockdown. Without a community shield we shall not pick up new cases and outbreaks early, and we shall be left with either repeat lockdowns, or allowing the virus to spread.”

The U.K.’s longest-serving health secretary, Jeremy Hunt, has also been an outspoken advocate of reintroducing the so-called test, trace, isolate strategy.

“If you have a system where anyone who has COVID systems can call [NHS phone line] 111, get a test immediately, we then track everyone they’ve been near and test and isolate them if necessary, you have an alternative to a lockdown,” he told POLITICO last week. “Which is why the shops, restaurants, offices are open in Korea, Taiwan, Singapore and Hong Kong.”

Hunt, who now chairs the House of Commons health committee, has highlighted World Health Organization advice that lists the ability to track and trace every single new COVID case in the community as one of six conditions for easing lockdowns.

“It’s a huge job, you’ve got to put teams in place,” he said. “The obvious thing I think would be to start in parts of the country where we have relatively low numbers of infections like Yorkshire and Cornwall and see whether you can get that mass community testing in place.”

www.markpack.org.uk 

In the run-up to the 2019 general election, there was a lot of media and political excitement about an apparent surge in electoral registration and why that might be good news for Labour.

My scepticism at the time, based on a little maths, was rather an outlier from what others were saying, based in particular on the likelihood that a high proportion of the registration applications would turn out to be duplicates. That is, people already on the register (or not qualified to be on the register) were putting in applications that would therefore not result in actual additions to the electoral register.

The Electoral Commission’s report into the 2019 general election, out this week, now gives us some data on that:

A large number of duplicate applications added unnecessary pressure for EROs and their teams. Data from EROs shows that many applications were submitted by people who were already correctly registered:

• Approximately one in three applications they received before the deadline was a duplicate
• In some areas the proportion of duplicate applications was even higher
• Only around half of all applications led to an addition to the register

That scepticism was justified then.

Overall, this story is a good example of how the truth often travels much more slowly than the news, in this case coming out many months after all those news stories. That’s a theme I expand on in my book, Bad News: what the headline’s don’t tell us.

The wisdom of the Government’s instinct to use privatisation solutions thrown into doubt. 

Hospitals sought to take over the operation of a flagship government coronavirus testing centre from the accounting firm Deloitte after severe failings in the service led to the test results of NHS staff being lost or sent to the wrong person, the Guardian can reveal.

Juliette Garside  www.theguardian.com 

The drive-through centre, at Chessington World of Adventures, in Surrey, was among the first in what will be a network of about 50 regional facilities, trumpeted by the health secretary, Matt Hancock, as key to delivering on the government promise of 100,000 tests a day by the end of April.

On Thursday the government insisted it was on track to meet the target, increasing the tests from less than 10,000 at the start of April and just 23,000 tests on 14,000 people on Wednesday.

Deloitte was hired to help scale up testing nationally, and is understood to be handling logistics across a number of the sites, working alongside other private firms such as Serco and Boots.

Deloitte says it does not run or manage the testing centres, but supports the Department of Health.

In revelations that raise concerns over the rapid outsourcing of testing during the pandemic, chief executives at hospitals in south-west London are understood to have had talks about removing Deloitte and running the Chessington drive-in testing centre themselves.

The alarm was sounded when doctors and nurses complained that test results never arrived, or that they had been sent someone else’s results. In other cases, the test centre, which is about 12 miles south-west of central London, was unable to ring through with the diagnosis because of a failure to record correct phone numbers.

In an email written in early April, and seen by the Guardian, the chief executive of Epsom hospital said: “Deloitte who have been commissioned by the Department of Health directly for this are not running this as well as we would like … [We] are asking whether we can take over the running of the Chessington centre because we really need it to work much better than it is.”

It is understood that the request to remove the firm was made in the first week of April, but that it was set aside after performance improved.

However, Epsom hospital stopped sending staff to Chessington 10 days ago after finding a more convenient alternative, it said. Staff are now swabbed at work and the samples sent to the laboratory at St George’s hospital, south London for analysis.

Epsom could soon be able to do the analysis itself, having ordered four machines made by a company spun out from Cambridge University, which can complete the process in 90 minutes.

The Chessington centre’s problems appear not to have been entirely resolved. A paramedic for the south-east coast ambulance service, who asked not to be named, said he had been tested along with a group of colleagues on 3 April. They were still waiting to hear from Chessington.

“None of us from my place of work, tested on that Friday, have had our results,” he said. “We were told our samples were taken to a lab in Southampton. It’s three weeks since the test and I don’t think I’m ever going to get the result. No one’s been in touch other than my managers to say they’re chasing it.”

The paramedic questioned the involvement of Deloitte, which specialises in management consultancy, tax and accounting but has little experience in running public services. “I’m not sure what is essentially an accountancy company can bring to this.”

A doctor at Epsom hospital, who was among the first to be tested at the end of March while self-isolating at home with symptoms, said she was still waiting to hear; after making enquiries she was told Deloitte could only release information to the person being tested, and not the organisation referring them. She has since been tested by her hospital.

Asked to comment, Daniel Elkeles, who runs Epsom, and its sister hospital, St Helier, in Carshalton, Surrey, said there were “clearly teething problems at Chessington at the start of this contract”.

“We are now assured that those teething problems are fixed and that the service is reliable. But it’s much more convenient for our staff to be swabbed [at the] Epsom and St Helier sites, and for us to send the swabs to St George’s for testing. This means our staff don’t have to travel to Chessington and also means the facility has more capacity for other parts of the health and care system.”

Normally, government contracts over a certain value are advertised publicly and awarded after a competitive tender.

However, it is understood that the health department appointed Deloitte without competition, under an obscure piece of legislation introduced in 2015 which ministries have been told they can use during the pandemic to avoid lengthy tendering processes.

A Deloitte spokesman said: “Deloitte, alongside many other public and private sector partners, is supporting DHSC (the Department of Health and Social Care) to help accelerate and scale testing capacity for the national Covid-19 testing programme.”

DHSC said that only a small number of people had experienced delays in getting their test results in Chessington and that most of those had now been delivered. It said it was continuing to investigate the remainder.