“The health secretary, Matt Hancock, has promised the NHS will have everything it needs to tackle coronavirus, but what it really needs is an effective public health response to keep it at bay. By failing to face up to its failures, the government risks unleashing a second wave.”….
“One of the most baffling aspects of the government’s response to the pandemic is its obsession with setting up new structures from scratch rather than working with what they already have.”…
Richard Vize is a public policy commentator and analyst www.theguardian.com
Local communities – not the NHS – are the frontline in the battle against Covid-19. Each hospital admission means the virus has already broken through.
The health secretary, Matt Hancock, has promised the NHS will have everything it needs to tackle coronavirus, but what it really needs is an effective public health response to keep it at bay. By failing to face up to its failures, the government risks unleashing a second wave.
The experiences of countries with an impressive record in controlling the pandemic, such as Germany, New Zealand and South Korea, show that even the best prepared systems can experience major flare-ups that are difficult to control. But still the UK government has not put in place the systems to identify local outbreaks quickly and come down on them hard.
A joint statement in the British Medical Journal (BMJ) signed by healthcare leaders including the presidents of 11 royal colleges and the Faculty of Public Health articulates widespread concern that England simply isn’t ready. Areas of weakness it identifies include coordination of national, regional and local bodies – such as councils and Public Health England’s regional health protection teams, the bedrock of any communicable disease response.
Even after more than 50,000 deaths and a daily infection rate that still far exceeds countries such as Spain, Germany, France and Italy, the government is failing to ensure local public health teams have everything they need to keep their communities safe.
There have been improvements in recent weeks. Evidence to the housing, communities and local government select committee shows councils are finally being listened to and their concerns understood.
But, as the Guardian has revealed, the government’s failure to share full details of who has caught the disease with local public health teams risks wrecking their ability to contain an outbreak.
The entire edifice of the test and trace system – our bulwark against a second wave of the pandemic – begins to collapse without this vital local intelligence. If council teams don’t know where the infections are they can’t control them.
This highlights the chasm between government rhetoric and its ability to deliver. A week ago, Hancock promised the Commons that data-sharing rules would not be allowed to get in the way of saving lives. No 10 adviser Dominic Cummings, meanwhile, has routinely touted his own supposed brilliance with data, writing excitedly about cognitive technologies and superforecasting. But faced with the first real-world data challenge of his reign, he has failed.
Public health teams don’t need a superforecast or cutting edge AI. They just need to know where people with infections live and work and where they have been.
At the heart of the government’s data operation is the new Joint Biosecurity Centre. At the beginning of June, Hancock admitted that it did not yet exist, but it is already on its second leader. It will be responsible for getting information to councils, but there is confusion about how it will work with both local government and Public Health England.
One of the most baffling aspects of the government’s response to the pandemic is its obsession with setting up new structures from scratch rather than working with what they already have. It caused confusion and has wasted effort and, above all, precious time, in setting up testing centres, laboratories, supply chains and contact tracing, all divorced from existing local government and NHS operations and dependent on a maze of private sector contracts.
The Joint Biosecurity Centre looks set to continue this folly. It won’t be fully operational until at least the end of the summer, and it seems foolhardy to insert a new, untested body into the pandemic machinery at precisely the time when a potential increase in infections from the relaxation of restrictions and the return of schools will put the system under huge stress.
Meanwhile, councils are preparing their local outbreak management plans. Trading standards, environmental health, social care and many more people besides are collaborating with the public health teams to ensure their response to any flare-ups is quick and robust. But they need the data.
- Richard Vize is a public policy commentator and analyst