Know the difference between “Pillar-one” and “Pillar -two” testing?
[Only the pillar-one testing is used in PHE’s online coronavirus dashboard, meaning that the majority of cases in the worst-hit areas are being left off this data.]
Bradford, Barnsley and Rochdale can be revealed as the places with the highest levels of new Covid-19 infections after Leicester, as fears grow of further local outbreaks and the UK heads towards Saturday’s lifting of more lockdown restrictions.
The official data, which has not been previously published on Public Health England’s online dashboard, comes amid complaints from local health officials and medics that a lack of detailed testing about local outbreaks is causing delays in attempts to curtail them.
It also raises fresh questions about the disproportionate impact of the virus on ethnic minorities, with seven out of 10 of the worst affected areas being in Yorkshire and Lancashire, including some of the most ethnically diverse parts of the country.
Leicester was locked down on Monday after the health secretary, Matt Hancock, said the seven-day infection rate was 135 cases per 100,000 people, the highest in the country. Figures from Public Health England now show that rate was even higher in the east Midlands city – just over 140 – in the week ending the previous Sunday, 21 June.
Bradford’s rate for that week was 69.4 per 100,000 people, Barnsley’s 54.7 and Rochdale’s 53.6, according to the official figures, which gather together both tests primarily in NHS settings and of healthcare workers and tests carried out in people’s homes and in the community.
The two strands are known as pillar-one and pillar-two testing.
In all of the top four cases it is the level of infection revealed in the pillar-two community testing that has driven up the numbers, accounting for between 71% and 94% of all infections.
However, only the pillar-one testing is used in PHE’s online coronavirus dashboard, meaning that the majority of cases in the worst-hit areas are being left off this data. This data did not show that as far back as the week beginning 1 June, PHE knew Leicester was among the two worst affected areas in England.
The Leicester MP Liz Kendall said it took “far too long to get even very basic postcode data, which is what we need to identify where the problem is; whether it is in schools, whether it is in certain factories and workplaces. You really do need that detail.”
About half of Leicester’s population is made up of ethnic minority groups and the latest figures will increase questioning of how Covid-19 is affecting those communities. So far across England 18.1% of the positive tests for the virus were among black, Asian and minority ethnic people, with the largest part of that – almost 10% – among people of Asian background, according to Public Health England. The ethnic minority population of England was 15.1% in 2016, according to official estimates.
Of the other 10 worst affected areas, Bedford, Oldham, Blackburn and Kirklees all have ethnic minority populations of between 20% and 30%, above the average for England. Rotherham, Tameside and Barnsley, which are also in the top 10 , all have higher than average white British populations.
Lord Woolley, the chair of the government’s race disparity unit’s advisory group, said on Wednesday Covid 19 “has had a devastating impact” on ethnic minorities and “has laid bare those elements in our society that are deeply racialised: that if you are black, Asian and ethnic minority you are two or three times more likely to be unemployed, 50% more likely to be on a zero-hours contract”.
Local public health officials and medics have complained that the government has not supplied sufficiently detailed information on local infections, the lack of which they say hampers attempts to quash new outbreaks.
Councils have been promised postcode-level data for weeks from Public Health England and the newly created Joint Biosecurity Centre. But some public health directors are concerned the centre has not been sharing data about potential clusters of infections with councils, which could enforce school or workplace closures that could suppress an outbreak at an early stage.
“If the only data you’re getting is ‘in this population of 90,000 people there are 40 positives’ it’s like looking for a needle in a haystack. If Leicester had got the data sooner they could have had a fighting chance of managing it,” said one public health director, who asked not to be named.
The British Medical Association also implored the government to ensure local leaders were given timely information about cases in their area to help contain the spread of the virus.Dr Chaand Nagpaul, the chairman of the BMA Council, said on Wednesday: “The prime minister has talked about a ‘whack-a-mole’ strategy to tackle local outbreaks, but this is no use if the people leading the response on the ground – be they public health teams or local leaders – are not given the most accurate up-to-date data possible. This is crucial to allow swift action and to protect lives and the health service, and something that is not happening right now. This is all the more important given that the ‘world-leading’ test and trace app is not in place, meaning local leaders and teams armed with up-to-date information will be vital in containing spread of outbreaks.”
The Department of Health and Social Care has said it has been “working closely with our local partners, providing them with the resources and tools so that they can take swift action to deal with any new local spikes in infection”.
In total, there are 47 English local authorities where there are more than 10 cases per 100,000. In a further sign that the disease has shifted away from the capital, not one of these 47 areas was in London.