Public health advice is no longer being followed under Boris Johnson’s “living with Covid” strategy to end mass testing, senior civil servants have acknowledged in a leaked account of a cross-Whitehall briefing.

Rowena Mason http://www.theguardian.com 

The briefing by a senior member of the Covid taskforce was delivered to civil service leaders across Whitehall on Thursday afternoon, making clear that following public health advice was no longer the sole priority.

The senior official said public health advice would not be met in NHS or social care settings in relation to the testing of staff, and that was a “decision that the PM, chancellor and indeed the cabinet have agreed to”.

On the call, he said: “It will be the case from 1 April that testing in DH own settings including the NHS and adult social care will not fully match the public health advice because of spending considerations. We will not be testing adult social care staff or NHS staff at the frequency recommended by clinicians because there is not the funding to pay for it.”

Johnson has repeatedly stressed throughout the pandemic that he would “follow the science” and listen to his public health experts. However, that appears to have ended with the “living with Covid” strategy, which set out a timetable for winding down testing and scrapping mandatory isolation.

The government has not published its public health advice from the UK Health and Security Agency but it is understood its advisers did not recommend winding down testing unless the prevalence of Covid was at a low level in the UK and that the pandemic was in a “steady state” near to endemicity. The government’s experts do not believe that state has currently been reached.

Chris Whitty, the chief medical officer, and Patrick Vallance, the chief scientific officer, stood beside Johnson in a press conference as he announced the strategy but they struck a much more cautious note, urging people to carry on washing their hands and wearing face masks in enclosed spaces.

The strategy to end mass testing was published after a row between Sajid Javid, the health secretary, who wanted up to £5bn more for testing, and Rishi Sunak, the chancellor, who insisted there would be no more cash after spending £15bn over the last year.

The strategy ends most symptomatic and all asymptomatic testing for the general population, as well as for NHS staff. It will be decided over the next month whether very elderly people and some vulnerable people will get free lateral flow tests if they are symptomatic. Medical settings should also get access to testing for symptomatic patients and care home residents as well as symptomatic social care staff.

In the briefing, civil service officers were told there would not be additional funding from the Department of Health and Social Care (DHSC) or the UK Health and Security Agency (UKHSA) to cover testing in vulnerable settings overseen by their departments where there was a risk of outbreaks.

This could include settings such as prisons, schools, children’s homes, detention centres, accommodation for asylum seekers and homeless shelters. Cabinet ministers will in future have to decide whether their budgets can stretch to additional testing in their areas and the senior civil service officials from departments across Whitehall were advised there was no expectation in future that they would follow public health advice in full.

The senior official told them he was sure there would be “plenty of other areas across government where ministers decide on balance the funding does not exist to follow the public health advice in full when it comes to recommended testing protocols.”

He made clear that the government was moving from a world where “public health advice is to be followed at all costs, and whatever the fiscal consequences money will be found to do exactly as clinicians recommend, towards a world where public health advice is one of several considerations to be taken into account and balanced decisions need to be made that consider public health advice but don’t necessarily follow it in all cases”. He added: “I think that is going to require a mindset shift across Whitehall.”

A senior official on the Treasury Covid response was also present at the meeting, spelling out that it was considered acceptable for the public health advice on testing not to be followed in vulnerable settings. “Ministers [the prime minister, chancellor and chancellor of the duchy of Lancaster] are not expecting to be continuing testing in these types of setting in the main,” she said.

Civil service officials on the call raised concerns that departments would find it difficult to make decisions about matters of public health on their own, weighing them up against financial considerations. There was also a worry that the costs of testing would have to continue to be absorbed by departmental budgets even if there were a new variant or spike.

The Cabinet Office and Treasury had no comment on the leaked account of the meeting.

“The real challenge is in making sure that levelling up isn’t just seen as giving the major cities what London has. It is also about how you move counties and districts into a position where people feel equal to those who live in larger urban areas in terms of access to services.”

www.room151.co.uk

The chief executive of West Lindsey District Council has called for the government’s levelling-up agenda to have a more rural slant to it.

Ian Knowles told Room151 that rural authorities had to rely too heavily on council tax rather than government grant, and that all government policies needed to be “rural proofed”.

“The real challenge is in making sure that levelling up isn’t just seen as giving the major cities what London has. It is also about how you move counties and districts into a position where people feel equal to those who live in larger urban areas in terms of access to services,” he said.

Knowles added that decision-making should take place at a “genuinely local level”, making better use of district councils working with town and parish councils.

“One of the ways to create that rural/urban balance is to make sure the decision making is at the lowest possible level and that is disaggregated to local communities rather than aggregated to a greater level.”

West Lindsey was successful last year in its bid for levelling-up funding and received just under £10.3m to help create a thriving Gainsborough town centre. This includes the construction of a cinema, restaurant and retail units, refurbishing the bus station, creating new homes above shops as well as restoring historic buildings, reviving Gainsborough marketplace and creating safe green spaces and a park that is accessible for children.

Knowles said that preparation for the bid had required ten weeks of planning by senior officers at West Lindsey, at a time when Covid cases were high and resources stretched, but the end result was of “outstanding” quality.

“We received massive support from stakeholders around the town – a lot of businesses signed up to support us, as did the college, university and chamber. We also had great support from Lincolnshire County Council, Sir Edward Leigh, our local MP, as well as strong support from our own councillors.”

Demand for nature is exceeding supply but new wildlife areas can be created by regulations to ensure housing estates bring about “biodiversity net gain”, according to the chair of England’s nature watchdog.

Patrick Barkham www.theguardian.com 

Tony Juniper said the post-pandemic surge in people visiting wild places for their mental and physical wellbeing – and to walk lockdown puppies – was concentrating footfall in relatively few nature reserves, which were increasingly used like public parks.

But Juniper, who has been reappointed as chair of Natural England for a second three-year term, said his agency must “increase the supply of nature”.

“Part of the challenge post-lockdown – the footfall in relatively few sites – makes you wonder how we’re going to cope with that increased demand for nature when nature is depleted and fragmented,” he said. “Visitor pressures on protected sites [such as national nature reserves] is a supply and demand question.”

Juniper, a former executive director of Friends of the Earth, has been credited with restoring morale – and adding a 47% budget increase this year – to beleaguered Natural England, which had been decimated by a decade of cuts.

But after three years “building the picture and getting the toolkit and resources to deliver it” he said it was time for him and Natural England to deliver on “the gargantuan task of nature recovery” to help the government meet its ambitious wildlife targets.

The government’s target to protect 30% of land and sea for nature by 2030 was “a big stretch”, he said. “We have targets coming on species abundance and nature recovery, and if we are going to get to those 2030 targets we need to start really hitting the ground now.”

The new “public money for public goods” farm subsidy system, although not fully finalised, should help, according to Juniper, who said he was also hopeful that wildlife could be restored via biodiversity net gain, which from 2023 obliges every housing and infrastructural development to create 10% more nature than was there before.

One-fifth of Tory party donations come from major developers but Juniper said biodiversity net gain was not “just a licence to trash” wildlife. “It isn’t, because we’re not abandoning anything we already have in terms of the existing protections and tests [for wildlife] that need to go through the planning system,” he said.

He admitted there were “tensions” between developers providing nature-friendly spaces close to new homes or boosting wildlife in distant sites. “On the one hand we want more bigger, better, more connected nature-rich places, on the other we want to improve the environments around where people are living,” he said.

Speaking during a tour of 25 acres of arable farmland acquired for restoration to wildlife-rich chalk grassland by the charity Cambridge Past, Present and Future, Juniper said it was important to plan a network of new nature-rich places close to new homes.

The restoration will increase Wandlebury country park by 20% but Cambridge’s population has grown by 20% this century, with an ongoing jobs, development and population boom.

“There’s limited semi-natural habitat around here so creating more of it to be able to serve that population makes sense,” said Juniper. “But doing it in the best possible way to get the biggest strategic impact is the key thing. We don’t want little pocket parks scattered all over the place randomly. We’d like to see the coherent construction of a nature recovery network which is not only taking account of biodiversity net gain but also the existing protected areas and blend that with the new agricultural schemes. It’s a jigsaw to piece together.”

While Juniper has helped win an enhanced role and funding for Natural England, and said he was hopeful of “further increases this year because the work is expanding”, Natural England staff went on strike in January over a decade of pay freezes and below-inflation rises.

Juniper said Natural England’s executive was doing all it could to push for more money for staff. “We’re very aware of the issues being raised by staff around pay. Since I’ve been there we’ve consistently done the maximum we could each year in terms of staff rewards and pay but the big picture is constraint – we have the rules set by the Treasury.”

In his next three years, Juniper said he hoped to create more big national nature reserves and said the issue of out-of-control dogs in wild spaces was raised wherever he went. He said it was still possible to make more space for wildlife and for people.

“Everyone at Natural England is convinced it’s not nature recovery or public access – it’s both. With some limits during the bird breeding season, raising awareness and management, I think we can do that.”

Torbay’s health chief has warned people in the bay not to be complacent and “trivialise” Covid-19 despite the lifting of many restrictions across the country.

Guy Henderson www.devonlive.com 

Speaking as all remaining legal Covid restrictions were removed in England, nearly two years after the first rules were introduced, he said rates of infection in the bay were still “very high”.

People are no longer legally required to self-isolate if they test positive for Covid – although they are still advised to do so.

But they should carry on wearing face-masks and washing their hands often.

In his latest video message, Torbay’s director of public health Dr Lincoln Sargeant said: “The policy has now shifted to living with Covid.

“Cases in Torbay have begun to fall, and all of our data are pointing to the fact that this fall is genuine.

“However, despite the fact that rates are falling, they still remain very high.”

The latest figures show that there are 580 new cases per 100,000 people in Torbay, and 1,000 new cases per 100,000 people in the “peak” age group for infections, those aged from 30 to 39.

“With high background rates the chances that you might come across someone who is infected, and if you are not careful become infected yourself, remain significant,” he added.

While the Omicron variant is milder than the previous Delta strain, it should still be respected, said Dr Sargeant.

“Omicron causes severe illness, particularly among those who are unvaccinated.

“We should not trivialise this disease or feel that somehow it has gone away. It is not just another cold, and the data do suggest that it does have a greater impact than normal seasonal flu.”

Dr Sargeant said public health measures such as regular handwashing would still be relevant, and were already contributing to lower-than-normal levels of traditional winter viruses such as flu and norovirus.

He went on: “While the background rates are still high, it does make good public health sense – and a good sense of courtesy, that face coverings are used in enclosed spaces, particularly indoors and particularly where it is crowded.

“As rates come down we may want to re-evaluate that, but it seems to make good sense.”

He said there were still a number of people in Torbay who had not been vaccinated at all, and a greater number who had not yet had a booster.

“There are people in our population who are clinically vulnerable with conditions which weaken their immune systems,” he said.

“These people will need to be more cautious when they begin to interact with others.

“It is important that we are respectful and mindful that there are others who we come into contact with who are cautious for good reason.

“We should not do anything that would inadvertently put them at risk of infection.

“It is important that we keep ourselves reminded of the good practices that will continue to protect us and protect others in Torbay.”