New contact-tracing app could be key to ending the coronavirus lockdown

The NHS is preparing to release an app that alerts users if they come into contact with someone who has tested positive for coronavirus, in a move that could pave the way towards the end of the lockdown. 

Given the source, Owl thinks it is likely to reflect the current government thinking on how to relax lockdown. However, as mentioned in the article, it does depend for success on a high level of testing. Owl also wonders how applicable this is outside a metropolitan/city environment.

By Sarah Knapton, Science Editor  www.telegraph.co.uk

The opt-in programme is likely to be rolled out as the current restrictions on movement are lifted – and, if successful at limiting the spread of the virus, could prevent the need for further clampdowns.

Experts are now expecting the British epidemic to peak around Easter, before a steady decline.

At the Government’s daily press briefing, Prof Stephen Powis, Medical Director of NHS England, said “green shoots” were emerging after new cases began to plateau.

But he warned the death toll would continue to rise in the next fortnight.

“So green shoots, but only green shoots, and we must not be complacent and we must not take our foot off the pedal,” he said.

The Government is hopeful that once the number of new cases is sufficiently reduced, the app could help it remain low, allowing the public to resume their daily lives.

It will work by using Bluetooth technology to connect users’ phones to other nearby phones, and to record people who have come into close proximity – at a distance of two metres – for 15 minutes.

If someone tests positive for coronavirus and records it on the app, it will automatically alert those who were near them in the past few weeks, and ask them to self-isolate.  

The success of the app will rely on the availability of widespread testing, which has not yet been achieved. 

The Government does not intend to make the app compulsory in order to lift the lockdown, but millions will be encouraged to use it in order to avoid lengthier and more stringent restrictions being put in place. 

If the limitations on movement are lifted and infections and deaths rise again, the country could be placed back into a strict lockdown. 

Countries across Europe, including Germany and Denmark, have started to consider when they can lift lockdown restrictions, amid growing concerns over the impact on the European economy.  

Singapore’s relatively low levels of coronavirus infection have been the result, in part, of the Government’s use of the contact tracing app TraceTogether. On Sunday, the city state recorded only its third death from Covid-19 from a total of 926 reported cases.

But there have been concerns over data protection and privacy amid fears the new app could lead to widespread surveillance of the population.

NHSX, the unit driving the digital transformation of health and social care in the UK, has been working with civil rights groups to make sure data is anonymised and not used to monitor citizens.

The Telegraph understands that NHSX has been working on a six-week development window, and the app should be ready within a month.

Developers hope a majority of the population will download it, but new modelling from Oxford University has shown that it does not need everyone to sign up to be effective.

Professor Christophe Fraser, Senior Group Leader at the Oxford Big Data Institute, said: “It’s not a niche thing – the majority of people will have to have it – but you don’t need everyone for it to work, and some people won’t have smartphones,” he said.

“We’re all in lockdown, and somehow or another we’re going to have to figure out a way to move on, and, yes, testing will be really important, but an app that helps make sure people self-isolate could solve a lot of problems.” 

Alongside a ramping up of community testing, the app could help Britain get out of lockdown sooner without risking a second peak, amid growing fears that the restrictions could cause more harm than good.

Boris Johnson, the Prime Minister, was urged by one of his ministers not to “crash our economy” by imposing further lockdown measures in the first sign of a Cabinet split on the issue.

Grant Shapps, the Transport Secretary, said that if people who cannot work from home were stopped from going to work, “millions” would be forced into poverty, which “would do more harm than the virus itself”. 

Mr Shapps told the BBC: “One of the things we need to be careful not to do is completely crash our economy to the point where it is impossible or very difficult to pick up again afterwards.”  

The Institute of Fiscal Studies (IFS) also warned that lower incomes would lead to a fall in tax revenues and higher public spending, which, taken together with emergency measures to help businesses, could leave Britain facing a £200 billion deficit, compared to the £55 billion forecast in the Budget just three weeks ago.

Isabel Stockton, a research economist at IFS, said: “A 5 per cent hit to GDP this year could be an underestimate, and even that would mean £115 billion less goods and services produced this year. That’s equivalent to over £4,000 per household in the UK.” 

In a letter sent out to every household this week, Mr Johnson said he would “not hesitate to go further if that is what the scientific and medical advice tells us we must do”.

But Cabinet ministers have privately expressed concerns at the Prime Minister’s suggestion that the national shutdown might get even stricter if the current lockdown measures do not have the desired effect.

One minister told The Telegraph that while the country was currently supportive of the lockdown, “that might not be the case after Easter”. 

Downing Street distanced itself from Mr Shapps’s comments and said that the Government had put in protections for the economy.  

Civil liberties groups warned that developing a contact tracing app so quickly could put people’s privacy and data at risk.  

In the UK, 22 per cent of adults do not have a smartphone, and this rises to 45 per cent of adults over 55, which has led to fears of health inequalities as those without the app will not know they are at risk.  

Jim Killock, Executive Director of Open Rights Group, said: “At the moment, with the information we know, it sounds like a reasonable approach – but as a whole, the Government has been quite bad at communicating.

“Something like this has a lot of risks involved: privacy, technical, data security and delivery risks. In order to build a huge piece of software that’s going to be used by millions of people in a couple of weeks, is a pretty challenging endeavour.” 

Silkie Carlo, Director of the civil liberties group Big Brother Watch, warned that, if abused, any automated contact-tracking data could become a form of ‘mass surveillance’.  

“Any experimental attempts at individualised tracking on a mass scale will be fraught with inaccuracies, further unnecessarily burdening our health services, and could damage trust in medical confidentiality to the point where people don’t report their symptoms.” 

The NHS is also believed to be involved in a number of other digital initiatives including a symptom tracker, data app and data store.  

An NHSX spokesperson said: “NHSX is looking at whether app-based solutions might be helpful in tracking and managing coronavirus, and we have assembled expertise from inside and outside the organisation to do this as rapidly as possible.”

 

Covid-19 tracker app posted by Owl 26 March, already producing results.

On 26 March Owl posted a link to a Covid-19 tracker app. The app was the brainchild of Prof Tim Spector, a genetic epidemiologist at King’s College. He and his team were aiming at 1 million downloads in 24 hours, but managed 1.5 million. This huge data base has already produced results.

Loss Of taste, Smell Key COVID-19 Symptoms: British Scientists’ Study

Reuters  www.nytimes.com

LONDON — Losing your sense of smell and taste may be the best way to tell if you have COVID-19, according to a study of data collected via a symptom tracker app developed by British scientists to help monitor the pandemic caused by the new coronavirus.

Almost 60% of patients who were subsequently confirmed as positive for COVID-19 had reported losing their sense of smell and taste, the data analyzed by the researchers showed.

That compared with 18% of those who tested negative.

These results, which were posted online but not peer-reviewed, were much stronger in predicting a positive COVID-19 diagnosis than self-reported fever, the researchers at King’s College London said.

Of 1.5 million app users between March 24 and March 29, 26% reported one or more symptoms through the app. Of these, 1,702 also reported having been tested for COVID-19, with 579 positive results and 1,123 negative results.

Using all the data collected, the research team developed a mathematical model to identify which combination of symptoms – ranging from loss of smell and taste, to fever, persistent cough, fatigue, diarrhoea, abdominal pain and loss of appetite -was most accurate in predicting COVID-19 infection. 

“When combined with other symptoms, people with loss of smell and taste appear to be three times more likely to have contracted COVID-19 according to our data, and should therefore self-isolate for seven days to reduce the spread of the disease,” said Tim Spector, a King’s professor who led the study.

Spector’s team applied their findings to the more than 400,000 people reporting symptoms via the app who had not yet had a COVID-19 test, and found that almost 13% of them are likely to be infected.

This would suggest that some 50,000 people in Britain may have as yet unconfirmed COVID-19 infections, Spector said.

Official figures showed confirmed cases rose 14% in Britain between Monday and Tuesday to 25,150 as of Tuesday at 0800 GMT. The government said 1,789 people have died in hospitals from coronavirus as of 1600 GMT on Monday.

(Reporting by Kate Kelland, editing by Grant McCool)

 

Coronavirus: Medics ‘threatened with sack’ if they speak of PPE shortages

Doctors and nurses who speak out about the lack of personal protection equipment for hospital staff are being threatened with dismissal, they have said, raising fears that health authorities are trying to hide the extent of the crisis.

Kat Lay | Katie Gibbons  www.thetimes.co.uk 

In a letter to the prime minister, 10,000 NHS staff demanded better protection. The government and health service chiefs insist there are adequate supplies of personal protective equipment (PPE) and say remaining delivery issues are being resolved.

However, in the first acknowledgement that there is a problem when the authorities sought to assure the public there was not, Dr Jenny Harries, the deputy chief medical officer, admitted she had “optimistically” said ten days ago that issues with PPE had been resolved but they had since reoccurred.

She said: “The distribution element has been a little bit tricky at times and we have now taken a whole strand of the logistics, including with the army’s support actually, out so that we are developing a UK position on that stock and distribution flow.”

The army has been brought in to move equipment around the country, while officials have adopted a “push” model of sending supplies to hospitals even before they are requested. However, some frontline staff continue to report being without protective equipment. They also say they have concerns about whether Public Health England guidance on what to wear is sufficient, as in some cases it appears to conflict with World Health Organisation rules.

Dr Rinesh Parmar, chairman of the Doctors’ Association UK, said their inbox was filling up with emails from people concerned about the issue but “being told they are going to lose their job if they post about it on social media”.

He said: “They raise concerns internally and nothing happens. It feels like those concerns land on deaf ears. They then take to social media and get told their social media is being monitored and they are going to lose their jobs.

“At a time when we need every single doctor on the front line, doing what they can, it is just not helpful for people to be afraid.” The authorities had been expected to update PPE guidance over the weekend, but they were flooded with more than 1,000 responses to a draft sent out to professional bodies. The Times understands Public Health England expects to release a new version today. Professor Martin Marshall, chairman of the Royal College of General Practitioners, said the draft had been “vague” on exactly when GPs should wear protective equipment.

Amid reports that community groups were responding to shortages with efforts such as sewing scrubs or 3d-printing visors an expert warned that new equipment could prove “worse than nothing” if not properly produced. Dr Al Edwards of Reading University said: “Poorly functioning equipment that only gives the false promise of protection could be worse than nothing.” There was no reason, however, why local small-scale production should not help if overseen by experts.

Ten thousand NHS workers are among 20,000 signatories to a letter asking for Boris Johnson to ensure all frontline medical staff have the correct face masks, goggles, gowns and gloves.

A consultant in Gloucestershire said: “Our ward covers confirmed Covid-19-positive patients. I was on it all weekend. We only have plastic aprons, gloves and surgical masks. There is one shared visor per bay [of six patients] for all healthcare workers. No gowns.”

Dr Julia Patterson, of EveryDoctor, co-ordinating the letter, said: “Patients are dying, healthcare workers are dying. It’s time to act.”

One London paramedic said the plastic apron, gloves and surgical mask that he had been issued would be more suitable for people making sandwiches. “It feels like every day I’m exposing myself and potentially my family to this virus,” he told the BBC.

A London Ambulance Service spokesman said: “We have sufficient stocks of protective equipment for staff.” An NHS spokesman said: “Staff continue to speak in a personal, trade union or professional body capacity, and it is self-evident from print and broadcast media coverage throughout this incident that staff are able and do in fact speak freely.”

 

Health officials ignored offers of coronavirus testing help as anger mounts at Government’s failure to ramp up capacity

As ministers face growing questions over the failure to ramp up testing, The Telegraph can disclose that officials have repeatedly ignored offers of help from many of the country’s leading scientific institutions.

By Bill Gardner and Gordon Rayner, Political Editor  www.telegraph.co.uk

The instructions from the World Health Organisation were clear.

“Our key message is: test, test, test,” WHO head Tedros Adhanom Ghebreyesus told world leaders on March 16.

But while nations including Germany and South Korea have already tested hundreds of thousands of their citizens, Britain is lagging far behind with the number of tests actually decreasing on Tuesday to 8,240.

As ministers face growing questions over the failure to ramp up testing, The Telegraph can disclose that officials have repeatedly ignored offers of help from many of the country’s leading scientific institutions.

Meanwhile, senior health sources warned that the moment for this country to launch a successful mass community testing programme may already have been lost.

Professor Matthew Freeman, head of Oxford University’s Dunn School of Pathology, one of the country’s leading disease research institutions, revealed that his repeated offers to provide dozens of specialised machines and expert staff had been largely ignored by health officials.

He said the department had 119 of the crucial PCR machines used to identify tell-tale genetic signs of coronavirus, but only one had been requisitioned for use.

Hundreds of specialist workers and trained graduate students were on standby to help ramp up testing, he added, but despite initial signs of enthusiasm he had heard nothing more from Public Health England.

“We’re clearly not doing as well as we could be doing as a nation when it comes to testing, and therefore people like us feel a bit frustrated,” he said.

“I’m not trying to be too critical here – I’m just struggling to understand it. We have a very large workforce of people experienced in antibody testing who would be very keen to be involved.

“When they sent round a request a couple of weeks ago to supply the PCR machines there was a very specific model they wanted. Of our machines there was only one of that type, and the army came and collected it and took it off to Milton Keynes.

“But we have another 118 machines that can broadly do the same job, but they don’t appear to be part of PHE’s plans. Not all are oven ready, but a proportion are. They could be adapted easily – it’s a totally routine lab technique. 

“About two weeks ago one of my colleagues spent two days trying to be a bit irritating and chasing PHE up to offer our help. There was a lot of general enthusiasm – they said, ‘Oh that’s great and we’re really happy that you want to help’. And then nothing really came of it. That’s been the same for many institutions across the country. I can’t really understand why.”

At the Francis Crick Institute, one of the world’s leading biomedical research centres based in London, insiders told a similar story.

The institute has supplied five PCR machines to PHE labs so far, but is understood to have dozens more inside its labs. A spokesman added that no firm word had yet been received from PHE as to whether any further machines or expertise would be required.

“We have hundreds of scientists with different areas of expertise ready and willing to step in to help support the national drive to tackle the outbreak,” the spokesman told The Telegraph.

“We were approached by Public Health England for support with their testing programme, and have already sent 5 PCR machines to support it. We are supportive their work at this really difficult time, are ready and enthusiastic to help with the testing programme, and recognise that setting it up and then scaling it can’t be done overnight.”

Other institutions across the country are understood to have had similar offers of help rejected by Public Health England.

Ministers are acutely aware that Britain’s failure to carry out more tests has become the weak leak in the response to the pandemic, and are desperate to ramp up mass testing.

Boris Johnson set a deadline of mid-April for testing to increase to 25,000 per day, only for Public Health England to say it could be the end of April before that target is reached – which will still be barely a third of Germany’s current capacity.

There is also growing anger at the NHS’s failure to take advantage of spare capacity in the system to test its own staff so that those who are self-isolating as a precaution can get back to work if they are virus-free.

Britain can now carry out 12,700 tests per day, but only 8,240 tests were done in the 24 hours to Tuesday morning, meaning opportunities were missed to test up to 4,460 doctors, nurses and medical staff.

The figure for “wasted” testing opportunities was more than 1,000 more than the previous day.

With up to a quarter of staff ill or self-isolating at some hospitals, Matt Hancock, the Health Secretary, made clear his frustration in a conference call with NHS and PHE bosses on Tuesday.

A rule that 85 per cent of tests had to be reserved for patients was scrapped on Tuesday by Mr Hancock, who told hospitals there was now no limit on the number of tests they could carry out on staff. “He thinks any spare capacity is unacceptable and doesn’t want any tests to go to waste,” a source close to the health secretary said on Tuesday night.

Senior health sources, however, told The Telegraph that the Government’s controversial strategy in the early stages of the pandemic may mean that Britain has already “missed the boat” on mass testing.

Initially the Government’s Chief Medical Officer, Chris Whitty, and Patrick Vallance, the Chief Scientific Adviser, decided with the agreement of senior ministers the disease should be mitigated rather than suppressed, sources explained.

The Government’s Chief Medical Officer, Chris Whitty (pictured), decided with the agreement of senior ministers the disease should be mitigated rather than suppressed Credit: GEOFF PUGH

It was agreed that under the much-maligned ‘herd immunity’ approach, widespread testing would not be required given around 60 per cent of the population was expected to catch the disease anyway. Instead, priority was given to protecting the vulnerable and ensuring the NHS did not become overwhelmed by building up intensive care capacity, and procuring ventilators to keep patients alive.

That meant laboratory capacity was not ramped up, and there was no drive to order the crucial components needed to produce thousands of testing kits. On March 12 it was decided to halt community contact tracing, and to focus testing on hospital patients instead.

Meanwhile, other countries took a different path, and began buying up large stocks of kit for mass-community testing. In Germany and South Korea, officials quickly mobilised a vast network of laboratories to start producing tests in huge numbers.

Around two weeks ago, Britain’s strategy switched after Imperial College modellers warned that leaving the disease to spread largely unchallenged could result in 250,000 deaths.

But by this time test kits were in short supply and laboratories had not been readied for action. Initially only a single Government lab, PHE’s main facility at Colindale, was charged with processing tests, with 11 more added later, along with 29 laboratory networks run by NHS Trusts.

At that early stage, thousands of swabs sent to PHE by GPs who suspected their patients had contracted the disease were destroyed before they were analysed because they did not meet strict criteria, sources revealed.

“If they had looked at those swabs earlier instead of throwing them away, we could have got a handle on this thing much earlier,” one GP told The Telegraph.

When it became clear that the herd immunity strategy risked disaster, the strategy changed and ministers and public health officials began prioritising testing amid widespread criticism.

But the about-turn may have come too late. Laboratories are now struggling to buy in key chemicals needed to produce the testing kits, with reports that NHS Trusts have been forced to “home brew” their own. One order of so-called “primers and probes” from a firm based in Luxembourg was even discovered to itself be contaminated with coronavirus, leading to a delay in production.

At the Downing Street press conference, Michael Gove insisted Boris Johnson was now personally leading efforts to source much-needed chemicals from abroad.

“The prime minister and the health secretary are working with companies worldwide to ensure that we get the material we need to increase tests of all kinds,” he said.

The Government still hopes to have millions of antibody tests to determine whether someone has ever contracted the disease available in the coming weeks.

Meanwhile, other nations have ramped up their testing programmes with Germany now expecting to test up to half a million people every week.

As the pressure grows, PHE is understood to still believe that a centralised testing system will produce better, more reliable results. There are also understood to be concerns around biosafety if thousands of samples are exchanged between smaller laboratories across the country.

Officials now plan to launch “supercentres” to process the tests on a larger scale, in partnership with the private sector. A test centre for NHS workers opened on Tuesday in the car park of an Ikea store in Wembley, north-west London.

A Public Health England spokesman said: “COVID-19 only started to emerge at the beginning of the year and since then, PHE has managed to rapidly develop, validate and deliver an accurate test. PHE has since expanded to 12 other testing sites in England and supported the NHS to start testing at greater capacity in their labs. 

“This is the fastest deployment of a novel test to PHE and NHS labs in recent history, including in the Swine flu pandemic in 2009.”

 

UK discussed joint EU plan to buy Covid-19 medical supplies, say officials

British officials took part in four meetings where EU projects to bulk-buy medical kit were discussed – the earliest in January, according to official minutes that heap doubt on government claims of missing an email.

Jennifer Rankin  www.theguardian.com 

Last week Downing Street claimed that it failed to take part in an EU scheme to source life-saving ventilators and other kit to treat coronavirus because it accidentally missed the deadline.

No 10 initially said it did not take part because the UK was no longer a member of the EU and was “making our own efforts”. After critics accused Boris Johnson of putting “Brexit over breathing”, Downing Street clarified that missing out was an error and it would consider participating in future. It is understood the UK claimed not to have received an email from the EU asking it to participate.

EU minutes seen by the Guardian show that a British official joined eight out of 12 EU health security committee meetings dedicated to the Covid-19 outbreak since the group was set up earlier this year, shortly before China’s Hubei province was put into lockdown.

At least four of those meetings discussed EU procurement schemes on: 31 January, 4 February, 2 March and 13 March.

While the government marked Brexit day on 31 January, a British representative joined EU member states and commission officials to discuss what was then called “the cluster of pneumonia cases associated with novel coronavirus in Wuhan, China”.

At this meeting, four EU member states said the virus could require increased stocks in Europe of personal protective equipment (PPE) such as gloves, masks and goggles, and the commission said it was ready to help if asked.

The EU executive stated it was ready to help countries bulk-buy medical equipment on 4 February. By 2 March, officials at the commission’s health department reported that 20 EU countries wanted to join a procurement scheme for personal protective equipment, such as overalls, gloves and face-shields. Later that month, on 13 March, EU officials discussed the combined purchase of ventilators.

Peter Liese, a German MEP and medical doctor who sits on the European parliament’s public health committee, said there had also been telephone calls between British and EU officials about the EU procurement scheme. “I know that they [British officials] were at a working level interested in joint procurement,” he told the Guardian.

The veteran German MEP dismissed UK government claims they missed an email. “It was not that they were not aware, but it was a decision not to participate,” he said. “If you are interested you don’t wait for an email.”

The UK was also able to sign up for EU procurement schemes via the EU’s “Early Warning and Response System”, an intranet site where European countries exchange information about communicable diseases.

The government claimed last week that the UK “did not receive an invitation in time to join in four joint procurements in response to the coronavirus pandemic”. Cabinet Office minister Michael Gove repeated this account on Sunday, when he said there had been “communication confusion”, although added he was unaware of the details.

A spokesperson for the Cabinet Office did not respond to questions about how “communication confusion” mentioned by Gove was possible given UK participation in meetings where EU procurement was discussed, as shown in the EU documents. Instead, the spokesperson sent a transcript of Gove’s remarks on the Andrew Marr Show.

Behind the scenes British officials maintain the UK did not receive an invitation in time to join four EU procurement schemes – an argument made last week by Number 10.

The four bulk-buying projects were conceived at different moments over several weeks in February and March, as the coronavirus crisis in Europe escalated, raising questions about whether there ever just one invitation covering all four schemes.

The Department for Health and Social Care has not yet responded to a request for comment.

The Department of Health initially declined to comment when the Guardian reported last week that the UK had decided not to participate in any of four EU procurement schemes to buy medical equipment in response to the coronavirus crisis.

Nearly all EU countries, 25 out of 27, are taking part in the project for shared purchase of ventilators, while the same number are joining forces to buy protective kit for medical staff, such as masks and overalls. Separately, 19 are teaming up to buy laboratory equipment needed for tests.

Under then prime minister David Cameron, the government signed the EU’s joint procurement agreement in 2014, which was drawn up after some member states experienced shortages of medical kit during the H1N1 pandemic. The terms of the Brexit transition deal means the government has the right to take part in EU joint procurement until 31 December 2020.

The logic behind joint procurement is to reduce red tape, get better prices through wholesale purchase and take advantage of medical purchasing skills that may be weaker in some countries, especially smaller ones.

Liese urged the UK government to continue working with the rest of Europe on the search for better treatments and a vaccine against Covid-19. “When the scientists from Berlin, Rome, Paris, Oxford and Cambridge work together [on treatments] we are faster and better than if we would work separately. The same applies to vaccines. European cooperation is crucial.”

The European commission said on Friday the UK “is most welcome to join any future procurement launch”.

 

MPs call for ‘virtual Commons’ amid Covid-19 early recess

MPs from across the political spectrum are calling for a virtual House of Commons to be established to scrutinise the government’s response to coronavirus.

Kate Proctor  www.theguardian.com

Ed Davey, acting leader of the Liberal Democrats, said the UK should also look to New Zealand and create a select committee to question the government’s Covid-19 strategy.

He wants a weekly PMQs with Boris Johnson through video-conferencing and an end to the rule that stops MPs from tabling written questions during recess so that the public can get more information from government.

Parliament broke for recess a week early as the number of cases of the virus around Westminster increased. MPs are not due back in the Commons until 21 April.

One hundred MPs from Labour, the SNP and the Green party have written a letter to the clerk of the House of Commons, John Benger, asking for his support in setting up a form of digital parliament.

Davey said: “If it wasn’t a dangerous infectious virus but a major emergency, parliament would have been recalled. We wouldn’t have gone on recess.

“We think scrutiny is good for government policy. We’ve shown opposition parties are prepared to behave responsibly. I think we can find a way to get things cracking and get an online virtual parliament to serve the nation.”

He said a specialist select committee focusing on Covid-19 could mirror the one set up in New Zealand in March, named the epidemic response committee, which is chaired by the leader of the opposition.

The letter to the Commons’ clerk was initiated by Labour’s shadow minister for innovation, Chi Onwurah, who said: “People up and down the country have made huge behavioural changes in a matter of days and we must show we are capable of it too.”

Darren Hughes, chief executive of the Electoral Reform Society, said: “Ministers and public officials must be held to account by those with a full suite of powers to call evidence, witnesses and use the full clout of parliament.

“Cabinet is showing that politics can continue to function during this crisis. Parliament must show the same, with the Speaker leading the way in providing accountability at this urgent hour.”

 

Office for National Statistics to provide full tally of Covid-19 deaths

The reported death toll from coronavirus in the UK is set to increase beyond the NHS’s daily tally on Tuesday when fatalities outside of hospitals are counted for the first time.

Figures from the NHS and Public Health England have so far been the key barometer of the impact of the virus but they have not included any deaths in homes, care homes and other non-hospital settings. Daily figures for Monday showed a rise in the UK death toll of 209 to 1,408 people, but these are only people who died in NHS care.

Covid-19: deaths outside hospitals to be included in UK tally for first time

Pamela Duncan  www.theguardian.com 

The Office for National Statistics will start publishing data about the rest of the deaths from 9.30am on Tuesday giving a fuller picture of the impact of Covid-19. They will tally all of the deaths from late December until 20 March which they believe occurred outside hospitals.

Unlike the NHS figures, which are limited to people who tested positive for the disease, they will also include cases where it is mentioned as a suspected cause on death certificates.

“It will be based on mentions of Covid-19 on death certificates,” said a spokeswoman for the ONS. “It will include suspected cases of Covid-19 where someone has not been tested positive for Covid-19.”

At the daily Downing Street press conference, the foreign secretary Dominic Raab was asked if the new data release showed the country has only been shown “part of the truth so far”. Raab did not answer, but Patrick Vallance, the chief medical officer, said he did not expect the increase in the death toll from the additional ONS data to be large, adding: “It’s important going forward that we have this reconciliation between all of the numbers.”

Every Tuesday the statistics authority will provide a backdated weekly count of all suspected coronavirus deaths of people who have died in their homes, care homes or hospices, which will be published in a combined form with the figures drawn from the daily death toll announced by the NHS in England, Wales, Scotland and Northern Ireland. The figures will be backdated to the previous week, starting with the week ending 20 March. It will include the ages of the people who died and give a regional breakdown.

Officials said that focusing so far only on hospital deaths, about which information is immediately available, has allowed the NHS and PHE to produce rapid and up-to-date figures. Deaths which occur out of hospitals can take longer to trace statistically because of the time it can take for paperwork to pass through coroners’ offices. But it has resulted in only a partial picture of the virus’s impact. Some of the hospital fatalities have also been slow to be recorded. One death reported on Monday actually occurred 17 days earlier.

The Department for Health and Social Care publishes daily UK-wide figures in a statement on its website which makes no mention that its figure of “patients in the UK who tested positive for coronavirus” do not include deaths outside hospitals.

Public Health England’s own online dashboard of the spread of the virus in the UK describes “reported cases of coronavirus in the UK”. Only if you click on a link “about the data” does it explain that it is limited to deaths in NHS services of patients who have had a positive test result for Covid-19.

A spokesperson for NHS England said it was “clear from the start these are people who have died in our hospitals”.

There are sometimes significant delays in deaths appearing in the NHS England figures. One death reported on Monday actually occurred on 13 March in Mid Essex hospital services NHS trust, a 17-day lag. Another, first reported on Saturday, actually occurred in Sandwell and West Birmingham hospitals NHS trust on 13 March.

At least 33 deaths which were reported by NHS England between Thursday and Sunday actually occurred more than a week earlier.

Of the 159 newly reported deaths recorded by NHS England today, at least 30% occurred on or before 27 March.

“There are various reasons why a hospital trust might delay reporting a death, including contact tracing, the internal validation processes and staff absences. For sheer capacity reasons, it’s occasionally necessary for some trusts to report over a longer time period,” an NHS spokesperson said.

  • This article was amended on 31 March 2020. In it, we gave the UK death toll as 2,433. This has been corrected to 1,408.