UK missed coronavirus contact tracing opportunity, experts say

The government has been accused of missing an opportunity after it failed to deploy 5,000 contact tracing experts employed by councils to help limit the spread of coronavirus.

Beggars belief – Owl 

Rachel Shabi  www.theguardian.com

The government has been accused of missing an opportunity after it failed to deploy 5,000 contact tracing experts employed by councils to help limit the spread of coronavirus.

Environmental health workers in local government have wide experience in contact tracing, a process used to prevent infections spreading and routinely carried out in outbreaks such as of norovirus, salmonella or legionnaires’ disease. But a spokesperson for Public Health England (PHE), which leads on significant outbreaks, said the organisation did not call upon environmental health workers to carry out contact tracing for coronavirus, instead using its own local health protection teams.

According to the Chartered Institute of Environmental Health the UK has, at a conservative estimate, 5,000 environmental health officers working in local councils nationwide.

The institute’s Northern Ireland director, Gary McFarlane, said government health bodies “absolutely should be drawing on the skills set of EHOs [environmental health officers] and if they aren’t, it’s a missed opportunity”. He said: “There is significant capacity that is sitting there for this kind of work to be done.”

PHE’s contact tracing response team was boosted to just under 300 staff, deemed adequate for the containment phase of handling the Covid-19 virus up to mid-March. In that time the team, working around the clock, traced 3,500 people and supported the 3% of contacts found to be infected to self-isolate. Tracing was scaled back when the UK moved to the delay phase of tackling coronavirus in mid-March. It is now carried out in limited form, mainly for vulnerable communities.

An environmental health worker for a council in Scotland, who does not want to be named, said: “If councils had been given the go-ahead from the start, they could have put plans in place and now have a much flatter curve.” Another, with decades of experience, said he was “struggling to figure out” why this was not the case.

One environmental health worker for a north-western council said his team were expecting a call at the start of the coronavirus outbreak. He said: “We are pretty good at infection control and contact tracing, it’s part of the job. We thought we’d be asked and were shelving other work.”

Environmental health workers have recently been tasked with ensuring the public stick to social distancing rules. They have also been monitoring takeaways and food deliveries. Environment health departments have, like other areas of local government, suffered austerity cuts since 2010.

Contact tracing involves getting in touch with everyone an infected person might have seen and asking them to self-isolate in an effort to contain the virus.

The government decision to all but abandon contact tracing is not consistent with WHO guidelines, which urge a test-and-trace approach. At a WHO media briefing on Covid-19 in March, director general Tedros Adhanom Ghebreyesus said: “Tracing every contact must be the backbone of the response in every country.”

The approach has been carried out in other countries, including Ireland, Germany, South Korea and Singapore. In Germany, thousands of contact tracers are still working – with more being recruited – in part clearing a backlog of infections that occurred before the nation’s shutdown measures, according to Dr Philipp Zanger , head of the Institute of Hygiene, Infection Control and Prevention at the Rhineland-Palatinate agency for consumer and public protection.

Contact tracing is also used to prepare to tackle any outbreaks when the lockdown is eased, since “once we let ourselves out again, we will see more transmission again,” he said.

The UK government approach is understood to be that once virus infection numbers have tipped, manual contact tracing is unworkable, while social distancing and self-isolation measures reproduce much of its effect.

But Anthony Costello, professor of global health and sustainable development at University College London, said giving up on it was a mistake. “You still need to do it,” he said, highlighting regions where infection numbers were relatively small. “In low-intensity areas you could ramp up your testing … use all your people to jump on it.”

Environmental health officers say that as well as helping to slow the spread of a virus, tracing could provide information on how it spreads and, if successful in containing outbreaks in specific areas, could help direct healthcare resources.

The UK, US and Germany are developing smartphone apps to help trace coronavirus infections to ease national lockdowns. Versions of this technology have been used in South Korea and Singapore. Initial reports suggest the UK app would operate on a voluntary basis, while there are privacy concerns around the security of health and location data provided.

A PHE spokesperson said that contact tracing was no longer useful because “with such a level of sustained community transmission there is limited value in doing so”.

 

Nearly 400 Care Groups face “Protection Shortage”

Not a good time to conduct an administrative closure of care homes to meet a new business model. See previous posts on the Abbeyfield closure of the Budleigh care home “Shandford” (there are many of them – Owl)

https://www.bbc.co.uk/news/health-52174520

Almost 400 care companies which provide home support across the UK have told the BBC they still do not have enough personal protective equipment (PPE).

Without protection, providers say they may not be able to care for people awaiting hospital discharge.

Of 481 providers, 381 – 80% – said they did not have enough PPE to be able to support older and vulnerable people.

The government said it was working “around the clock” to give the sector the equipment it needs.

The BBC sent questions to the nearly 3,000 members of the UK Homecare Association. 

About a quarter of respondents said they have either run out of masks or have less than a week’s supply left.

Second home owners ‘sharing tips on avoiding police’ to sneak into Wales at night

Second home owners are sharing tips so that they can sneak into Wales while avoiding police enforcing a ban on unnecessary travel, an MP has said.

nation.cymru

Dwyfor Meirionnydd MP Liz Saville Roberts said that tourists were sneaking in at night in order to avoid detection, or even accepting the £60 fines and travelling on.

“I’m really sorry to have to make this message today but it’s evident that people are still arriving at their second homes and their holiday homes,” she said in a video message.

“The police are doing the best they can with the resources that are available to them and they do ask local people who have any reports of people travelling to such accommodation to contact them via email or via webchat.

“But we also have accounts of people with holiday homes sharing advice with each other to travel at night to avoid the police.

“And even the people who don’t care if they’re fined when they travel – they’ve set out and they want to arrive.

“Now, for people who are thinking about this, the rules are there for a reason. If you think you’re the exception to the rule, think again. You’re not. There are no exceptions in a pandemic.

“In south Gwynedd we do not have sufficient medical resources to cope with extra people. The shops don’t have the supplied to be able to cope with extra people.”

‘Hotspots’

Meanwhile, Anglesey Council’s tourism portfolio holder, Councillor Carwyn Jones, has written to MP Virginia Crosbie urging her to press on the Army to blockade routes into the island.

“Reports are coming thick and fast from every corner of Anglesey of holiday homeowners and tourists arriving in their droves for a bit of Easter fun,” he said.

“Needless to say, the worry this is causing local constituents is considerable and it’s clear that these are showing no regards to the measures put in place by the Government and are putting lives at risk.

“The risk to the residents of Anglesey is increasing considerably and the ability of our NHS to cope. The measures need to be much stricter, powers to enforce stronger and more resources needed to manage and control the measures.

“The police are doing a fantastic job with the resource at their disposal, however more backing is needed and I would now suggest the Army needs to be deployed to help the situation by manning the two bridges and hotspots before more and more start arriving.”

LINO gets the message and so does Devon County – better late than never

Councillor Ben Ingham, Leader in name only (LINO) having lost his majority in EDDC, went on BBC Spotlight last night to tell visitors not to come to East Devon, or any other part of Devon, over Easter. 

On 22 March a group of MPs  across the region backed the call for tourists and second home owners in Devon and Cornwall to ‘Come back later’ in a bid to save the lives of those who live here during the coronavirus virus.

North Devon, whose Chief Executive took the lead a couple of weeks ago, has been more explicit and says that it is “closed” to visitors.

But only on 3 April were they joined by Devon County Council

www.devonnewscentre.info /devon-backs-calls-for-visitors-to-stay-home-and-stay-safe/

Devon backs calls for visitors to stay home and stay safe:

Devon County Council is backing the call from across the South West for visitors not to be tempted to visit the region at this time.

In the run up to the Easter bank holiday weekend, local authorities are reminding people of the Government advice against non-essential travel, as well as ensuring holiday accommodation providers stay closed.

The County Council recognises the importance of the tourism sector for Devon but it is urging people to stay at home, stay safe and wait until Covid-19 restrictions are lifted before paying a visit to the county.

Hotels, hostels, B&Bs, holiday rentals, campsites and caravan parks are among the businesses forced to close under Government guidelines to tackle the coronavirus pandemic. Among the exceptions are where:

  • People who live permanently in caravan parks or are living in holiday accommodation temporarily because their main residence is unavailable;
  • Critical workers and non-UK residents who are unable to travel to their country of residence during this period can stay in hotels or similar;
  • People who are unable to move into a new home, due to the current restrictions, can stay in hotels;
  • Where hotels, hostels and B&Bs are supporting homeless and other vulnerable people, such as those who cannot safely stay in their home, through arrangements with local authorities and other public bodies.

Councillor Rufus Gilbert, Devon County Council Cabinet Member for Economy and Skills, said: “The partial lock-down implemented by the Government is for everybody’s benefit as the country battles to bring the coronavirus under control. We all need to play our part to protect each other and do what we can to reduce the spread of coronavirus, and we would hope that everyone obeys the national guidance.

“Tourism is an important part of Devon’s economy and tourism businesses and accommodation providers will be suffering, just as many sectors are during this crisis. If we all take the Government advice on board to stay at home and only make essential journeys, the sooner we will get through this crisis and get Devon open for business, so that people can pay us a visit at a later date.”

Police and Devon, Somerset and Torbay Trading Standards have powers to investigate any holiday accommodation that might be flouting the current Government guidelines.

Local people using Devon’s Public Rights of Way and recreational trails as part of their daily exercise are also being urged to follow Government guidance while outside.

Notices on some of Devon’s public rights of way are reminding people to keep a 2-metre distance with a maximum of two in a group from the same household. Dog walkers are also asked to keep dogs under close control and to keep to the line of the path.

 

ExCel U-turns on charging NHS for hospital site

The owner of London’s ExCel centre has performed a U-turn on charging the NHS to use the site as a hospital to treat coronavirus patients.

https://www.bbc.co.uk/news/business-52172007

ExCel chief executive Jeremy Rees said an initial agreement with the NHS to house the temporary Nightingale Hospital “included a contribution to some fixed costs”.

But he said: “We have since decided to cover the fixed costs ourselves.”

Mr Rees added that the ExCel had always been provided to the NHS rent-free.

The Sunday Times reported that the centre, which is owned by Abu Dhabi National Exhibitions Company (ADNEC), was charging the NHS between £2m and £3m in rent to use the east London site.

Humaid Matar Al Dhaheri, managing director and group chief executive of ADNEC, said: “To be clear, profit has always been the furthest thing from our minds.”

He added: “It is our firm commitment that we will not charge a penny for the use of our facilities, and we will provide the NHS with the operational and logistical support it needs for NHS Nightingale London.”

The field hospital can hold as many as 4,000 patients and is the first of a number of similar facilities planned for the UK.

 

Rees-Mogg firm accused of cashing in on coronavirus crisis

Government minister Jacob Rees-Mogg’s investment firm has been criticised for exploiting the coronavirus crisis after telling clients it provided a chance to make “super normal returns”.

Sarah Butler  www.theguardian.com 

Somerset Capital Management (SCM), which manages investments in emerging markets, told clients that the dive in stock market valuations around the world since the pandemic took hold had made “excellent entry points for investors”.

“Market dislocations of this magnitude happen rarely, perhaps once or twice in a generation, and have historically provided excellent entry points for investors,” SCM fund manager Mark Asquith wrote in a note to clients.

“History has shown us that super normal returns can be made during this type of environment.”

Rees-Mogg co-founded SCM and continues to hold a 15% stake in the business. He stepped back from day-to-day work at the firm when he became an MP in 2010 and quit his role as part-time adviser when he became a minister in 2019. He reportedly received a payout of about £1m from the business last year.

The firm said assets in Latin America, Europe, the Middle East and Asia were cheap following the recent heavy falls in global stock markets. Asquith noted that in the 12 months following the 2008 global financial crisis, the value of smaller companies in emerging markets rose more than 150%, with some Brazilian firms surging by about 500% within two years.

The company said it has recently taken advantage of the downturn to invest in Hapvida, a Brazilian medical insurer and hospital operator; Advantech, a firm behind technology used in China to monitor the temperatures of people in public places during the pandemic; and the South African pharmacy chain Clicks.

Keir Starmer, the new leader of the Labour party, said: “Nobody should be seeking to take advantage of this crisis. We should all be asking ourselves what we can do for our country and each other.”

The shadow chancellor, John McDonnell, said: “This attitude is about as sick as it comes. Profit seeking from people’s suffering is nearly as low as you can get. When we come through this we need a windfall tax on the profiteers.”

However, Jolyon Maugham, the campaigning lawyer who backed legal action against Brexit, described the criticism as “a bit silly”.

“No fan of Rees-Mogg, and of course super-profits must be properly taxed, but this is a bit silly. SCM wants to invest in bombed out share prices. This is actually a good thing as higher share prices will make it easier for those businesses to attract fresh capital and survive,” Maugham said on Twitter.

Oliver Crawley, a partner at SCM, said: “Our thoughts are with those suffering as a result of these tragic circumstances and we are full of admiration for the huge commitment so many are making to fight this pandemic.

“Our fund managers’ investment commentary is focused on the valuations currently seen in the emerging markets, not the appalling human cost of the virus, and we sincerely hope these comments are not misconstrued as being unsympathetic.”

 

A week of missed chances, blame games and a loss of confidence

Owl thought that the “Torygraph” might be an interesting place to get an inside story of the testing fiasco.

By Edward Malnick, Sunday Political Editor www.telegraph.co.uk

Ministers and Whitehall officials insist they want to avoid a “blame game” for the UK’s apparently under-powered efforts to carry out mass coronavirus testing to date. But the remarks that follow such claims tend to involve implicit or explicit criticism of Public Health England, the quango responsible for protecting the nation from health emergencies, such as pandemics.

A recent, official survey of PHE’s own staff found that confidence in the organisation’s leadership was lacking from within as well. Less than half (49 per cent) of the body’s employees, 81 per cent of whom took part in the survey, said they had confidence in the decisions of senior managers.

In Downing Street too, confidence appears to have been lacking in recent weeks both in the Department of Health and PHE, with an acknowledgement that more should have been done earlier to roll out mass-testing, particularly of NHS staff unable to work because they or members of their household had displayed Covid-19 symptoms. One claim repeated inside and outside of Whitehall is that PHE has failed to capitalise on offers of help from the private and academic sectors, to help increase its capacity.

Tom Shinner, the highly-regarded official previously in charge of no-deal planning, was drafted back to No 10 a fortnight ago, having left Whitehall last year to become chief operating officer of Entrepeneur First, a technology investment firm. But the week in which public focus turned to testing coincided with Boris Johnson, Matt Hancock, the Health Secretary, and Dominic Cummings, the Prime Minister’s chief adviser, all physically isolated from each other and the rest of the government machine, and suffering, with varying degrees, from Covid-19 symptoms. Mr Johnson, who still has a temperature, and Mr Cummings, both remain in isolation as they attempt to shake off the virus, although Mr Johnson has continued to chair daily meetings on the issue.

Now, Lord Bethell, the former managing director of the Ministry of Sound nightclub, has been appointed as the de facto minister for testing in the Department of Health. While Mr Hancock named Prof John Newton, the director of health improvement at PHE, as the senior official who would steer through the new plan to reach 100,000 tests per day by the end of this month, Lord Bethell will have ministerial oversight.

Dedicated teams in the Department of Health will now, among other tasks, be responsible for involving industry and universities in the Government’s efforts to ramp up the number of tests taking place.

A growing number of experts see mass testing, together with the tracing of anyone who has come into contact with those who have tested positive, as key to helping the UK out of its impasse, where lifting the current restrictions on the population would almost certainly cause an upsurge in infections and overwhelm the NHS.

On Saturday, Neil Ferguson, the Imperial College London professor upon whose modelling the Government has relied, said he was “hopeful” that some of the strict social distancing measures could be substituted with rapid access to testing and contact tracing in a few weeks’ time – once case numbers are lower.

A growing number of experts see mass testing as key to helping the UK out of its impasse Credit: PA

In an interview with BBC Radio 4’s Today programme, Prof Ferguson said that in January, when Covid-19 was discovered in the UK, “it wasn’t felt by PHE and others that we could ramp up testing fast enough for it to be an option then”.

When testing and contact tracing was rolled out the following month, it was focused on people returning from affected countries, rather than more widely across the population. An early detection policy, involving the isolation of all positive cases and those who have come into contact with patients, appears to have significantly helped to reduce the spread of Covid-19 in countries such as Singapore and South Korea, which learned lessons from the Sars outbreak in 2003.

In the UK, however, “we didn’t have the tests, as the epidemic took off, available to really roll it out on a national scale,” Prof Ferguson said.

Now, in early April, there not only remains a major shortfall in the the country’s capacity to test large sections of the population, but, as of Friday, only 5,000 of the health service’s 1.4 million staff had been tested, with many having to remain off work, without tests, because they live with family members or friends who have displayed symptoms in the last fortnight.

Some members of the cabinet are among those who are sceptical of Mr Hancock’s pledge to reach 100,000 tests by the end of this month. A previous announcement that the Government had purchased 3.5 million immunity home testing kits has so far failed to materialise, and there is a concern that ministers have previously rushed through major announcements without the evidence that they can be followed through.

On March 24, Mr Hancock said: “Of course it really matters for getting people back to work, so we have now bought 3.5 million antibody tests.

“That will allow people to see whether they have had the virus and are immune to it and then can get back to work.”

But on Thursday, the Department of Health and Social Care (DHSC) conceded that the Government had not actually bought the tests but had put agreements in place to allow them to buy 3.5 million kits from a number of manufacturers, provided they receive official approval.

“We have not yet bought any tests but we do have contracts agreed subject to testing,” a DHSC spokesman said. “We have secured small numbers with potential to get much larger orders.”

Mr Hancock’s new five-point plan to ramp up testing to 100,000 per day includes both swab testing, to see which patients have the virus, and rolling out antibody tests which would establish whether individuals have already had and recovered from the disease.

Under the plan, PHE is “leading” on plans to increase the number of tests of inpatients and the most critical workers from 13,000 to 25,000 per day by mid-April, using eight of its labs and 44 across the NHS. But the Department of Health, under Mr Hancock and Lord Bethell, is leading work on all forms of testing as well as ensuring the involvement of private and academic bodies in testing and supplying equipment.

The set-up appears to leave significant room for inter-governmental blame to arise again if the 100,000 tests-a-day target fails to materialise by the end of this month. But one Whitehall source insisted that with the return of Mr Hancock and Chris Whitty, the Chief Medical Officer, following week-long home isolations, “it feels like the grown-ups are back”.