Much of the world is puzzled as to why we have had so many people die in care homes in Britain. So it’s a relief to know the prime minister has worked it out: it’s because the care homes “didn’t follow the correct procedures”.

They did it themselves, the idiots. They probably served up bowls of coronavirus instead of custard, and told residents if they had a tickly cough, they should relax in the bath while cuddling an electric fire.

And yet Boris Johnson offered clear guidelines, such as, “you can’t catch the virus by shaking hands with infected people in care homes”.

If only they’d followed that advice, and asked the most infected people to rub themselves up against the other residents, and maybe organised naked Greco-Roman wrestling tournaments for maximum bodily contact, they’d all have been fine.

Another clear guideline was to announce that elderly patients in hospital who tested positive could be admitted to care homes.

Then how did the care homes interpret that? They thought it meant elderly patients in hospital who tested positive should be admitted to care homes. That’s the trouble with some people, they don’t know how to follow simple instructions.

Some people have criticised the government for pouring infected people into care homes, but Boris Johnson replies this isn’t fair, because this happened before we realised how the virus works.

This makes sense because back in April who could possibly have guessed that the people who might spread the virus were people who had the virus? It’s all very well being clever with hindsight, but until then, lots of us thought the people most likely to spread the virus were people who didn’t have it, or perhaps it was people who didn’t exist like characters out of books, or maybe it was cartoons or people in dreams who have the face of a guinea pig.

Luckily this deadly advice was aimed at a sturdy section of the population, the elderly who are too frail to live at home and are all squashed next to each other, so it couldn’t do much harm.

As well as the obviously infected, other hospital patients who didn’t have coronavirus symptoms were sent back to care homes without being tested. The government instruction was: “Negative tests are not required prior to transfer of patients back to care homes.”

So the care home staff interpreted that as meaning negative tests were not required prior to the transfer of patients back to care homes. They should have realised this was a crossword clue. The next instruction was probably “Russian Queen mixes violin with panda juice perhaps (7,4,2,6)”.

In fact the care homes would have been better off if they’d been given guidelines by the people who issue instructions for putting together an Ikea bookcase, such as “Attach 89-year-old B to walking frame pinion ratchet F folding in up towards back nodule virus-preventative symptom bracket Q”.

Boris Johnson now excuses the policy of sending patients back into the care homes without being tested, saying: “We didn’t know you could carry the virus without having symptoms.” But one month earlier the government’s own scientists insisted people could have the virus without showing symptoms.

Maybe the government didn’t have time to listen to all those boring announcements from scientists. On and on they went, every day, about flattening curves and keeping two metres away – you can’t expect a prime minister to take notice of all that twaddle while he’s got a pandemic to sort out.

Instead of following boring science, Johnson has been clear all the way along. Four weeks before we had to shut everything down, he stated we shouldn’t shut anything down, as we could become the “Superman” of Europe. That’s the way to explain things, with fun language anyone can follow.

If only the rest of Europe had followed his lead. Instead of waffle about washing hands and staying indoors, Angela Merkel could have said: “This is an extremely serious situation. But we will be like the Incredible Hulk – we can punch the virus and lift a car up and drop it on its head, let’s see the weedy French match that.”

There is a consistency to the government’s attitude. A few weeks ago, Matt Hancock told us the reason there wasn’t enough protective equipment in hospitals was the staff were changing it too quickly.

If the government ran a restaurant, and one night every single customer died of food poisoning, it’d say: “It’s the idiots’ own fault. That fish was meant to be danced on, not eaten.”

Even now, the guidelines are beautifully pointless. Only a handful of people are wearing face masks because the guidance on wearing them is you can wear one if you fancy it, in the same way you can wear a waistcoat if you like, it’s up to you.

It all depends on this week’s fashion. Their instructions might as well involve Matt Hancock saying: “Hi, this is your weekly briefing so let’s see what’s in and what’s for the bin. First up, masks, UGH, they are SO June. They belong with shoulder pads my darlings, rip them off, feel free to cough.”

Rishi Sunak doesn’t even pretend: he’s pictured serving up food without wearing one. There will probably be a government guideline to waiters: “We advise against masks, and suggest if you are going to spit in someone’s food, try and do it on the potatoes as the gob will blend in with the butter to make a smooth paste.”

Then, when 7,000 diners drop dead, Boris Johnson will say: “Is it any wonder when these idiots didn’t do as we said? Honestly, this country doesn’t deserve me.”

Public First, a small policy and research company in London, is run by James Frayne, whose work alongside Cummings – the prime minister’s senior adviser – dates back to a Eurosceptic campaign 20 years ago, and Rachel Wolf, a former adviser to Gove who co-wrote the Conservative party’s 2019 election manifesto.

The government justified the absence of a competitive tendering process, which would have enabled other companies to bid, under emergency regulations that allow services to be urgently commissioned in response to the Covid-19 crisis.

However, the Cabinet Office’s public record states that portions of the work, which involved focus group research, related to Brexit rather than Covid-19, a joint investigation by the Guardian and openDemocracy has established.

A Cabinet Office spokesman said this was because of bookkeeping methods, and insisted that, contrary to government records, all the focus group research done by Public First was related to the pandemic.

The Cabinet Office, where Gove is the minister responsible, initially commissioned Public First to carry out focus groups from 3 March, although no contract was put in place until 5 June.

Government work is legally required to be put out for competitive tender to ensure the best qualified company is appointed, unless there are exceptional circumstances, such as an unforeseen emergency.

When a contract was finally produced on 5 June, it was made retrospective to cover the work done since 3 March. The Cabinet Office paid Public First £253,000 for the two projects listed as being Brexit-related and two more pieces of work done before the contract was put in place.

Public First was required to conduct focus groups “covering the general public and key sub-groups”, according to a Cabinet Office letter.

The firm was required to provide the government with “topline reporting” of their findings on the same day, with fuller findings reported the following day. The deal also included “on-site resource to support No 10 communications” in the form of a Public First partner, Gabriel Milland, being seconded to Downing Street until 26 June.

Milland was the head of communications at the Department for Education when Gove was the minister and Cummings was his political adviser.

The Cabinet Office said in the letter that it had commissioned the work from Public First for a total of £840,000 without any tender “due to unforeseeable consequences of the current Covid-19 pandemic”.

According to further details published by the government under its transparency requirements, Public First was paid £58,000 on 18 March for its first focus group work, classed by the Cabinet Office as being for “Gov Comms EU Exit Prog”, then a further £75,000 on 20 March for work classed as “Insight and Evaluation”.

On 2 April, 10 days into lockdown and with increasing numbers of people dying from Covid-19, the Cabinet Office paid Public First £42,000 for work listed again as “EU Exit Comms”. The first payment for work listed as being coronavirus-related was on 27 May: £78,187.07. A total of £253,187.07 was paid to Public First before the contract was entered into on 5 June.

The Cabinet Office spokesman told the Guardian that all the focus group work was related to the government’s Covid-19 messaging, and that the references to Brexit in the government’s official disclosures were misleading.

He said the Cabinet Office accounts department did not immediately open a “cost code” classification for expenditure relating to the crisis, so the payments were initially allocated to an existing cost code, which included communications about Brexit.

The political partnerships of Frayne and Cummings date back to at least 2000, when they worked together on Business for Sterling, the campaign against Britain joining the euro. In 2003, they co-founded a rightwing thinktank, the New Frontiers Foundation, and the following year set up the campaign to fight the proposed formation of a regional assembly in north-east England.

Cummings has described that successful campaign, which was based on portraying politicians as a drain on ordinary people, as “a training exercise for an EU referendum”.

Gove became the education secretary after the 2010 election, with Cummings as his chief political adviser, and Frayne was appointed as the department’s director of communications the following year.

In 2010, Wolf, a former special adviser to Gove, was running the New Schools Network to promote free schools, which was awarded a £500,000 contract by the department that year without a tender. It was justified on the basis that it was the only organisation able to provide expert support quickly enough.

The Cabinet Office contract with Public First is being challenged by the Good Law Project, which wrote to Gove on Thursday arguing that the absence of a tendering process was unlawful and not justified by the Covid-19 emergency provisions.

In a letter telling Gove that they plan to seek a judicial review of the contract award, the project’s lawyers, Rook Irwin Sweeney, argue there is “apparent bias” in the contract going to Public First, due to their “close personal and professional connections” with Gove and Cummings.

Asked if Public First’s links to Gove and Cummings were a factor in the firm being awarded the contract, the Cabinet Office spokesman replied: “This is nonsense. Public First were contracted to undertake this work because of their wealth of experience in the area.

“Public First was awarded a contract to carry out daily focus groups across the country in response to the Covid-19 crisis,” the spokesman said. “They carried out this work to make sure the vitally important public health messages the government was issuing were the right ones. This work will continue to inform future Covid-19 campaign activity.”

Rachel Reeves, the shadow Cabinet Office minister, said: “It beggars belief that the government’s desperate defence of handing a contract for daily focus groups on Covid-19 to longstanding friends of ministers is coincidence, and to blame clerical incompetence for the reference to the work on Brexit. They should come clean about the purpose of this project, why this company was chosen without it going to tender and publish the research findings and recommendations for people to see for themselves.”

Public First declined to comment.

As Britain sought to assemble its coronavirus testing programme, all the usual rules were broken.

In their effort to release rapid data to show the increase in testing capacity, officials from Public Health England (PHE) and the Department of Health and Social Care (DHSC) “hand-cranked” the numbers to ensure a constant stream of rising test numbers were available for each day’s press conference, Sky News has been told.

An internal audit later confirmed that some of those figures simply didn’t add up.

According to multiple sources, the data collection was carried out in such a chaotic manner that we may never know for sure how many people have been tested for coronavirus.

“We completely buffed the system,” says a senior Whitehall figure.

“We said: forget the conventions, we’re putting [this data] out.”

Sky News has learned that in the early days of mass COVID-19 testing, the statistical problems were so deep that one minister sat at their desk with Excel spreadsheets in front of them, calling round to try to collect data to use in each daily press conference.

Even as Health Secretary Matt Hancock struggled to get the number of tests carried out up to 100,000 a day by the end of April, the collection of those testing statistics was still so primitive that they were being compiled with pen and paper.

Sky News has uncovered hand-written tables of testing data, allegedly from mid-May, which show national testing figures for different parts of the operation.

The government is still struggling to get a handle on the testing data.

Late last week, it admitted that there was significant double-counting in those early testing statistics, saying the total number of cases in the UK was 30,000 fewer than its original data claimed.

Over the weekend, it said that it would no longer publish a daily estimate of how many people had been tested for the disease.

And while it has insisted that many of these problems are historic and have now been addressed, question marks over the data on testing continue to bedevil the government.

On Tuesday and Wednesday, it was forced to revise its estimate of the number of tests carried out yet again, eliminating another 10,000 tests which had been double-counted in the original data, then adding back another 20,000 tests yesterday.

It is the latest chapter of a fraught saga which goes back to the early days of the pandemic.

It is a saga which can now be told in the fullest detail yet.

This account is a product of dozens of conversations with individuals involved in the testing programme, including practitioners, managers, technologists and government officials – most of whom spoke on condition of anonymity.

The picture that emerges is of government departments, agencies and their consultants struggling to navigate a maze of different computer systems, and a Byzantine pathology sector, of flawed decision-making based on targets rather than sustainable systems.

The upshot was that in its early months, both the testing system and the data produced by it were simply “not fit for purpose”, according to one senior official.

That matters because testing, and the data produced by a testing programme, are a crucial part of the response to the pandemic. Without a quick, reliable testing programme Britain will struggle to combat any future upsurge in COVID-19 cases.

Without the data that comes from it, authorities will struggle to assemble their response, be that local lockdowns or the administration of forensic quarantine programmes.

If that data is not trusted, there is no guarantee that those lockdowns will be obeyed. In short, the programme and its data are the most potent defence against a second wave of coronavirus cases.

For an illustration, one need only look at Leicester, where the lockdown has been extended locally because of an upsurge in cases in the city.

Such local lockdowns are likely to become more commonplace in the coming months as public health officials battle flare-ups. However, the Leicester episode also underlined another ongoing problem: a lack of clear, quick data.

Local officials said they had only been provided with postcode-level data on cases on 25 June, just days before the lockdown was announced.

And while DHSC insists that some postcode-level data on cases was provided to local authorities on an ad hoc basis from mid-June, and stresses that it has worked closely with Leicester City Council, the episode underlines the continuing struggles over data as the government works to unpick the errors baked into the system at the start.

Government sources insist the system is improving, pointing to small but significant changes in the way information is recorded and reported.

Late last week, NHS Test and Trace was able to announce some statistics on turnaround times for tests. For the first time since May it is now publishing the number of people being tested, albeit on a weekly rather than a daily basis, and without providing a cumulative number since the outbreak of the disease.

Some of the early double counting is being gradually removed, but DHSC has acknowledged that there is more to come. In its update to the statistics yesterday it said: “Due to data not being made available, it’s likely that pillar 2 numbers for the 7 July are over-reported. The figures will be revised, once the necessary data has been made available this week.”

It is the latest evidence of the difficulties officials continue to have in putting numbers on the test and trace system, which was assigned a further £10 billion of funding by the Chancellor this week.

There have been concerns with Britain’s testing data for some time.

Last month, Sir David Norgrove, the chair of the UK Statistics Authority, wrote to Mr Hancock and warned that “the figures (on testing) are still far from complete and comprehensible”.

He told him: “The way the data are analysed and presented currently gives them limited value… The aim seems to be to show the largest possible number of tests, even at the expense of understanding.”

But it turns out the problems with data over-testing went far deeper than is evident from the Statistics Authority letter.

They were a consequence of a system which, according to Sky News sources, was born out of chaos, where little thought was given to the kinds of data collection practices which are expected of most government enterprises.

Those problems began early on in the pandemic, with two fateful decisions about the way Britain’s testing infrastructure would be arranged.

When news first broke of the virus in China at the turn of the year, the working plan at DHSC was to rely on PHE and its existing network of testing facilities.

Britain’s pathology sector is not lavishly funded, but it has tried and tested practices that ensure results are delivered quickly and are usually fed back into medical records.

However, in the first three months of the year, PHE struggled to increase testing capacity at its labs – to the enormous frustration of central government.

“It was a risk,” says one senior source.

“We bet on red. And it came up black. The Germans were lucky. They had lots of machines lying around and a system in place. We had next to nothing.

“This country’s pharmaceutical industry has a real advantage when it comes to ‘high science’ – blockbuster drug development, biotech and so on – the sexy stuff. But we’re far less focused on the unsexy end: diagnostics, where we tend to buy the kit in from abroad.

“That was a massive problem. Many of the NHS pathology labs are effectively cottage industries, cooking up tests by the day. They weren’t equipped for what was coming their way.”

Many working in NHS pathology labs reject that characterisation.

They argue that if the government had turned to them, then testing would be in a far better position – and point to their successes as proof.

Others working in academic labs say they offered their services to the government and PHE to push up testing capacity.

But in March, the government decided to reject those advances and set up an entirely separate network of testing sites and facilities, run in large part by commercial partners.

It was a bold, disruptive move in the face of what was seen as foot-dragging by PHE and NHS labs, but multiple sources from inside government, from labs and from the technology sector told Sky News it was this move more than any other that set in motion the problems with testing results and data that have plagued the system ever since.

Leaving PHE in charge of the “core” tests for hospitals and key health workers, which it now labelled “Pillar 1”, it conceived of a mammoth new testing programme for the general public, with a network of “Lighthouse Laboratories” around the country.

This centralised testing scheme was named “Pillar 2” and would encompass home-testing kits and drive-in and walk-in centres around the country.

Having made testing an internal priority, on 2 April the health secretary doubled down with a public pledge to raise the number of daily tests to 100,000.

At that stage there were barely more than 10,000 tests a day being carried out, but Mr Hancock gambled that with the new Pillar 2 system being hastily set up, it was just possible to meet the target by the end of the month.

That target was the second fateful decision: from that point most of the focus in Whitehall was on hitting 100,000 as quickly as possible.

In the face of the unprecedented outbreak, less thought and time than usual was given to putting in place the systems and safeguards that would ensure test results could be robustly reported and tabulated into the data that would help inform Britain’s response to COVID-19.

Quantity trumped quality.

A host of departments and consortia were engaged.

Deloitte was contracted to set up the booking system – everything from the digital infrastructure (websites, portals and booking systems) to the coding that would associate an individual with their testing vial.

Amazon was brought in to manage logistics and the army was asked to help out in operating some of those test centres.

It was a gargantuan operation which did indeed push up testing numbers rapidly, but as it expanded, those involved found it even more difficult to keep track of the crucial statistics.

Even in the absence of human error, managing a testing programme is a demanding logistical challenge, involving a chain with many points of fragility.

Consider a home testing kit. Nearly three million of these tests have been mailed out to households around the UK.

Each contains a swab, a vial, some packaging, and a lengthy 16-page booklet of instructions about how to self-administer the test.

Having taken a sample from their throat and nose, the individual must then attach a barcode to the vial the correct way round, put it in the packaging and send it back to one of the Lighthouse Labs.

Since the tests are time-sensitive, if it doesn’t arrive within 48 hours the results could be invalid.

When the vial reaches the test centres another crucial chain of events begins: the vial needs to be assigned to a specific place in the polymerase chain reaction (PCR) machine, where the test itself takes place.

Sometimes mistakes happen at this stage: the vials are dropped or contaminants are introduced.

Sometimes tests have to be reprocessed.

But even if the test is done perfectly and the result is delivered quickly, without the associated data it quickly loses meaning.

According to one senior source, “we had problems not just with capacity but creating an end-to-end process”.

They said: “Deloitte were amazing and threw together something extraordinary in weeks.

“But in the early days there’s no doubt it was chaotic. A bag of tests would arrive on a given night and we wouldn’t know where it came from”.

Deloitte, whose consulting arm has worked on similar schemes in other countries, created a database which would collect as many of these datapoints as possible – down to whether a vial was dropped or spoiled.

According to insiders, it now connects directly to labs – via a data transfer system called the National Pathology Exchange (NPEx) – so that data is in the hands of the NHS.

But that arrangement took time to get up and running, and even in recent weeks doctors say they have struggled to get the data they need.

Tom Lewis, a doctor who oversees testing at North Devon Healthcare NHS Trust, says that when tests are carried out by his own labs the results come back within 12 hours.

Most importantly, those results are tied to crucial data points: they are filed alongside each person’s unique NHS number, forming a permanent, traceable record of their coronavirus status.

By contrast, when tests are done by the national system, the results take far longer to arrive, in large part because the tests need to be transported to the Lighthouse Labs before processing.

Worryingly, those crucial data points, including links with an NHS number, are not routinely collected – making it extremely difficult to reconcile the test results with a given individual and their accompanying medical records.

This helps explain why DHSC was unable for many weeks to publish data for the number of people tested in England.

Dr Lewis said the data problems are particularly acute when he attempts to get confirmation of test results for his staff from Pillar 2 centres.

In order to verify that a staff member has been tested, he has been forced to ask for screenshots, which he then enters manually into an Excel spreadsheet.

Handling an outbreak at a care home, he was unable to find out who had been tested and what the results were.

“You know things have happened and you don’t know when and to whom,” he says. “It’s a mess, a total mess.”

The number of tests conducted by North Devon Hospital are tiny compared with the national scheme, but Dr Lewis says it could have been the basis for something much bigger, if only the increased capacity was linked to existing infrastructure.

As evidence, he points to the fact that he sends some swabs to a larger teaching hospital in Exeter – but because each test is linked to an NHS number, it is recorded, traced, and made easily accessible as soon as it is done.

“The government system could have worked exactly the same way, if you had done it right,” he says. “But instead they got management consultants and the military to sort it out.”

Many of those Sky News has talked to referred back to that fateful decision to reject the offers of help from the existing lab community – both in hospitals and the academic sector – as one of the moments things started to go wrong.

Those in government say there was simply no other way to raise testing capacity comfortably into six figures, though they acknowledge that Pillar 1 testing has increased its capacity well beyond what anyone expected in March.

Even there, there were still problems as people scrambled to meet the health secretary’s target.

“There were multiple test formats, multiple outputs, multiple different barcodes,” said a senior manager in the Pillar 1 testing sector.

“We had one testing lab operating on one type of barcode system, hospitals on another, then another barcode system altogether in a different lab. These systems are extraordinarily complicated – and doing that at scale – well, it’s no surprise there were so many problems.

“But the real problem was: there were too few people at the very top who understood the nature of the tests they were dealing with.”

Still, while those working in the established testing sector had reliable ways of turning their results into overall data, Deloitte struggled to do so from the early days of the Lighthouse Labs of Pillar 2, according to one senior technologist who witnessed the testing scheme in operation.

“It was literally done on pen and paper; we were startled by how primitive the data collection process was,” they said.

“It was barbaric. There were hundreds of people working on this new system, yet the national test results were being literally hand-written.”

Sky News has seen one of those hand-written tables of test results, compiling results from regional testing sites and mobile testing units around the country.

Those involved argue that staff may have written out testing data with pen and paper – but say that such notes were likely to have been backups for electronic records, which were collected manually before a digital platform was put in place in mid-April.

However, that hand-written table allegedly dates from mid-May, when the system was already up in place.

And in the rush to get figures out, there were few checks being made at the very top to ensure nothing was falling through the cracks.

“We were committed to publishing data on a daily basis,” said a senior source at DHSC.

“None of it was properly audited. You can’t throw up a new system in a few weeks and expect it to be perfect.”

The Statistics Authority and Office for Statistics Regulation ask government statistics providers to try to follow the statistical code of conduct.

It stipulates: “Statistics must be the best available estimate of what they aim to measure, and should not mislead. To achieve this the data must be relevant, the methods must be sound and the assurance around the outputs must be clear.”

Departmental insiders privately admit that it fell foul of this requirement.

“Normally when the government publishes data it takes three months to get the system approved,” said the Whitehall figure.

“We didn’t have that kind of time. So we completely buffed the system. We said: ‘Forget the conventions, we’re putting things out’. We didn’t want to be accused of a lack of transparency.

“In doing so we probably broke some of the rules. But I don’t think there was some wild cover-up.”

Sky News has been told that while ministers were well aware of these problems with the data, they were nonetheless actively pushing to get that data released.

In the early days of the programme, one minister themselves phoned around to get numbers to add to Excel spreadsheets to produce each day’s testing figure.

Come the end of April, Mr Hancock was able to claim that his target of 100,000 tests per day had been carried out – but only because the DHSC included thousands of tests that had been mailed out to households around the country.

The target was met but at some cost, with the majority of the test kits sent out to households not returned for processing.

According to DHSC data, some 4 million kits have been sent out since late April, but 2.6 million tests have not yet been processed – around two in three of every home kit.

Even after the target had been hit, officials pushed on, producing statistics each day on the number of tests and the number of people tested.

Then, on 23 May, DHSC abruptly stopped publishing any numbers on how many people had been tested.

It removed the data series from its website, saying: “Due to technical difficulties with data collection we cannot provide people tested figures today.”

This week it confirmed that it would no longer produce those statistics each day, pointing people towards a weekly measure of people tested from the new Test and Trace programme instead.

However, it still has yet to produce a cumulative number for people tested.

In May, DHSC recruited Baroness Dido Harding, former chief executive of telecom company TalkTalk, to manage the NHS Test and Trace programme.

Following the series of letters with the Statistics Authority, she undertook to improve the collection of statistics – and, in recent weeks, new information has started to trickle out.

Gaps remain. Test and Trace is not able to say how fast many tests in care homes are done, for instance, as these are conducted by pharmaceutical company Randox, which uses a different system to manage its records.

Yet insiders report a slow but steady improvement in the flow of data through the system.

However, there are still serious gaps. Asked whether it knew how many people had been tested in total since the disease reached the UK, DHSC said more than 11 million tests had been delivered, with a capacity to carry out more then 300,000 a day.

Asked repeatedly to respond to the main claims in this piece, about problems with data, about poor standards of collection and double counting, it added: “Throughout the pandemic, we have been transparent about our response to coronavirus and are always looking to improve the data we publish, including the way we update testing statistics.

“We have engaged with the Office of National Statistics and the Office for Statistics Regulation on our new approach to these publications and will continue to work closely with them as we develop these figures.”

Deloitte, meanwhile, declined to comment.

But inside the department, there is an acknowledgement that for all the recent improvements in data gathering, the early mistakes may never be erased.

As one senior insider put it: “There’s a growing recognition that we may never know for sure what happened with many of those early tests.

“We will probably never know how many people have been tested for the virus.”

In the wake of this article’s publication, DHSC published a new data series of the number of people tested for Coronavirus going back to January.

These new data shows that the cumulative number of people tested between the end of January and late May was just under 2 million, split evenly between pillars one and two.

Dr Virgina Pearson was answering questions at Devon County Council’s DCC cabinet meeting on Wednesday, April 8 about the county’s Local Outbreak Management Plan.

The plan is a blueprint for managing any future outbreaks of the virus in Devon, outlining how they would be managed and how transmission would be contained.

It involves bodies including the NHS, local authorities, emergency services, schools, care providers and businesses all working closely together in partnership.

It also highlights additional support needed for those particularly vulnerable to the virus such as the elderly, those with chronic health conditions and those in vulnerable ethnic groups.

Dr Pearson also chairs the COVID-19 Health Protection Board, a committee of specialists who can coordinate a swift response to an outbreak of the virus.

Dr Pearson told the cabinet that the board has already begun meeting.

“The Local Outbreak Management Plan is a dynamic document and it is subject to change as we learn,” she said.

“We are working with partners on how we put in place these operating procedures in the event of any outbreaks, and how we test these procedures so that we are practised in how we would work should we get any outbreaks.

“Currently levels of Covid-19 within the county are very low.

“We have the second lowest cases in the national league table per 100,000 population…so actually we’re in a very positive position.”

She added: “We’ve been very fortunate in the South West. Because we’ve had the level of data that we needed for many weeks now…that’s helped us to constantly track what’s going on.

“Understanding the data and monitoring it is critical to keeping on top of what’s happening locally. It helps us with prevention and helps us with early intervention should we need it.”

As of July 8 there have been 1,190 confirmed cases of Covid-19 in Devon.

There have been 234 cases in Exeter, 210 in East Devon, 205 in Mid Devon, 204 in Teignbridge, 119 in North Devon, 98 in South Hams, 71 in West Devon and 49 in Torridge.

The job of monitoring how the outbreak plan is implemented will fall to Team Devon, the Local Outbreak Engagement Board which is headed up by council leader Councillor John Hart.

Cllr Hart said: “Local government asked for the responsibility of managing any local outbreak should it occur, on the grounds that we can do the job better than London.

“It’s now up to us to make it work and this we can do with our Team Devon partnership working together for our residents.”

Blue Islands, which has been operating “lifeline” flights from Jersey to Southampton and Gatwick during the pandemic, has also relaunched with a new livery.

Hillingdon hospital in north-west London stopped letting patients attend its emergency department or accepting any new emergency admissions on Tuesday after 70 of its staff had to self-isolate.

It has had to tell the London ambulance service to take patients from the area to other hospitals because the number of its own staff who are now in quarantine means it has too few personnel to provide a full range of services.

The outbreak began last Friday, but its impact on the hospital’s workforce has escalated since then as growing numbers of staff have been identified through the track-and-trace scheme as having been in contact with colleagues who have tested positive and so have had to self-isolate.

Hillingdon is the main hospital used by voters in the prime minister’s Uxbridge and South Ruislip constituency, in the London borough of Hillingdon.

However, the Guardian can reveal that the hospital’s chief executive, Sarah Tedford, has blamed the outbreak on “irresponsible” staff flouting infection control rules by not wearing a mask while at work, as all NHS staff in England now have to do, and standing or sitting too close to each other.

In a message she sent to staff last Friday, Tedford said: “All the way through this [pandemic] we have followed national guidance and it has kept us safe. So what is happening now? I am told some of you are not wearing appropriate masks and you are not adhering to social distancing. This has resulted in an outbreak on a ward where our staff have contracted Covid-19.

“If you do not follow the guidance, we cannot keep you safe. I don’t like wearing a mask, but it would be irresponsible of me not to do so. Please think very carefully about what you are doing and ask yourselves if you are keeping yourself safe and if you are keeping each other safe. This is no time to be complacent: we are not out of the woods yet.”

She then added: “Can I please remind you to take responsibility for yourself and your team and help us all beat Covid-19? The lockdown is being lifted. Please ensure we play our part in not spreading Covid-19 and leading by example.”

Tedford went on: “This is such a serious matter, and at the moment I’m afraid some of us are not demonstrating the behaviour we should be. If you see someone not adhering to the guidance, please remind them of their responsibilities. We all need a little nudge at times.”

In a statement on Wednesday, a spokesman for Hillingdon hospitals NHS foundation trust said: “An outbreak of Covid-19 was declared on Friday 3 July 2020. As of Tuesday 7 July, 70 members of staff are now isolating, a number of whom have tested positive for Covid-19.

“As a result, the trust has taken the precautionary decision to close Hillingdon hospital to emergency ambulances and emergency admissions. The trust is managing the outbreak in line with Public Health England guidance.”

In April the trust was criticised by a healthcare assistant who quit when managers at the hospital refused her permission to wear a surgical mask to protect herself and her patients.

Tracy Brennan had self-isolated for 14 days after her daughter had shown symptoms. When she returned to work, she wore a surgical mask she had bought herself, to reduce the risk of her contracting or passing on the infection. But when her bosses told her that the next day she could not do so, she removed it. However, she explained in her resignation letter that managers again told her later that day that she could not wear the mask even though a patient had accidentally coughed into her unprotected face when she was taking blood.

In her letter she said: “With a heavy heart and sadness I feel I have no alternative but to hand this letter in as my formal resignation and will be unable to work my notice due to not being allowed to wear sufficient PPE [personal protective equipment] for the duties I perform.”

At the time, the trust said it took the safety of all its staff extremely seriously and followed national guidelines.

A spokesperson for Hillingdon hospital said: “The vast majority of our staff are maintaining social distancing and it is essential that everyone follows the guidance if we are to provide the safest care to our patients.”