The UK’s chief scientific adviser has told MPs it would have been “beneficial” to have ramped up testing for coronavirus quicker.

Understatement – Owl?

Angharad Carrick www.cityam.com 

Sir Patrick Vallance told the Commons Health Select Committee that testing alone would not control the virus. The UK government moved away from contact tracing and testing in the community before lockdown started.

Instead, ministers focused their efforts on testing patients with symptoms of coronavirus in hospitals, care homes and prisons.

England’s deputy chief medical officer Jenny Harries said that “things would have been done differently” if testing capacity had not been limited.

Speaking to MPs, Vallance said: “I think that probably we, in the early phases, and I’ve said this before, I think if we’d managed to ramp testing capacity quicker it would have been beneficial.”

“And, you know, for all sorts of reasons that didn’t happen. “I think it’s clear you need lots of testing for this, but to echo what Jenny Harries has said, it’s completely wrong to think of testing as the answer.”

Health secretary Matt Hancock today announced a goal of 100,000 coronavirus tests a day by the end of April. The government initially succeeded but has struggled to hit the target in recent days.

It came as the government rolled out the NHS contact-tracing app for the first time today. Key workers on the Isle of Wight are the first to trial the new smartphone app from today, and will be made available to the rest of the island on Thursday.

The app is an attempt to slow the spread of Covid-19 by informing people if they have been in contact with someone who later reports they have virus symptoms.

The technology relies on a large uptake by the population, so the government will be encouraging as many smartphone users as possible to download the contact-tracing app.

Right now, offices around the UK are sitting empty while most of us work from home. But when lockdown lifts and workplaces are told they can start bringing employees back, they will return to a very strange environment.

Francesca Perry www.wired.co.uk

Government guidelines shared with businesses and unions this weekend gave a glimpse of what is yet to come. Hot desking will be curtailed and employees will be kept two meters away from each other with sticky tape on the floor; lifts will remain half empty and face-to-face meetings will be banned. Working hours will be staggered to reduce the amount of people in the office at any given time, and office canteens will be kept shut.

After coronavirus, the open-plan office format has suddenly become more risky than revolutionary; especially in light of previous studies which suggest the format results in a 62 per cent increase in sick leave. A recent survey from the Trades Union Congress (TUC) reported that 39 per cent of workers are concerned about not being able to socially distance from colleagues when back at work. Now that barriers have become synonymous with protection from infection, could we see a return of the cubicle-style office – or are there other ways to achieve workplace safety?

The open-plan layout was designed for collaboration, not isolation. Rising to prominence in the early 2000s and spurred on by young tech firms like Google, the open office signalled an end to the ‘cubicle farm’ era. Though some companies still use cubicle working, most abandoned it; according to a 2019 Savills survey, 73 per cent of UK workers use an open-plan office. And over the years, the open-plan office has become denser. According to the British Council of Offices (BCO), the average space per workstation in the UK has dropped from 11.8 square metres in 2008 to 9.6 square metres in 2018, meaning employee proximity has only increased.

Although the government has yet to confirm when a post-coronavirus return to the office might happen, companies and workplaces have started strategising. WeWork produced a slick video and announcement outlining “what the future of work looks like as we face the new realities of a post Covid-19 world”. The co-working provider’s measures include increased cleaning, PPE for members, touch-free soap dispensers, behavioural and wayfinding signage, professional distancing standards and limitation of capacity in its lounges, working nooks and meeting rooms – but no cubicles.

Google CEO Sundar Pichai has said employees will not return to offices until June at the earliest, and even then will do so in a staggered way. He also suggested the pandemic creates “an opportunity to reimagine how we work,” though Google has not announced details on what this entails.

Ken Cooper, Bloomberg LP’s global head of HR, says the majority of his company’s global workforce – including more than 95 per cent of UK-based employees – has been working from home since mid-March. “In London, we have introduced non-contact infrared temperature screening and are planning to adopt a gradual, phased approach to office return based on guidance from local authorities and our own risk assessment procedures.” Key considerations in Bloomberg’s operational strategy, Cooper explains, include re-configuring office movement, implementing social distancing across office floors and enhanced cleaning procedures.

Perkins + Will, a global architectural firm, recently announced its strategy for safer workplaces post-Covid, including a phased return to work, office capacity limits and distancing signage. “Instead of transitioning to a cubicle style of working, we will be using simple and cost-effective measures such as replanning our existing open-plan desks and re-organising circulation routes to allow for social distancing,” explains Linzi Cassels, principal and design director at its London studio. Some desks will be removed to reduce density and circulation routes will be redesigned to allow for one-way directional movement. “Adaptability will be key, with the ability for spaces to flex to accommodate future waves of pandemic,” says Cassels, “but this should be achievable through creative, yet uncomplicated, office design solutions.”

Global commercial real estate services firm Cushman and Wakefield has introduced the “6 Feet Office” concept to help its clients prepare for a return to the office that maintains physical distancing. Is this costly? “Clients are implementing different levels [of it],” says Nicola Gillen, head of total workplace EMEA. “Most are working with signage and graphics which is the cheapest approach with least intervention. Some are installing screens. Some are moving furniture out which involves labour costs and storage. Fewer are changing physical environments, which is the most costly.”

In fact, changes need not be physical at all. Using generative algorithms, global design firm Gensler has developed a digital tool for post-Covid workplace occupancy planning. Named ReRun, it uses the existing layout of a workplace to identify an optimal plan for assigning seating in order to accommodate safe physical distancing.

In April, the British Council of Offices released a briefing note on office design and operation after Covid-19. Its suggestions include automatic doors, reception screens, reconfigured meeting rooms, enhanced fresh air and touch-free devices. “Touchless devices do require investment,” explains Richard Kauntze, chief executive of BCO. “However, many of the immediate measures our paper suggests can be delivered for relatively little cost. Good hygiene practices are vitally important, however these can be enforced without significant cost – they’re more a question of effort and discipline.”

Office density is perhaps the biggest challenge for businesses returning to work. As fewer people are allowed to be in an office at any one time, companies will need to deploy rotas, explains Rosie Haslem, director at London-based design and research studio Spacelab, which has shaped workplaces for clients such as Virgin and Bauer Media. “In the shorter term for the return to work, we will need to ensure people can socially distance. This can be achieved through both management of people – such as flexible hours and rotas for how many people come into the office each day – and management of space, including reconfiguration or removal of desks and the closure of certain communal spaces. These things are low-cost ways of getting people back into work, quickly. Investment in technology to assist in the management of people flow and space occupancy, and to enable things to be ‘contactless’ may indeed follow – but arguably this is just an acceleration of pre-existing proptech trends.”

Regardless of what companies’ strategies are, we will not see a dramatic return to the cubicle, says corporate real estate consultant Anthony Slumbers, “at least not by anyone that wants a productive, effective workplace. The smart companies will use the Covid-19 tragedy to update and improve their workplaces. The worst companies will build cubicles.”

Some companies, however, have been buying in partitions and desk dividers – though none so far are announcing it. UK firm Panelscreens, which supplies office screens and partitions, has seen a 86 per cent month-on-month increase in revenue after the UK lockdown began. What’s more, its MOM average order value increased by 426 per cent. “The orders and enquiries we are getting are from large-scale businesses, who want quotes for multiple sites, where the volume of screens we’re being asked to quote on is over 5,000,” a representative explains. “These are not a cheap purchase on the volumes we are dealing with.”

The major change will be companies admitting that it is possible for their workforce to work remotely , says Matthew Blain, principle at design firm Hassell, which has designed offices for GSK and Sky. Preliminary findings from Spacelab show a large majority of workers (59 per cent) want to work from home at least two days per week in future. When asked their views on the most important future design considerations for the office, respondents prioritised the provision of technology that would enable “work anywhere” collaboration.

“Covid-19 has enforced a global working from home experiment which has accelerated long-term underlying trends in several areas,” says Gillen. “One of these is rethinking how and where we work and the idea that work has to be tied to an office. Many businesses are now fundamentally asking ‘Why do we go to the office?’ and therefore ‘What is the office for?’ It doesn’t make much sense for people or the planet for everyone to travel into city centres in order to work alone, two metres away from each other, at desks or in cubicles, every single day of the working week.

“The office should be a place we choose to come to for activities that are better done in person such as building relationships, learning, socialising, personal conversations and serendipitous interaction. That trend was already underway and we see it accelerating.”

Professor Neil Ferguson, an epidemiologist whose modelling convinced Boris Johnson to press ahead with a UK-wide lockdown, stood down from the scientific advisory group for emergencies (Sage) after allegations emerged in the Daily Telegraph on Tuesday evening.

Ashley Cowburn Political Correspondent www.independent.co.uk

A key scientist advising the government on coronavirus has resigned after reportedly flouting social distancing restrictions, admitting he made an “error of judgement”.

Professor Neil Ferguson, an epidemiologist whose modelling convinced Boris Johnson to press ahead with a UK-wide lockdown, stood down from the scientific advisory group for emergencies (Sage) after allegations emerged in the Daily Telegraph on Tuesday evening.

It was claimed professor Ferguson had allowed a woman to visit him at home in London at least two occasions during the lockdown.

In a statement, the professor of mathematical biology at Imperial College London, said: “I accept I made an error of judgement and took the wrong course of action.“

He continued: “I have therefore stepped back from my involvement in Sage. I acted in the belief that I was immune, having tested positive for coronavirus, and completely isolated myself for almost two weeks after developing symptoms.

”I deeply regret any undermining of the clear messages around the continued need for social distancing to control this devastating epidemic. The Government guidance is unequivocal, and is there to protect all of us.“

A government spokesman confirmed Prof Ferguson’s resignation when approached by The Independent.

His is not the first high-profile resignation of the pandemic, with Dr Catherine Calderwood having quit as Scotland’s chief medical officer after making two trips to her second home.

Sir Iain Duncan Smith, the former Tory leader, told The Telegraph: “Scientists like him have told us we should not be doing it, so surely in his case it is a case of we have been doing as he says and he has been doing as he wants to.

”He has peculiarly breached his own guidelines and for an intelligent man I find that very hard to believe. It risks undermining the government’s lockdown message.“

Prof Ferguson’s research with Imperial College London colleagues warned that 250,000 people could die in the UK without drastic action shortly before the prime minister imposed the restrictions.

“Now, the Guardian has seen a letter from the Department of Health to NHS trusts instructing them to stop buying any of their own PPE and ventilators.

From Monday, procurement of a list of 16 items must be handled centrally. Many of the items on the list, such as PPE, are in high demand during the pandemic, while others including CT scanners, mobile X-ray machines and ultrasounds are high-value machines that are used more widely in hospitals.

Centralising purchasing is likely to hand more responsibility to Deloitte…… “

Rupert Neate www.theguardian.com

The government is using the coronavirus pandemic to transfer key public health duties from the NHS and other state bodies to the private sector without proper scrutiny, critics have warned.

Doctors, campaign groups, academics and MPs raised the concerns about a “power grab” after it emerged on Monday that Serco was in pole position to win a deal to supply 15,000 call-handlers for the government’s tracking and tracing operation.

They said the health secretary, Matt Hancock, had “accelerated” the dismantling of state healthcare and that the duty to keep the public safe was being “outsourced” to the private sector.

In recent weeks, ministers have used special powers to bypass normal tendering and award a string of contracts to private companies and management consultants without open competition.

Deloitte, KPMG, Serco, Sodexo, Mitie, Boots and the US data mining group Palantir have secured taxpayer-funded commissions to manage Covid-19 drive-in testing centres, the purchasing of personal protective equipment (PPE) and the building of Nightingale hospitals.

Now, the Guardian has seen a letter from the Department of Health to NHS trusts instructing them to stop buying any of their own PPE and ventilators.

From Monday, procurement of a list of 16 items must be handled centrally. Many of the items on the list, such as PPE, are in high demand during the pandemic, while others including CT scanners, mobile X-ray machines and ultrasounds are high-value machines that are used more widely in hospitals.

Centralising purchasing is likely to hand more responsibility to Deloitte. As well as co-ordinating Covid-19 test centres and logistics at three new “lighthouse” laboratories created to process samples, the accounting and management consultancy giant secured a contract several weeks ago to advise central government on PPE purchases.

The firm said it was providing operational support for the procurement process of PPE from existing and new manufacturers, but declined to comment further.

“The government must not allow the current crisis to be used as cover to extend the creeping privatisation of the NHS,” said Rachel Reeves, the shadow chancellor of the Duchy of Lancaster.

“The process for the management and purchase of medical supplies must be open, transparent and subject to full scrutiny. Deloitte’s track record of delivering PPE to the frontline since this virus began is not one of success and taking more decision-making authority from NHS managers and local authorities shifts power further from the frontline.”

Tony O’Sullivan, a retired paediatrician who co-chairs the campaign group Keep Our NHS Public, said this was a “dangerous time” for the NHS, and that the “error-ridden response” from government had exposed a decade of underfunding.

“Now, rather than learning from those errors they are compounding them by centralising decision-making but outsourcing huge responsibility for the safety of the population to private companies,” said O’Sullivan.

Allyson Pollock, the director of the Newcastle University Centre for Excellence in Regulatory Science, said tasks including testing, contact tracing and purchasing should be handled through regional authorities rather than central government.

“We are beginning to see the construction of parallel structures, having eviscerated the old ones,” she said. “I don’t think this is anything new, it just seems to be accelerated under Matt Hancock. These structures are completely divorced from local residents, local health services and local communities.”

Friday’s letter, signed by two officials from the Department of Health and Social Care, says that from Monday key equipment will be purchased through a procurement team comprising hundreds of staff from the government’s commercial function and other departments.

Global demand for equipment has been “unprecedented”, according to the letter, and it is therefore “vital that the UK government procures items nationally, rather than individual NHS organisations compete with each other for the same supplies”.

Trusts are told to flag any purchases already in progress so that these can be taken over by the central team and put into a central pot. “The national team can help you to conclude the deal, reimburse you, and manage the products through the national stocks.”

In a separate email, sent from NHS England on Saturday, trusts have been instructed to carry out a daily stock check from the beginning of this week. They must report down to the nearest 100 their stores of 13 types of protective equipment, including gloves, aprons, masks, gowns and eye protection. The information is being gathered by Palantir, a data processing company co-founded by the Silicon Valley billionaire Peter Thiel.

The information will be used to distribute equipment to those trusts most in need, and in some cases move stock from one hospital to another.

A purchasing manager, speaking anonymously, said hospitals were concerned they might be forced to hand over stock and then run out before it could be replaced. “The lead time on some of these orders is 90 days,” said the manager. “Centrally, there is nobody who is able to deliver things more quickly. What this is going to do is force people to hide what they’ve got.”

“This coronavirus pandemic is being used to privatise yet more of our NHS against the wishes of the public, and without transparency and accountability,” said Cat Hobbs, director of campaign group We Own It. “This work should be done within the NHS. It shouldn’t be outsourced.”

“This is not the time for a power grab,” said the Labour MP Rosie Cooper, who sits on the health and social care committee, which is conducting an inquiry into the management of the outbreak. “Whatever contracts are awarded they have got to have a sunset clause. Three months, six months, it has got to be shown to be cost effective for it to continue after a certain date,” she said.

The Department of Health was contacted for comment.

Outsourcing

Testing centres

Contracts to operate drive-through coronavirus testing centres were awarded under special pandemic rules through a fast-track process without open competition. The contracts, the value of which has not been disclosed, were granted to accountants Deloitte, which is managing logistics at a national level. Deloitte then appointed outsourcing specialists Serco, Mitie, G4S and Sodexo, and the pharmacy chain Boots, to manage the centres.

Lab tests

A coalition of private companies and public bodies have come together to form Lighthouse Labs, to test samples in three centres in Milton Keynes, Cheshire and Glasgow. Deloitte is handling payroll, rotas and other logistics, working alongside pharmaceutical giants GlaxoSmithKline and AstraZeneca, as well as the army and private companies Amazon and Boots.

Nightingale hospitals

Dozens of private companies have won contracts to build, run and support the Nightingale hospitals. Consultancy firm KPMG coordinated the setting up of the first Nightingale at the ExCel centre in east London alongside military planners. Infrastructure consultants including Mott MacDonald and Archus also had roles in the project.

Outsourcing firm Interserve worked on the construction of the Birmingham Nightingale hospital at the NEC, and was awarded a contract to hire about 1,500 staff to run the Manchester Nightingale. G4S secured the contract to supply security guards for all the Nightingale hospitals.

Recruiting extra NHS and hospital staff

Capita, another outsourcing firm, was awarded a contract to help the NHS “vet and onboard thousands of returning nurses and doctors”.

PPE

The government appointed Deloitte to help it ramp up British production of protective equipment and source stocks from the UK and abroad. Some figures in the UK manufacturing industry have described the project as a “disaster” and accused Deloitte of pursuing factories in China – where prices have leapt and supply is tight due to huge global demand – rather than focusing on retooling UK factories to make more kit.

Clipper Logistics, a Yorkshire-based logistics and supply chain firm founded by the Conservative donor Steve Parkin, was awarded government contract to supply and deliver protective equipment to NHS trusts, care homes other healthcare workers.

“The inside story of what happened in this period is one of early panic and confusion, of companies with expertise clashing with those seizing the limelight with ambitions to innovate, of questionable designs, and the desperation of a government setting targets and then deciding it didn’t need to meet them after all.

The judgment as to whether ministers have made the right call will be made in the months to come. Either way, the clinicians and medical device experts who spoke to the Guardian say lessons have to be learned.”

Rob Davies  www.theguardian.com 

As realisation dawned that a full-blown coronavirus outbreak was inevitable, the government set British industry a seemingly impossible task.

The NHS had about 8,000 ventilators available but the latest modelling, based on evidence from China, suggested that up to 30,000 would be needed, within a matter of weeks.

During a conference call on Monday 16 March, dozens of manufacturers and medical device specialists were told the grim news and asked to launch a wartime-style effort – dubbed the ventilator challenge – to bridge the gap.

Nearly seven weeks later, things look very different. The NHS has neither needed 30,000 ventilators, nor has it come close to calling on the 18,000 that health secretary Matt Hancock set as a revised target in early April.

The inside story of what happened in this period is one of early panic and confusion, of companies with expertise clashing with those seizing the limelight with ambitions to innovate, of questionable designs, and the desperation of a government setting targets and then deciding it didn’t need to meet them after all.

The judgment as to whether ministers have made the right call will be made in the months to come. Either way, the clinicians and medical device experts who spoke to the Guardian say lessons have to be learned.

The ventilator challenge began on Saturday 14 March, led by chief commercial officer, Gareth Rhys Williams, the civil servant who oversees state procurement.

“I got an email at midnight asking if I could call him [Rhys-Williams],” said Nick Grey, a designer and inventor behind Worcestershire-based technology firm Gtech. “He said the PM had given him a special job: ‘we’re going to need up to 30,000 ventilators in two weeks, is that something you can help with?’”

Building a modern high-quality machine from a standing start would, he believed, have been impossible. But like many other designers and engineers who responded to the rallying cry, Grey believed he could knock up something serviceable.

“I said, ‘If you’re really stuck and people can’t breathe I can produce something that can keep them going.’ It would have had to have been really bad to do that.”

Grey wasn’t the only who was sceptical about producing something more sophisticated. Asking manufacturers to switch from cars or jet engines to specialist medical devices was unrealistic according to Craig Thompson, head of products at Oxfordshire firm Penlon, one of the few specialist ventilator firms in the country.

But at this stage, according to Whitehall sources, ministers were desperate; they believed tens of thousands of people might require ventilation. Basic devices, however undesirable, might have to do.

“We were of the view that we had to back every horse,” said an adviser to a cabinet minister involved in the plans.

The strategy was threefold; buy proven devices from the few small firms that made them, import some from overseas and, most importantly, look to the the ventilator challenge to deliver thousands more machines.

Already though, some experts were concerned at how much credence was being given to the notion that non-specialist companies could build their own simple devices.

“They [the government] were initially talking about a Manley-Blease-style ventilator,” said a source at one specialist ventilator company. “They sent links to it.”

He was referring to a 1960s design by Roger Manley and the Blease Medical company, a major advance at the time but crude by modern standards.

In a document sent to manufacturers, the government said the new devices should ideally be able to support a patient for a number of days, but left open the option to build devices capable of providing support for a few hours to a day.

“These companies were all focused on the big prize of coming up with their own ventilator,” said the source. “I saw videos of some of them … the jerky motion suggested something that hadn’t been fully thought through. They didn’t exactly impress me as far as working concepts go.”

Dr Alison Pittard, dean of the Faculty of Intensive Care Medicine, has said that simple devices of this nature would have been “of no use”.

Yet firms with no prior experience were increasingly bullish that they could design and build a prototype within weeks.

One of these was Dyson, the engineering group whose success was built off the back of the bagless vacuum cleaner invented by its founder, Sir James Dyson. On the evening of 25 March, the billionaire Brexit-backer indicated in an email to staff that the prime minister, Boris Johnson, had personally asked him for help.

The company had been working with Cambridge-based The Technology Partnership on the CoVent, a breathing device that it believed would help meet the nation’s needs. The government, he said, had ordered 10,000.

Within an hour of the memo to staff, Dyson was sending out mocked-up images of the CoVent. The move angered some of those involved in parallel projects, who felt the buccaneering tone masked the enormity of the challenge.

“Dyson jumping the gun wasn’t helpful to anyone,” said one source. “We were looking at them aghast. Nobody said you had to start from scratch.”

According to one source, the firms that opted to design and build new machines had to lean heavily on support from the medical device regulator, the Medicines and Healthcare products Regulatory Agency (MHRA).

“Without the independent regulatory teams, most of these projects would have gone nowhere,” the source said. “It’s easy to say you can just design a ventilator but the safety isn’t just in the design, it’s about how you make them, the quality management, servicing them. It’s not an innovation programme, it was there to meet a clinical need. And that need was always most likely to be met by scaling up manufacture of existing devices.”

Only one group had taken this latter approach and it was quietly making more progress than any other.

The Ventilator Challenge UK consortium, involving more than 20 firms, counted the likes of Rolls-Royce, Airbus, Ford and McLaren among its number. It is on track to deliver thousands of ventilators to the NHS. Rather than reinvent the wheel, the consortium focused on existing designs.

“It was our choice that it was the quickest route,” said Dick Elsy, the consortium’s chairman. “Others pursued the start-from-scratch approach and some [of those projects] have been turned off.”

By early April, Ventilator Challenge UK was inching towards production and imports were starting to trickle through, albeit not in the volume the government had hoped for.

Meanwhile Dyson, defence group Babcock and a group of Cambridge scientists called Sagentia were continuing to work on their new prototypes.

Still though, the numbers were far lower than hoped. The NHS now had close to 9,000 devices but none had yet come from the ventilator challenge.

“The fact is that the industry has answered the call but the government wasn’t shouting early enough,” confided a frustrated source involved in one of the projects in early April.

Despite commissioning multiple new devices with no measurable chance of success, the government hadn’t, in fact, backed every horse.

The UK failed to join an EU procurement scheme that promise to source proven designs, a revelation that led to the prime minister being accused of putting “Brexit over breathing”. The row descended into farce as the government changed its story, first indicating the snub was deliberate before blaming a “communication problem”.

By 5 April though, the health secretary, Matt Hancock, had reduced the target to 18,000 ventilators, a more manageable if still rather distant prospect.

Three days later, based on clinical advice, the government upgraded its requirements.

Doctors treating Covid-19 patients had learned that they typically suffered rapid fluid build-up in the lungs, requiring frequent drainage. The initial specifications had not envisaged this and some of the more basic models were not equipped to handle it.

One anaesthetist, who asked not to be named, said the Department of Health and Social Care should have been aware of this issue far earlier.

“We had done strategies for changing over ventilators as people built up fluid. We knew that was going to be the case.”

Other clinicians say doctors’ understanding was constantly changing.

“What I would say is that this is genuinely a new disease,” said Dr Daniele Bryden, vice-dean of the Faculty of Intensive Care Medicine and an intensive care practitioner who has treated coronavirus patients. “It takes time to understand long-term impacts for the individual.”

Some projects fell by the wayside. Even the high-spec Penlon Prima EOS2, manufactured by Ventilator Challenge UK and now being used in hospitals, had to be sent back to the factory to be refined.

With cancellations and delays like these affecting the race, time appeared to be running out – 10 days after Hancock revised down the ventilator target to 18,000, the NHS still had only 10,000.

Luckily for Covid-19 patients – not to mention the ministers overseeing the ventilator challenge – external factors came to the rescue.

Only about half of Covid-19 patients admitted to intensive care with breathing difficulties were being put on mechanical ventilators.

Martin Allen, a consultant respiratory physician and board member of the British Thoracic Society, explained why.

“In Wuhan, when they tried other ventilation strategies they failed. Everyone needed to go on to invasive ventilation, so there was a concern that spread throughout the rest of the world,” he said.

In Italy though, a lack of the devices forced doctors to try other strategies, such as increased use of Cpap machines, which deliver oxygen via a mask rather than requiring intubation – where oxygen is delivered by the ventilator through a tube inserted into the airway.

Of the experts who spoke to the Guardian, many felt that the ventilator strategy would not have withstood a sterner test.

“The country has been fortunate that we’ve not see the levels we frankly should have expected” said one ventilator expert. “It could have been far worse.”

The government said that it was, at all times, guided by expert scientific advice.

Yet manufacturers felt the plan began too late, while imports that were supposed to number around 8,000 have only just passed 800. Last week it emerged that 250 from China were ditched because doctors feared they might harm or even kill patients.

Of the “new” ventilator projects, none have reached the final stages of testing and the majority – including those made by Sagentia and Dyson – have proved surplus to requirements.

Dr Bryden questioned whether the intense focus on ventilators was ever the most sophisticated approach.

“You cannot save somebody’s life with a piece of equipment alone. You also need someone who knows how to look after the patients.”

Prof Carl Heneghan, director of the centre for evidence-based medicine at Oxford University, believes that a strategy that relied on firms cobbling together life-saving devices in a matter of weeks should teach us more enduring lessons.

“When we look back there will be serious questions to answer about all of the decisions made. What’s been very noticeable is that we always seem to be one step behind on the policy.

“If it’s not ventilators it’s tests, if it’s not tests, it’s PPE. It’s an important lesson that we have to invest, to create overcapacity for these moments.”

“We’ve really cut to the bone in this country far too much.”

Owl has an international following – following a tip off – here is an Aussie view from the Sydney Morning Herald dated 3 May. It’s a devastating examination of our Governments handling of the pandemic.

Bevan Shields www.smh.com.au 

Health Secretary Matt Hancock was midway through a radio interview when the phone call came through live to air. On the line was Intisar Chowdhury, whose father Abdul had made a prescient public plea to Boris Johnson in late March.

Through a Facebook post, the 53-year-old consultant urologist for a London hospital had urged the Prime Minister to make sure every health worker in Britain would be given protective equipment during the coronavirus pandemic. Abdul Mabud Chowdhury died just three weeks later, after contracting the disease.

In his phone call, the doctor’s grieving son asked for answers and an apology: “The public is not expecting the government to handle this perfectly,” he told Hancock. “We just want you to openly acknowledge that there have been mistakes in handling the virus, especially to me and to so many families that have really lost loved ones as a result of this virus and probably as a result of the government not handling it seriously enough.”

Chowdhury seemingly spoke on behalf of a growing chorus of health experts, MPs and members of the public who think Britain’s response to the crisis has suffered from a series of deadly mistakes and miscalculations.

The charges focus on four areas: that healthcare workers struggled to access personal protective equipment, that Britain was too slow to implement a lockdown, that it bungled testing, and that vulnerable care home residents were not properly protected.

Downing Street and key ministers such as Hancock have been reluctant to concede many errors, although their tone has shifted over recent days as the official death toll hit 28,446, one of the highest in the world and well above the 20,000 figure Chief Scientific Adviser Patrick Vallance once said the government hoped to not exceed.

Says Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine and an adviser to the World Health Organisation: “The countries that moved fast have curtailed the epidemic. The countries that delayed have not. It’s as simple as that.”

Dr Richard Horton, editor in chief of The Lancet medical journal, is even more damning: “The handling of the COVID-19 crisis in the UK is the most serious science policy failure in a generation.”

Hancock and Johnson had their first discussion together about the virus on January 7. The government’s crisis committee, COBRA, would meet several times over the following weeks and the Scientific Advisory Group for Emergencies started crunching the numbers. The government knew a threat existed but did it fully understand just how bad it could get?

By March 12 a full-scale outbreak had taken hold in Italy and the illness was spreading across Europe. More than 1000 Italians had already died and thousands more were gravely ill in packed hospitals in the country’s hard-hit north. The deadly potential of an invisible killer was becoming more obvious by the hour.

That day, Johnson announced Britain would move from the “contain” phase of the emergency to the “delay” phase. This decision would prove a pivotal moment. The shift meant contact tracing would be abandoned, and testing would be restricted to those only in hospital with symptoms. The move was at odds with the WHO, which urged countries to “test, test, test”, as well as Germany’s much-lauded program of mass testing.

The Prime Minister warned at the March 12 press conference that the “worst public health crisis for a generation” was about to hit the country and that “many more families are going to lose loved ones before their time”.

What he did not announce was a lockdown. Or anything close to it. Tougher measures would come but not yet, Johnson said, citing the need to introduce measures when they would have the most impact. But his chief scientific adviser also cast serious doubt on whether closing schools, banning mass gatherings or stopping international flights would ever be effective levers to pull.

Instead, Brits were encouraged to wash their hands and stay home for seven days if they had symptoms. Schools remained open, restaurants and bars traded as usual, and visitors were still allowed into care homes. Flights were arriving from mainland China, even though Australia had banned them six weeks earlier. Heaving public events were still allowed. A Champions League match in Liverpool drew a crowd of 52,000, about 3000 of whom came from Madrid, where a partial lockdown was already in force. More than 250,000 tickets were sold for the Cheltenham horse racing festival. Both events are now being investigated by health officials who suspect they may have contributed to the rapid spread of the disease in the areas surrounding the venues.

By March 16, the government’s advice abruptly strengthened. People were told to stay away from pubs, theatres and clubs, to avoid non-essential travel and to work from home if possible, although the orders were not yet mandatory.

Why the sudden change? The government had just been handed a bombshell piece of research by scientists from Imperial College London warning that taking a light-touch approach to the virus would cause 250,000 deaths in Britain and overwhelm the National Health Service (NHS). Any hope of defeating the virus by building “herd immunity” in the community was smashed. The only way to prevent 250,000 deaths was through draconian measures, the researchers concluded.

Even then, Johnson would not put Britain into lockdown until one week later on March 23. By that point, many other European countries with a much smaller death toll had already been locked down.

Says David Hunter, an Australian-educated professor of epidemiology and medicine at the University of Oxford: “It’s very easy in hindsight to state the obvious, which is that the lockdown came too late.

“The British response so far is not a model to follow. It has one of the worst epidemics in Europe and the world. That may have happened anyway. There’s no way to know for sure, but some aspects of the response have almost certainly contributed to the high mortality.”

A former Australian high commissioner to Britain, Mike Rann, says crucial mistakes were made right when they had the most damaging impact: “The earliest stages were handled negligently,” Rann says. “A shambles of mixed messaging, poor organisation and a complacent attitude that what was happening in Italy wouldn’t happen here.”

Hunter says border closures in Australia and New Zealand stood in stark contrast to Britain, which only briefly imposed restrictions on people flying in from Wuhan. Even today, the few passengers still arriving in Britain are under no obligation to self-isolate.

“Good public health practice would be to, if not close the borders, then at least have some sort of mandatory self-isolation for people coming in during the very early stages of the pandemic,” Hunter says.

“The reasons why the UK did not do it are unclear. Australia, albeit at a different stage of the epidemic, has been highly successful in closing its border, as has New Zealand, and that has almost certainly played a role in the much much lower number of cases.”

Arrivals at Heathrow Airport were half what they normally were in March but still, 3.1 million landed there over the month. Nearly half a million came from the Asia-Pacific; 875,000 were from the European Union, and 711,000 came from North America.

Home Secretary Priti Patel supported a ban on travellers who had been in hotspots but was slapped down by Downing Street, which cited scientific advice that doing so would have little impact on the spread of the infection. When this spat was under way, Australia’s borders had already been closed for a week to all foreign travellers. Australia banned flights from China as early as February 1.

The decision on March 12 to abandon mass testing meant the government could only guess who was infected with the virus and how it was behaving. Government experts at one point estimated as many as 55,000 people had contracted coronavirus, even though there were just 2000 confirmed cases. The extent of its spread would not become obvious until hospitals started to fill with seriously ill patients.

Of the few tests that were available, the results were initially processed by a small number of government-run laboratories. Private sector labs and universities offered to help but now say they were given the cold shoulder before the government eventually embraced them as the answer to ramping up testing.

Nobel prize-winning geneticist Sir Paul Nurse told the BBC’s Question Time program that testing was “absolutely critical and hasn’t been handled properly”.

“We know that with this particular disease, you can be infected and have no symptoms. Now, this makes absolutely no sense. We were allowing, potentially, for front-line workers to be on the wards, potentially infecting people, because we weren’t testing.”

Nurse, who is the director of Britain’s largest biomedical research lab, the Francis Crick Institute, likens the addition of private facilities to the flotilla of small boats that rescued British soldiers from the beaches of Dunkirk and says their call-up was long overdue.

One of the strongest critics of the testing system has been Jeremy Hunt, the health secretary under former prime ministers David Cameron and Theresa May. Piers Morgan, a polarising morning television presenter and former tabloid newspaper editor, repeatedly mauled government ministers on his Good Morning Britain program about the deficiencies.

Under pressure, Hancock announced a plan to lift the number of tests conducted each day to 100,000 by the end of April. He achieved it − sort of. The government reported 122,000 tests on April 30. The devil is always in the detail, though: about 40,000 were tests mailed to people but not yet returned to labs for results. Regardless, Hancock’s ambitious goal has transformed Britain’s approach to testing and, if sustained, it will make it one of the world’s most prolific testers. The government is also hiring 18,000 “contact tracers” by the middle of May.

Despite the recent surge, those early delays mean Britain has conducted just 10.13 tests per 1000 people, the lowest rate in western Europe. Italy’s rate is 32.73, Ireland’s is 31 and Germany’s is 30.4.

Australia’s testing effort has been double the relative size of Britain’s, despite having a far less serious outbreak. And for all the criticism of the US response to the crisis, the rate of testing there never fell below the rate in Britain in April.

In his first address from Downing Street after his own battle with the virus, Johnson said the government was determined to fix the “challenges” that “have been so knotty and infuriating”.

“I’m not going to minimise the logistical problems we have faced in getting the right protective gear to the right people at the right time, both in the NHS and in care homes. Or the frustrations that we have experienced in expanding the numbers of tests.”

The additional testing capacity has allowed the government to get a better grip on the unfolding toll in Britain’s care homes. It was previously flying blind. Only three weeks ago, even symptomatic care home residents and staff did not qualify for a test. For many weeks, patients were discharged from hospitals and into care homes without being tested to check whether they would be taking a deadly virus to a place where it could unleash havoc.

The Office for National Statistics, which compiles death data based on whether COVID-19 was mentioned on death certificates − believes 4343 care home residents died in England alone in the fortnight ending April 24. In the week ending April 17, 7316 people died in care homes from all causes. This was 2389 more deaths than the week before and almost double the week before that.

Care home deaths were not added to Britain’s official death toll until late last week, and the true extent of the loss is still unclear. In early March, Johnson and his team spoke of “shielding” care home residents during the worst of the epidemic. They have since failed, but are not alone: all badly affected countries in Europe have experienced a wae of death in care homes.

While the Prime Minister has enjoyed a sharp rise in his personal approval ratings since the outbreak began, polling firm Ipsos MORI has recorded a “significant rise” in the number of people that think the government acted too late. Two weeks ago, 57 per cent felt that way but that figure now stands at 66 per cent.

Johnson and Hancock have been keen to stress that Britain has passed through the peak of the virus without the NHS being overwhelmed, pointing to a massive and rapid expansion in capacity and the early purchase of thousands of ventilators.

Chief Medical Officer Chris Whitty says the only way to truly compare Britain’s response will be once the pandemic has run its course not just in Britain but in other countries that may yet experience serious outbreaks.

“We are nowhere near the end of this epidemic. There is a very long way to run for every country in the world on this and I think let’s not go charging in to who’s won and who’s lost.”

When “three houses” Robert Jenrick was not required to resign over travelling to his second home, Owl thought this Government was without shame.

A close ally of Boris Johnson has resigned as a minister after being found to have used his position to try to intimidate a member of the public.

Rajeev Syal www.theguardian.com

The international trade minister, Conor Burns, was found by the standards committee to have made a series of veiled threats while attempting to intervene in his father’s dispute over a loan.

The committee recommended a suspension from parliament over multiple breaches of the MPs’ code before No 10 announced his resignation. A Downing Street spokesman said Burns had resigned after the committee’s report.

The commissioner for standards received a complaint from a member of the public connected to a firm with which Burns’s father was in dispute over the repayment of a loan. The complaint centred on a letter sent by Burns, which claimed his father had made extensive attempts over a period of years to reach a settlement on repayment of that loan.

In the letter, written in February 2019 on House of Commons notepaper, Burns stated he was writing on his father’s behalf enclosing an earlier letter sent by his father to the company to which, he stated, no response had been received.

“I am acutely aware that my role in the public eye could well attract interest especially if I were to use parliamentary privilege to raise the case (on which I have taken advice from the house authorities),” Burns wrote.

The MP suggested the complainant, a former senior civil servant whose name was redacted from House of Commons documents, could avoid having him raise the case in the Commons by securing the payment of the loan to his father.

Burns noted the complainant’s “high-profile role” outside the company “could well add to that attention”. By raising the case during parliamentary proceedings, Burns’s words would have been protected from a legal challenge by parliamentary privilege.

When confronted by Kathryn Stone, the commissioner for standards, Burns said he had not sought formal advice. Stone said his behaviour “gives fuel to the belief that members are able and willing to use the privileges accorded them by their membership of the house to benefit their own personal interests”.

“The content of the letter suggests the use of the principal emblem of the house was more deliberate than accidental. And, as I explained in my letter to Mr Burns of 11 June 2019, his reference to having sought advice about privilege from the house authorities was misleading,” Stone wrote.

The report released by the standards committee found that he had also misused parliamentary-headed notepaper. It accused Burns of behaving “disrespectfully” during the investigation and of claiming he had not received a memo from Stone over several months.

The cross-party committee recommended he should apologise in writing to the Commons and to the individual concerned – a recommendation that will need to be signed off by the Commons.

“The right of members of parliament to speak in the chamber without fear or favour is essential to parliament’s ability to scrutinise the executive and to tackle social abuses, particularly if the latter are committed by the rich and powerful who might use the threat of defamation proceedings to deter legitimate criticism.

“Precisely because parliamentary privilege is so important, it is essential to maintaining public respect for parliament that the protection afforded by privilege should not be abused by a member in the pursuit of their purely private and personal interests,” the report said.

Burns, 47, was made a trade minister in July when Johnson became Conservative leader and was a key member of his campaign team. He was elected to represent Bournemouth West in 2010 and defended his seat in 2015, 2017 and 2019.

He served as parliamentary private secretary to Johnson when he was foreign secretary but resigned from the post in July 2018.

Burns expressed his regret in a tweet on Monday. “With deep regret I have decided to resign as Minister of State for International Trade. @BorisJohnson will continue to have my wholehearted support from the backbenches,” he said.

In a separate development, another minister at the Department for International Trade, Greg Hands, was ordered on Monday to apologise for misusing parliamentary stationery to send a letter to thousands of constituents.

In October 2019, the Chelsea and Fulham MP had told the commissioner he was willing to publicly acknowledge he had breached the rules, apologise and reimburse the £4,865 costs. But with the election looming, Hands changed his mind.

The committee said: “It is hard to avoid the conclusion that Mr Hands may well have been motivated by a desire to avoid the embarrassment of having to make a public apology for breaking parliamentary rules during a general election campaign.”

Yesterday the “alternative Sage” said the Government needs to clarify whether its objective was to suppress or manage infections of Covid-19. Owl is concerned about one, little mentioned, aspect of the long term consequence of  “managing within the capacity of our NHS” .

Owl hears a lot about NHS capacity being measured in terms of the supply of PPE, number of beds and ventilators etc, not much about the limits of human endurance. In a couple of articles Owl has posted recently, Max Hastings has drawn comparisons between this emergency and the way resources are, or have been, mobilised in war. One wartime experience is a recognition of “battle fatigue” and the need  to manage this through “troop rotation” (either as individuals or as units) to maintain full efficiency. (Owl uses the recognised military terms to facilitate research searches.)

Frontline NHS staff have been working at full stretch in extremely stressful conditions. It is unlikely that this peak work rate could , or should, be sustained indefinitely.

Before coming to the article, Owl reports that there is now a substantial “fringe” scientific effort: 

DELVE: Data Evaluation and Learning for Viral Epidemics is a multi-disciplinary group, convened by the Royal Society, to support a data-driven approach to learning from the different approaches countries are taking to managing the pandemic. 

RAMP: The Royal Society is also convening the Rapid Assistance in Modelling the Pandemic (RAMP) initiative to support efforts to model the Coronavirus (COVID-19) pandemic. RAMP is bringing modelling expertise from areas other than pandemic modelling to support the pandemic modelling community already working on Coronavirus (COVID-19). 

Nicola Davis  www.theguardian.com 

The government has fundamental questions to answer about its approach to tackling Covid-19, an independent body of experts have said.

The Independent Sage committee – a body of 12 scientists and experts set up in parallel to the government’s Scientific Advisory Group for Emergencies (Sage) – is chaired by the former UK government chief scientific adviser Sir David King, who has criticised the official body’s previous lack of transparency.

Its members said on Monday that the government needed to make clear whether its objective was to suppress or manage infections of Covid-19, saying the two required very different processes and it was unclear which the government is pursuing.

The team have also recommended that new health policies for ports are developed to prevent cases of Covid-19 being imported, particularly as and when restrictions are lifted, while they have stressed the need for better financial support for marginalised groups and the BAME community.

Among other recommendations, they also advise that the government needs to move towards a local approach to testing and tracing.

The group was set up by King and Professor Anthony Costello after concerns about the lack of transparency around the government’s current Sage participants, and the revelation that 16 of the 23 known members are employed by the government. While the official Sage group is known to include behavioural scientists, pandemic modelling experts and infectious disease specialists, Dominic Cummings, Boris Johnson’s chief political adviser, is also known to have attended meetings.

Holding their first meeting on Monday, the Independent Sage group discussed a number of points, including the need to avoid stoking social divisions as lockdown is eased.

“People were very surprised at how adherent the population has been and a lot of that is down to collective solidarity as people have been rising to the challenge,” said Prof Susan Michie, a behavioural psychologist at UCL. “Going forwards, in terms of lifting lockdown, it’s going to to be a very different situation. A lot of thought has to be given to how this will be managed. If it’s not handled well, it risks potential divisions between groups.”

Other topics included the potential benefits to harnessing the island status of the UK and Ireland, as countries such as New Zealand have done, and developing new port health policies.

Prof Gabriel Scally, president of the epidemiology and public health section of the Royal Society of Medicine, noted that unlike many countries, Britain and Ireland have maintained open borders in the face of Covid-19.

“That seems to me, as we go into a situation where we are thinking of lifting restrictions, places us in sudden jeopardy,” he said, adding that a key issue at present in countries including China is cases of coronavirus imported into the country, including from citizens who had returned from travelling abroad.

At a press conference, chaired by the MP David Davis, after the first meeting of the new group, King added that the government needs to manage the pandemic without banking on a vaccine, noting that it remains unclear at present how well the newly developed vaccines will work, while Prof Karl Friston, of University College London, cautioned against placing too great an emphasis on the “effective reproduction number”, or R, which is the average number of people that one infected individual will pass the virus on to and has been a recurring figure in the government’s daily press conferences.

“R in an of itself is not a cause of pathology, death, suffering or any other measurements of those things,” Friston said. Indeed R is not fixed, and is affected by a number of factors, including by policies such as social distancing.

Friston added that the current prevalence of the virus in the population is a more useful figure when it comes to making important policy decisions.

“R is post-hoc reflection, it is a nice statistic, it is easy to model,” he said. “However, it is not really the thing you should be aiming at.”

Hundreds of fish have died after a major pollution incident on an East Devon river at the weekend.

Ten kilometres of river were affected after 100,000 litres of slurry poured into Southleigh Stream near Colyton.

Keith Rossiter  www.devonlive.com

The stream is a tributary of the River Coly, which in turn feeds into the River Axe southeast of the town.

The Environment Agency said it stepped in to investigate after a local farmer reported the loss of 100,000 litres of slurry from a storage tank. The agency said a number of fish had died, and officers were carrying out a fish kill assessment on the River Coly.

An East Devon news website said the farmer dug a ditch to reduce the flow to the stream after he was made aware of the incident, which is understood to have happened on Friday.

Most of the slurry reached the watercourse which was heavily discoloured when officers arrived on site on Sunday, making it difficult to assess the impact of the pollution, the Midweek Herald said.

“The Umborne Brook joins the River Coly at Colyton which will help dilute any pollution,” the Environment Agency told the news site.

“Officers have returned today to carry out a fish kill assessment and consider any further remedial measures.”

The Environment Agency said that it is investigating how slurry entered Southleigh Stream from a large store in the area.

“Our officers have recovered more than 400 dead fish, including brown trout, salmon fry, bullheads, stone loach, minnows and lamprey, and are now looking at the impact on the watercourse’s invertebrates.

“Any future action will be informed by the outcome of our investigation.

East Devon councillor Paul Arnott, who represents Coly Valley, told the Western Morning News yesterday that he understood hundreds of fish had died.

“The ecological impact on the River Coly is a disaster. It’s not just fish but birds and all sorts of other flora and fauna.

“I walk the river with my wife and daughters and appreciate what a beautiful thing it is and how crystal clear the water is.

“But if you go there now, you can’t see the river bed. The water is brown. It’s a tragedy.

“We will be looking for good, strong action from the Environment Agency.”

Ed Parr Ferris, Devon Wildlife Trust conservation manager, said:

“This incident has occurred on a section of river, the River Coly, already classed as in poor condition by the Environment Agency due primarily to agricultural pollution.

“The EA has been focusing attention on agricultural pollution on the River Axe, of which the River Coly is a tributary, due to the failing status of this important river. The Axe is recognised internationally as a Special Area of Conservation for its plants, invertebrates and populations of important fish – Atlantic salmon, bullhead, brook lamprey and sea lamprey.

“The estuary is also a Marine Conservation Zone.

“This is especially concerning as it’s the second major pollution incident on the river in two years which emphasises the need for stronger regulation, alongside advisory support for farming businesses to manage and protect our amazing river wildlife.

“Devon Wildlife Trust is working closely with the Environment Agency and other organisations to better protect and enhance the wildlife and environment in the Axe catchment.”

Morten Morland Times cartoon 4 May

Following Owl’s post reviewing the 207 planning applications, determined by EDDC in April, whilst all committee meetings have been cancelled, a correspondent has been in touch.

This correspondent has drawn Owl’s attention to the latest retrospective application the Carters have made in a catalogue of retrospective applications going back for years.

In Owl’s view it is also one of the most significant in terms of its adverse impact on the environment. Worse even than the Clinton application to extend the Blackhill Engineering site on the disused quarry on Woodbury Common.

This is retrospective application 20/0297/FUL for the partial retention at Ladram Bay of a raised viewing platform including balustrade and storage areas, validated 17 February. It appears to have been made in response to an enforcement notice issued in 2018. Owl has found it difficult to conduct a full audit trail of this application.

The case concerns the construction of a viewing platform and deck projecting through the narrow natural access chine from the camp site to the beach. The platform extends in front of the World Heritage Site (WHS) cliffs towards the east at Ladram Bay. It is supported by piles driven into the beach which will undoubtedly influence the natural erosion process. Owl’s correspondent isn’t sure when this platform first appeared but it was certainly seen in the summer of 2018.

Ladram Bay showing extent of the deck

Owl will start with the planning application form.

On page 4, the answers given in box 12, concerning the reasonable likelihood of the proposal having an adverse effect on designated sites and/or on features of geological significance, are boldly marked “no” in both cases. (Designated sites include SSSI and AONB. The Jurassic WHS is defined by a series of SSSI designations. The sea frontages of the larger towns in East Devon are excluded from the WHS. But for the smaller towns or coves such as Ladram Bay the WHS coverage is continuous across the sea frontage. The definitive DEFRA “Magic” map showing this for Ladram can be found here. The “Magic” map is an invaluable tool providing authoritative geographic information about the natural environment from across government. The information covers rural, urban, coastal and marine environments across Great Britain.)

The applicant cites three main reasons why permission should be granted: to support economic growth and productivity; to provide disabled access and to provide a platform to monitor the safety of swimmers. But it acknowledges that there would be a harmful visual effect from the development. This would be minimised in the summer months by the presence of boats hiding the development but when the beach is not used in the winter months would be very visible. (Judge for yourself from the photo and think how it must look from the coastal cliff path)

Now to comments, and Owl can find no better to make the case than those of Natural England:

The development is set within the boundary of the Ladram Bay to Sidmouth SSSI, the Dorset and East Devon WHS and has significant landscape and visual impacts on these and the East Devon AONB.

Dorset and East Devon WHS: The Dorset and East Devon Coast has an outstanding combination of globally significant geological and geomorphological features. The cliff exposures along the Dorset and East Devon coast provide an almost continuous sequence of rock formations spanning the Mesozoic Era, or some 185 million years of the earth’s history. The area’s important fossil sites and classic coastal geomorphologic features have contributed to the study of earth sciences for over 300 years.

Through a search of the site’s planning history, it is not apparent that the original viewing deck, which this application seeks to secure an extension to, ever received planning permission. Please confirm what date this was granted and any conditions relating to that initial permission. [Does Owl detect a rat hole here?]

We strongly suggest that the Planning Authority enforces the removal of this structure.

Other elements of the planning application excluding the extension to the viewing platform. [Owl emphasis] 

There are a number of developments within the site including various retrospective, permitted and unconsented developments which cumulatively result in a significant impact upon the purposes of designation of the AONB. [More rat holes – Owl?] We consider that without appropriate mitigation this application would:

• have a significant impact on the purposes of designation of the East Devon AONB through landscape changes and visual impacts in this location.

In order to address these cumulative impacts and to mitigate these adverse effects and make the development acceptable, the following mitigation measures are required:

• any permission for the remainder of the elements should be granted for a temporary period in line with NPPF paragraph 167 or development in areas subject to coastal erosion, e.g. for 20 years and with a condition requiring restoration of the site at the end of that period or sooner should it become unsafe due to cliff stability/coastal erosion.

• a comprehensive landscape masterplan for the whole of the Ladram Bay Holiday Park site, incorporating mitigation for this development and also previous unmitigated development impacts, to ensure an overall improvement in the appearance of the site and mitigation of its impact on the landscape of the AONB.

Natural England has also said:

Natural England is likely to oppose any attempts to interfere with natural processes through cliff protection or coastal defences in this location, which could directly impact on the Ladram Bay to Sidmouth SSSI/WHS.

(As might be expected the WHS site have also formally objected)

None of the District Councillors: Alan Dent, Paul Jarvis, Paul Jarvis or the environment supremo Geoff Jung have yet commented. The Parish Council unaccountably have raised “no objection”.

Is there no one who can take the lead to save the environment and, not just ours, but the world’s heritage?

Ladram c.1910

“Thousands of kits are sitting unused, social services chiefs said, because of a lack of clarity about who can administer them.

Residential care homes, which are registered by the Care Quality Commission, are not registered to carry out nursing tasks. Social services officials say they are unsure how far they are allowed to bend the rules on this.”

Sarah Marsh and Diane Taylor, the Guardian, 4 May 2020

Ministers are facing criticism over coronavirus testing as the number of daily tests dropped below 80,000, care home staff reported difficulties in getting checked and home kits were delivered without return envelopes.

On Friday, the health secretary, Matt Hancock, announced the government’s target of 100,000 tests a day by the end of April had been achieved, with more than 122,000 provided on the last day of the month. Since then, the number has dropped by more than 40,000, with just 76,496 delivered in the 24 hours up to 9am yesterday.

NHS England’s national medical director, Prof Stephen Powis, said: “You will see that testing capacity has ramped up very quickly over the last week or so and we are now at a very high level of testing, over 100,000 – a little bit of a dip in the weekend, but we anticipate that testing capacity will continue to increase.”

The Guardian has learned that just 7% of the 31,000 tests delivered to care homes for residents and staff had been carried out by this weekend.

Thousands of kits are sitting unused, social services chiefs said, because of a lack of clarity about who can administer them.

Residential care homes, which are registered by the Care Quality Commission, are not registered to carry out nursing tasks. Social services officials say they are unsure how far they are allowed to bend the rules on this.

One social services director said: “There’s a major flaw in this plan. Residential care staff are not registered to carry out this procedure. Yesterday not a single person was swabbed in any of our care homes. It’s another fiasco.”

The Department of Health and Social Care said: “Since we announced the further expansion to all symptomatic and asymptomatic care home staff and residents on 28 April we have delivered almost 31,000 tests. The tests are easy to use, with care workers needing to carry out simple swabs.”

The Care Quality Commission said it was not involved in mass testing in care homes.

The government has admitted “a small number” of the home corona-virus tests sent out did not have the right information to be processed. Baschea Walsh was one of those who reported receiving a test without a return envelope. “I asked how to send it back without a return envelope. I was told to chuck it in the bin – I asked them if they could send me an envelope and they said no, I would need to do a new test.”

A DHSC spokesperson said: “We are urgently seeking to resolve this so anyone affected can either be provided with a new label or order a replacement kit online, which won’t be counted in the daily figures”

Devonlive have just published an interactive map showing where Covid-19 related deaths have occurred across the country, and in Devon, up to 18 April. Sidmouth Town has the largest recorded number in East Devon (5) – below is a summary including caveats about the data. Go on-line for the details.

www.devonlive.com

A new map shows the true number of people from Devon who have died from coronavirus.

The interactive map, which you can view below [go online], means you are able to see exactly where a person lived, who had COVID-19 mentioned as the underlying cause on the death certificate, or as a contributory factor.

The Pennsylvania and University area in Exeter has the most deaths recorded, with a total of six people from that area having died from coronavirus.

The map only includes deaths that occurred between 1 March 2020 and 17 April 2020 and registered by 18 April 2020 and points on the map are placed at the centre of the local area they represent and do not show the actual location of deaths and the size of the circle is proportional to the number of deaths.

People who die at a Devon hospital could live elsewhere, or a person from the county may have died at another hospital in the country.

You can use the widget above to look at the map – or find your area in the list below [go online].

The map shows a stark contrast between the South West and the rest of the UK.

“………recent figures for cases of Covid-19 which have shown a drop in numbers of new cases in hospitals but reveal significant rises among health and social care workers.

This point was stressed by epidemiologist Anne Johnson at University College London. She said cutting transmissions of Covid-19 to health and social care workers had now emerged as a major priority. “Half of all new infections reported last week were among healthcare workers,” she told the Observer. “This has now become the leading edge of the spread of the disease.”

Robin McKie  www.theguardian.com 

British scientists are racing to try to answer fundamental questions about the Covid-19 virus and its transmission before the lifting of the current national lockdown is approved by the government in the near future. Researchers say relaxing social distancing should occur only once it is understood why new infections of the disease are still being diagnosed in their thousands every day.

Such a rate means efforts to test and trace infected contacts – a key plank in the government’s anti-Covid strategy in coming months – would be quickly overwhelmed. Far more information is needed about the way the coronavirus is transmitted, they say. The new data will feed into the debate about the settings in which lockdown will be lifted first – for instance, whether it’s relatively safe to stage outdoor events.

And last week, several groups launched studies aimed at providing answers. These include projects to analyse how virus-laden aerosols behave in the air in a bid to understand how the disease is passed between humans. In addition, other schemes will target healthcare workers to investigate how the virus is being spread to them from patients and then on to others.

The importance of this latter approach was revealed in recent figures for cases of Covid-19 which have shown a drop in numbers of new cases in hospitals but reveal significant rises among health and social care workers.

This point was stressed by epidemiologist Anne Johnson at University College London. She said cutting transmissions of Covid-19 to health and social care workers had now emerged as a major priority. “Half of all new infections reported last week were among healthcare workers,” she told the Observer. “This has now become the leading edge of the spread of the disease.”

Lack of protective equipment and clothing may have worsened the situation, she added. “However, what is certain is that care workers are still at risk from their patients from whom they can pick up the virus and, in turn, pass it on to their colleagues, to their own families and possibly to other patients. We need to focus on limiting the spread of Covid-19 among health and social care workers as an absolute priority if we want to have a chance of bringing this epidemic to a halt.”

This view was backed by infectious diseases expert Tom Wingfield of the Liverpool School of Tropical Medicine. “The numbers show that the rate of decline of new cases is slower in the UK than other European countries and that is likely to be down to transmission occurring within health and social care settings, transmission in the community despite social distancing and, to a lesser extent, chains of transmission that are still occurring within households, especially in larger households or shared accommodation.”

Half of all new infections reported last week were among healthcare workers. Photograph: Murdo MacLeod/The Guardian

Last week, researchers at Bristol University launched a major study aimed at finding out precisely how health workers are being infected by the Covid-19 virus. “We have taken a group of 130 health workers and we are going to test them intensively over the next three months,” said Professor Adam Finn, the leader of the project.

“We will take swabs from them twice a week, take blood samples regularly, and catalogue their symptoms – in the expectation that some of them will become infected. Then we will be able to find out when they became infected; how that relates to their symptoms at the time; and how it relates to their immune response. We are going to uncover details of the disease’s natural history because none of this information is known in detail. On the other hand, it is vitally important if we are to understand how this disease behaves.”

Finn said current modelling of the disease – although superb – was based on assumptions. “Essentially, the models are guesswork about the way the virus behaves. To get rid of the guesswork we need to supply evidence about how the virus actually behaves.”

A different approach is being taken by another Bristol University group, led by chemist, Professor Jonathan Reid. His team is studying the way the Covid-19 virus is passed from one person to another. This happens when fairly large droplets are coughed up or sneezed out by infected people. However, it is also possible viruses may be spread by much smaller aerosol particles – although it is unclear if they can carry enough virus to be infectious.

“It is clearly important to find out because aerosols can travel much further than heavier droplets,” said Reid. His team has just constructed a high-containment, automated laboratory containing a device in which clouds of virus-laden aerosol particles can be suspended while researchers alter temperature, humidity, ozone, levels of sunlight and other variables.

“In this way we can study how the virus’s infectivity changes,” added Reid. “That might tell us if it is affected by heat. If it is there might be some seasonality to this epidemic. We could also get a better idea of how to run air conditioning in hospitals, care homes and public spaces – in terms of temperature or humidity – in order to reduce the lifetime of the virus so that exposure to it is reduced.”

Devonlive reviews an extensive list of ideas and suggestions coming from Government and local businesses and MPs.

Colleen Smith www.devonlive.com

As Prime Minister Boris Johnson prepares to unveil plans for what happens next in the Covid-19 crisis, we take a look at how Devon and Cornwall will look in the next few months.

The future is looking harsh for the region with tourism and hospitality forming the backbone of the economy and the sector facing the most unanswered questions.

Cabinet Office Minister Michael Gove warned that people will not be able to travel to visit seaside resorts in places such as Devon and Cornwall ‘for some time to come’.

And rather than easing the ban on holidays and travel, harsher fines for those breaching the lockdown rules are expected to be announced.

Tourism industry chiefs and MPs are working with the Government to try to find ways to keep staff and customers safe.

One suggestion is a ‘compliance certificate’ for businesses who prove they can trade in a way that stops the spread of coronavirus infections.

One holiday park owner has come up with a ‘soft opening’ plan by allowing people to take a holiday only within their own health authority area.

So what will reopen, what will stay shut – and how will everyday life change across Devon and Cornwall? We’ve had a look at the main proposals below.

Our teams at Cornwall Live, Devon Live and Plymouth Live are committed to bringing you the latest news, guiding you through this global pandemic and providing the stories that matter.

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Choose which newsletters apply to you from across our Devon and Cornwall titles here – so that you can stay informed, stay home and stay safe.

The PM’s plan will make clear that the UK is not ready to return to business as usual. Some restrictions will be eased, but others – like fines for breaches – will be made harsher than they are now.

Fines – The government is considering raising the penalty for defying lockdown from £60 to £100 for a first offence with a maximum fine rising from just under £1,000 at the moment to £3,200.

Social bubbles – People could meet small bubbles of friends and family in  one of the first steps out of lockdown.  But it will have to be the same small group of people for many weeks, to prevent Covid-19 being passed on more widely.

Schools – will be first to go back, with a phased return. Ministers hope that will be before the summer holidays. Boris Johnson has signalled he wants primary schools to open first, and it has been suggested Year 6 could go back first.

Years 10 and 12 (GCSE and A-level years) would be the first in secondary schools, according to one plan seen by the Sunday Telegraph.

Pubs, big sports events and large social gatherings – Pubs will be the last places to reopen as lockdown is eased, the Government has confirmed. Large indoor events could be banned until 2021.

Devon-based JDWetherspoon boss Tim Martin says he hopes to open his 900-strong stable to pubs from June.

Workplaces – The two-meter apart rules will change the way workspaces look. the Tuesday following the second May bank holiday has been highlighted as a possible date for offices, factories and some shops to re-open. But it looks as if home working will stay the norm where possible.

Sport – smaller, local cricket and grassroots football could return first, as long as spectators can stay in the open air and do not congregate in the club bar after the match.

Public transport – the time ‘is not yet’ right to allow people on to super-spreader, public transport vehicles like buses, trains and planes. But the plans include supermarket-style spacing, one-way systems and hand sanitisers. Firms could stagger work hours to cut the numbers at rush hour.

Tourism and hospitality – Sadly for the South West this vital part of the economy could be one of the last industries to reopen fully. Spaced out tables, screens between customers, paper menus…there are just some of the ideas being thrown around about how the restaurant trade will reopen.

In Parliament Michael Gove told MPs that “at the moment and for some time to come” members of the public should not travel to visit popular seaside resorts.

Cornwall’s tourism chief Malcolm Bell says said that any opening up of the holiday industry would have to be gradual. “You don’t suddenly want five million visitors from across the UK and abroad descending on us. But what’s wrong with somebody from Devon going to a Cornish holiday park? We are both relatively low-risk areas.”

Devon and Cornwall is understandably proud of its renowned stunning coastlines, wide open spaces and gallons of fresh air and thrive from the millions of visitors who come to enjoy our part of the world each year.

However, the outbreak of coronavirus in the UK has changed our day to day lives while the government is calling for the nation to stop all non essential travel in a bid to stop the spread of the disease that has so tragically claimed lives in the UK.

In the South West not only do we have a proportion of elderly people living here, those who are some of the most vulnerable to coronavirus, but we also have NHS trusts that are stretched to capacity without any extra pressure.

We want to help saves lives and help bring an end to the outbreak as soon as we possibly can.

Therefore we are aiming to spread the message of come back later as far and as wide as possible through a campaign launching today – #comebacklater.

The only alternative would be a huge injection of government cash – in the region of £1 billion for Devon and Cornwall – to mothball the tourism industry until 2021, Mr Bell said.

Andrew Baragwanath, owner of Ayr Holiday Park in St Ives  suggests a staged plan: “If for example someone from Truro wanted a couple of days away in St Ives and maintained social distancing measures, the risk to the Royal Cornwall Hospital being overcrowded wouldn’t be much different to as it is now.

“But if we suddenly allowed people from a coronavirus hotspot to travel in one go, then the risk of overloading the hospitals down here is much greater as there are more people.”

The legal date to review the lockdown is Thursday May 7, and Boris Johnson is expected to extend it for another three weeks, possibly with a few minor changes.

But the PM will also – separately – announce a “roadmap” for easing the UK out of lockdown. This is expected later in the week, possibly only on Sunday 10 May.

The timing depends on the “R”, or reproductive rate, of the virus, which must be under one – with infections continually falling.

The ‘R’ number is the average number of people infected by each Covid-19 carrie.

Here at Devon Live, we’re normally all about showing you the best places to eat, drink and generally go out and have a good time.

But as social distancing replaces socialising in the battle to slow the spread of coronavirus, that’s had to change for now.

And in response we’ve created Stay In – because staying at home is the best thing we can all do to support our NHS and save lives.

We’ll be focusing our attention on ways to help you stay entertained at home – from the best film and TV recommendations to live streamed gigs and theatre shows you can watch from your sofa.

From fitness routines you can do at home to cookery tips to help you make the most of a limited larder, we’ll be bringing you daily ideas to help you get through the lockdown.

We’ll continue to champion our local businesses by showing you alternative ways we can all support our local restaurants, bars and venues during this difficult time.

With schools now shut, we know many of you will now be juggling working from home – or going out to work as a key worker – with childcare and home schooling, and we’ll be publishing plenty of family-focused content that will help you to find that balance.

You can also expect plenty of fun stuff to take your mind off the current crisis, from quizzes and activities to good old-fashioned nostalgia.

View all our Stay In articles here. Stay home. Stay safe.

Currently R is about 0.7 because so many people are out of contact with each other. Every time you relax a lockdown rule, R rises again. Ministers say they won’t do anything that pushes the R number back above 1.

The UK must also pass five tests before easing lockdown:

• The NHS is able to cope
• A sustained fall in deaths
• New infections dropping enough
• Adequate testing and PPE
• No risk of a second peak that overwhelms NHS

This would allow businesses to get ready to bring in new social distancing measures for workers, such as screens and spaces between desks, designed to prevent any further spread of coronavirus.

Adam Kucharski, an associate professor at the London School of Hygiene and Tropical Medicine, is advising the Government and has warned that the virus could spread at an exponential rate if the lockdown is ended too early and certain events are allowed.

How the Government’s post-lockdown safety proposals will work…

• Carrying out risk assessments for Covid-19 at all workplaces
• Keeping people working from home where they can
• Keeping workers two metres apart in the workplace where possible
• Using PPE – face coverings will be useful in some workplaces where social distancing

is impossible, but also for giving people confidence they can go back to work

• Using floor markings and one-way flow at entrances and exits to businesses
• Cutting maximum occupancy in lifts
• Staggering break times to reduce pressure on the break rooms or canteens
• Staggering start times
• Changing workspace layouts and seating plans to let employees work

further apart

• Moving vulnerable workers into lower risk activities where they have the highest chance of remaining two metres away from others or roles where they can work from home
• Introducing more frequent deep cleans of work areas, and cleaning and

disinfecting objects and surfaces that are touched regularly

Owl has already reported on preliminary testing involving the RAF. The Isle of Wight is an intriguing choice. Sky news reports: “It has previously been suggested that areas that trial the app could also have coronavirus lockdown measures eased.”

Jon Stone Policy Correspondent www.independent.co.uk

A new NHS app to help trace those who have come into contact with coronavirus will be rolled out later this month, the government has said.

Transport Secretary Grant Shapps said on Sunday morning that the software will “go into testing this week on the Isle of Wight”.

The app is being developed by NHSX, the digital arm of the health service. Matthew Gould, the arm’s chief executive, told MPs last week it would be “ready for when it will be needed” and trialled in a small area.

“That system’s going into testing this week on the Isle of Wight and then later in the month that app will be rolled out and deployed, assuming the tests are successful of course, to the population at large,” Mr Shapps told Sky News.

He added that “the idea is that we will encourage many as people to take this up as possible” , and that it would need at least 50-60 per cent of the population using it to work, adding: “I appreciate for various reasons that not everybody will download it.”

Addressing privacy concerns, Mr Shapps described the situation as “a huge national effort” and said: “It will be the best possible way to help the NHS, in fact it will be an NHS app. It will be completely confidential, the information doesn’t stay on there, you don’t know who the individuals are, but what it will do is alert someone if they’ve been near someone who has coronavirus.”

Other countries such as China, South Korea and Singapore have used contact tracing apps to help suppress the virus while allowing people more freedom than a full lockdown would allow.

Used in tandem with large-scale testing of the population, the apps have proven useful in keeping the transmission rate of the virus low – with a so-called “R” number below 1.

In Europe, Germany has also started to pursue a similar strategy, though concerns have been raised there about privacy.

In some countries, such as India, the app has been made compulsory for workers.

The latest news on Brexit, politics and beyond direct to your inbox

Sir Ian Diamond, the UK’s national statistician and head of the UK Statistics Authority, said it was too early to say how many people had had the virus. 

“What we now need to do is monitor the course of the epidemic to understand the proportion of people at any time who are carrying the virus and the proportion of people who have the antivirus,” he told the BBC’s Anrew Marr Show.

He said a new survey to determine additional useful information about the virus was “just starting to get some initial results”.

Daniel Clark www.devonlive.com 

Every week dozens of planning applications are submitted to the local councils, and the coronavirus pandemic has not changed that.

While some council services have been suspended as a result of COVID-19, planning departments are still working as usual to validate and to decide upon applications.

The Devonlive site carries the full list of applications that have been submitted and validated by the various local councils or planning authorities in Devon in the last week.

Owl only copies those below for East Devon.

Will these all be determined under delegated authority?

EAST DEVON

• Change of use of part of existing caravan storage area to permit the siting of 85 storage containers in addition to storage of touring caravans – Hunthay Farm Axminster EX13 5RJ – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q9GF7KGHLGS00&activeTab=summary
• Proposed roofing over existing concrete yard – Coryton Farm Kilmington Axminster EX13 7RE – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q9CPS5GHLG100&activeTab=summary
• Construction of single storey side and rear extension – 16 Greenway Gardens Budleigh Salterton Devon EX9 6SW – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q9CPTTGHLGB00&activeTab=summary
• Construction of porch – 23 Honey Ditches Drive Seaton EX12 2NU – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q9AV6XGHLFT00&activeTab=summary
• Proposed roofing over an existing concrete yard and slurry store – Coryton Farm Kilmington Axminster EX13 7RE – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q9CPSIGHLG300&activeTab=summary
• Proposed conversion and extension of former chapel to unit of holiday accommodation and provision of associated parking area – Sheldon Chapel Sheldon – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q98XRSGH0GE00&activeTab=summary
• Certificate of lawfulness for the construction of a single storey rear extension – Bonheur Sidmouth Road Honiton EX14 1BE – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q95B6AGHLDV00&activeTab=summary
• Construction of single storey rear extension and provision of cladding – 1 Withycombe Barton Mews St Johns Road Exmouth EX8 5EG – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q95B5HGHLDR00&activeTab=summary
• Construction of single storey side, rear and front extensions (revision to 19/1627/FUL); demolition of an existing outbuilding and construction of new single storey building to provide a therapy/store room (resubmission of expired application 16/0400/FUL) – Khadine Slade Road Ottery St Mary EX11 1JE – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q8FDTHGHL6U00&activeTab=summary
• Certificate of lawfulness for the construction of a single storey extension – Abbotsford Longmeadow Road Lympstone Exmouth EX8 5LE – https://planning.eastdevon.gov.uk/online-applications/applicationDetails.do?keyVal=Q95B6TGHLDY00&activeTab=summary

This is a warning of what could happen with prolonged suspension of full and effective democratic scrutiny of local Government. Parliament has found a way of opening up under lockdown. Some of the select committees have also been very active and effective.

At the moment EDDC has cancelled all meetings, including the Development Management Committee. 

Owl has previously posted lists of planning applications in one week to show that these have not been stopped by lockdown.  Planning applications are being dealt with by planning officers under delegated authority (signed off by Cllr. Mike Howe, Chairman DMC).

Owl has reviewed determined applications by EDDC for April, hopefully other applications are pending the resumption of the DMC. Out of 207 applications, six were withdrawn and only about ten were refused. Perhaps the majority of the nearly 200 applications granted, under delegated authority by planning officers, were for minor alterations such as to dormer windows or small extensions. The larger developments which affect many people should surely be subject to debate by councillors. The 30 houses at Beer, previously reported by Owl, are included in the applications granted permission for April.

EDDC needs to sort out a mechanism of holding a “virtual” DMC very soon.

David Collins, Northern Correspondent www.thetimes.co.uk 

Concern is growing that emergency powers given to Manchester city council during the Covid-19 crisis will be used to pass controversial decisions, including plans for the UK’s largest indoor arena, “behind closed doors”.

A £350m concert arena with a capacity of 23,000 is being planned next to Manchester City football club’s stadium. Two other projects — a block of flats and student accommodation — were previously rejected but now look likely to be passed.

The council has suspended its planning committee to ensure social distancing. Campaigners say the emergency arrangements, under which some decisions are taken by the chief executive, Joanne Roney, are not democratic.

Planning applications will now be considered by Roney, the committee chairman, Basil Curley, and his deputy, Nasrin Ali.

The proposed concert venue has been opposed by the operators of the Manchester Arena. Critics say the council has a “conflict of interest” as it has a 20% stake in the land where the arena is to be built. Manchester City’s owner, the Abu Dhabi United Group, controls the rest of the land. It is a partner with the council in city-centre blocks of flats.

John Sharkey of ASM Global, operator of the Manchester Arena, said: “A planning application of this scale and size is a matter for the whole of Manchester.”

The council said it was following national guidance, and that the ability of the public to engage in the planning process had not changed. It said it hoped to move to a “virtual planning committee”.

Owl has never understood why no records appear to have been collected of those self isolating with symptoms  by either NHS 111 or GPs. Such records would be very useful now wouldn’t they?

Hannah Devlin  www.theguardian.com

Is 100,000 enough for tracking and tracing?

The government has been accused of counting some tests prematurely, reportedly expanding its daily count to include tests that have been sent out in the post, rather than those actually carried out in labs. While it denies the charge, regardless of whether the 100,000 target has been met, countries that have taken a “test, trace, isolate” approach are running a far higher proportion of tests to positive cases than the UK. Germany, which is down to fewer than 1,000 daily positive cases, is performing nearly 1m tests per week. South Korea is doing 15,000 tests per day, but has had no more than 100 daily cases since the beginning of April. So, for a robust “test, trace, isolate” regime in the UK, the number of tests would need to be vastly increased or we would need to wait for the number of cases in the community to fall significantly.

Will healthcare workers be screened?

There have been calls for healthcare workers to undergo routine weekly screening to ensure that transmission between staff and patients is minimised. This is particularly important as people are known to be infectious before symptoms appear, meaning that hospitals could become hotspots for infection. However, regular screening of staff requires testing to be performed in hospitals or very nearby, and may also require staff to be available to take swabs. The government’s approach of centralising testing raises questions about how quickly local capacity could be rolled out to facilitate this.

Is the right data being collected and reported?

Questions have been raised about whether the data currently being collected is sufficient to support a “test, trace, isolate” programme, and community surveillance to pick up early signs of upticks in transmission in an area. Are testing centres starting to collect postcode information of those tested, for instance, or are they merely recording whether samples come back positive or negative? There are also concerns among statisticians that data is not being reported in a way that allows useful analysis. For instance, breakdowns of the number of positive tests from hospital patients, health workers and other groups have not been provided, and it is not clear why so many of the tests being performed appear to be repeat tests of the same person on the same day.

Are the right people getting the tests?

The rationale of the prioritisation of different groups – testing has this week been expanded to key workers, those who need to go out to work and over-65s – has not been clearly explained and there are still some groups reporting serious problems getting access to testing. Care home staff, in particular, have struggled to access tests, despite signs that the numbers of deaths in care homes will be very high. Given that care home residents do not have the option to self-isolate, it is crucial that staff are tested – and ideally regularly screened – to keep the virus out.

Is the quality of testing good enough?

In the rapid surge of testing, including at drive-throughs around the country, concerns have emerged about the reliability of test results and delays. Staff working in “mega-labs” have reported concerns about mislabelling of samples and lost results. Some people, including healthcare staff, have complained of waiting days or weeks for a result. There are also concerns that many drive-through sites are asking members of the public to self-administer swab tests, which could result in the samples being suboptimal.

The British government is quietly seeking access to the European Union’s pandemic warning system, despite early reluctance to cooperate on health after Brexit, the Guardian has learned.

Jennifer Rankin www.theguardian.com

The UK is seeking “something akin to membership” of the EU’s early warning and response system (EWRS), which has played a critical role in coordinating Europe’s response to the coronavirus, as well as to earlier pandemics such as bird flu. According to an EU source, this would be “pretty much the same” as membership of the system.

The government’s enthusiasm in the privacy of the negotiating room contrasts with noncommittal public statements. Detailed negotiating objectives published in February merely stated that the UK was “open to exploring cooperation between the UK and EU in other specific and narrowly defined areas where this is in the interest of both sides, for example on matters of health security”.

Health was not even mentioned in the government’s written statement to Parliament, aside from a reference to pharmaceuticals. Meanwhile, the Daily Telegraph reported on 1 March that No 10 had blocked the Department of Health’s request to be part of the EWRS.

A government spokesperson did not respond to a question about whether the UK was seeking a form of membership or participation in the EWRS, but referred back to the February negotiating objectives.

In private, the coronavirus, which had claimed at least 26,771 lives in the UK by Thursday, appears to have altered government thinking.

“There was not much appetite from the UK at the beginning,” said the EU source, referring to cooperation on health. “That’s been corrected. They are keen and they are keen to be seen to be keen. Both sides want close cooperation.”

However, the EU is not prepared to offer the UK full membership of the EWRS, an online platform set up in 1998 where public authorities share information about health emergencies.

Instead, EU officials propose to “plug the UK into” the system when a pandemic emerges, similar to arrangements for other non-EU countries.

Health security does not feature in the UK negotiating text sent in private to the EU’s chief negotiator, Michel Barnier, although EU officials have received a “non-paper” outlining government aims on health.

In another sign of rising British interest in European cooperation, the Guardian has established that the UK attended all five of the EU’s health security committee meetings on the coronavirus pandemic in April, a perfect attendance record, compared with a 70% British presence between 17 January and 30 March.

During the April meetings, officials discussed lockdown exit strategies and launching a joint procurement scheme on therapeutics in intensive care. No decision has been taken to launch this bulk-buying programme.

The Guardian first reported in March that the UK was not taking part in any of the EU’s four procurement schemes, missing bulk-buying efforts on personal protective equipment for medical workers, ventilators and testing kit – despite having attended relevant meetings.

Meanwhile, among NHS senior managers there is anxiety that Brexit talks risk “significant elements of health being forgotten about”, said Layla McCay, the international director of the NHS Confederation.

“NHS organisations have been stood up and stood down and stood up again for potentially a no-deal Brexit,” she said. “If a quite thorough future relationship for health matters is not on track come June, then the NHS is going to have to start to prepare for specific disruption next year as a result of Brexit, and it will have to do so while also facing both winter and coronavirus challenges. It will be a significant extra ask.”

British membership of the EWRS and broader EU health network “strengthen our ability to respond as effectively as possible” to health emergencies, McCay added.

The UK government spokesperson said: “The safety and security of our citizens is a top priority. The UK is ready to discuss how our citizens can be kept safe and benefit from continued international cooperation on health security following the end of the transition period, where it is in our mutual interest.

“Any such arrangements must align with the fundamental principles of respecting the UK’s political and economic independence, recognition of the UK and EU’s status as sovereign equals, and ensuring the UK has control over its own laws.”