More than two months after the government said it was no longer necessary to identify every new case – and abandoned the World Health Organisation’s standard containment approach of find, test, treat, and isolate – Matt Hancock announced details of the next phase of their testing and tracing strategy. For weeks now, whilst ministers could have been using lockdown to put the fundamentals of infectious disease control in place, the government’s focus appears to have been on meeting their arbitrary testing capacity targets.
And yet their own statistics show that the target for 100,000 tests a day by April 30th was only met once in the first two weeks of May – by the end of which the Prime Minister had stated his ambition would be to reach 200,000 tests a day. And they will mark this by testing capacity, not actual people tested, which has never risen over 100,000 despite Boris Johnson claiming that the target referred to people – not tests. Whilst ambitious aims are welcome, targets for increased capacity are not a strategy in itself.
It is clear that there is still a long way to go before there is sufficient capacity and availability to enable the level of testing that any meaningful testing and tracing strategy requires. There remains large discrepancies between the number of tests available, the number carried out and the number of people tested. There are also issues with the reliability of self-administered tests and the availability of local testing facilities. Even today, there are yet more reports of healthcare workers being unable to access tests for themselves, their patients, and their family members. These all need to be resolved if we are to have a successful testing and tracing strategy.
There has rightly been a great deal of concern amongst the public about the implications of the recent relaxation of the lockdown rules. It is more important than ever, with regards to building public confidence and trust, that a testing and tracing plan is accompanied by the publication of a clear and credible strategy – together with the scientific evidence supporting that strategy. Critically, we need to know what the anticipated level of new infections will be each day, to match the number of staff engaged in the project. If infections are too high and there are not enough tracers to do the work required, it will soon become overwhelmed.
I recently wrote to Baroness Harding, the government’s newly appointed national lead on testing and tracing, setting out a series of important questions and issues we need clarity on in relation to this strategy.
Given the recent statistics on the impact of inequalities, and the higher number of BAME people affected by the virus, any new strategy must include details on what consideration has been given to prioritising the roll out of community testing and contact tracing to the most vulnerable. Including those in the most deprived areas and in areas with a higher proportion of BAME residents.
With regards to testing, we need specific assurances on when routine testing of NHS and social care staff will start; when it will become a requirement that all patients discharged into social care settings are tested beforehand; when no-one seeking a test will have to travel for longer than 20 minutes to reach a testing station; and whether the return of test results will be within a timeframe that enables effective tracing.
Alongside evidence of the number of additional tracers needed for the strategy to be successful, we also need clear answers on how the government will make best use of existing local public health teams who know their communities and are best placed to respond to local outbreaks. We must also know how the government plans to reach those sections of the population who do not have a smartphone, particularly the elderly and schoolchildren. And what plan is in place to encourage take-up and usage of the app, and to reassure the public that data collected via the app is secure and only used for the intended purposes.
Only through mass testing and contact tracing can we identify, contain, and prevent further spread of the virus, controlling new outbreaks quickly and efficiently. We need a fully resourced and effective plan that will enable that to happen.