What is wrong with the Covid test and trace system in England? | World news

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When the NHS test and trace system was launched in late May, Boris Johnson vowed it would help ‘move the country forward’. We could see our families, go to work and prevent the economy from collapsing.In the absence of a vaccine, the Prime Minister’s ‘beating the world’ scheme would be worth every penny of the £ 10 billion funding announced by Rishi Sunak in July. The chancellor said it would allow people to lead normal lives.

Now that pubs are ordered to close, extended families are forced to stop reuniting, and intensive care beds are filling up quickly, government science advisers Sage have concluded that the NHS test and trace did not work.

Too few people get tested, results come back too slowly, and not enough people are sticking to instructions to self-isolate, they say.

The system “has a marginal impact on transmission”, therefore, and unless it grows as fast as the epidemic, this impact will only diminish.

So what is wrong?

Too centralized from the start …

Tasked in the spring with deploying millions of coronavirus tests, Secretary of Health Matt Hancock opted for a centralized system using private companies. The consulting firm, Deloitte, was awarded a contract to help run tests at local, walk-in testing sites, with swabs being sent for analysis at a network of national laboratories, many of which are also contracted out. Serco also has an agreement to manage contact tracing and outsource work to other companies.

The stakes for their success were high. An Imperial College study found that if testing and tracing worked quickly and efficiently, the R-number could potentially be reduced by up to 26%.

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Local public health directors knew this from experience dealing with sexually transmitted diseases and food poisoning epidemics, but their role was limited, making many exasperated at being excluded.

As the system became operational over the summer, ONS surveys into the prevalence of the virus suggested that the NHS test and trace could only detect a quarter of actual cases.

In July, one of the system’s top officials, Alex Cooper, privately admitted that the system only identified 37% of the people “we really should find.” The clamor of mayors and local public health officials for a greater role has grown.

Finally, this week the government admitted that cities and regions should receive help to do more.

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“We always knew that there was a need for a local element of testing and traceability, as a centralized system lacks local expertise and is not able to cut through the most communities. hard to reach, ”Andy Street, the conservative mayor of the West Midlands, told The Guardian this week.

The pressure on a centralized system has been clear. Sarah-Jane Marsh, director of tests at the NHS test and trace tweeted last month: “The test team works 18 hours a day, 7 days a week. We recognize that the country depends on us. She is about to resign after less than six months in her post.


Laboratory bottlenecks

Warnings from the website that no tests were available exposed the testing crisis to the British public almost daily this summer, particularly in September when schools returned.

System manager Dido Harding said last month that the number of people wanting testing was three to four times the number available. The “flagship” national laboratories of Milton Keynes, Cheshire, Glasgow and Cambridge had reached their capacity.

More than a quarter of people attending 500 local testing centers after coming into contact with someone who had tested positive were simply turned away because they did not show symptoms.

The scale of the task was shown when Harding told MPs that around half of the tests available were used by NHS patients, social services and NHS staff.

Such was the tension that tens of thousands of tests had to be sent for processing abroad.

And the need for testing will only increase.

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Johnson has pledged a daily testing capacity of 500,000 by the end of the month. As of Tuesday, it was 309,000 people.

Already very far from the target, the system will come under increased pressure in the coming weeks. On Tuesday, the government finally said visitors to care homes could be tested regularly in an attempt to end the isolation caused by banning their visits to loved ones. There are 400,000 nursing home residents.

Slow results

New labs in Newcastle, Bracknell, Newport and Charnwood are expected to open within a few weeks and they cannot arrive soon enough. As early as May, Sage experts said the speed of the results had a significant impact on the virus’ reproduction rate. Turnaround times should be 24 hours or less and it was “critical” that this capacity be achieved in the fall / winter.

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