Government figures released on Thursday 24 June show just how poorly the test and trace system is working in the UK yet correcting this doesn’t appear to be a priority for the government rushing towards ending quarantine rules and lockdown. Statements that our ‘test and trace’ will be world class by September don’t really inspire confidence in the public at the end of June with nearly 45,000 deaths in three months. Medical opinion is that test and trace is the only safe way to exit lockdown, yet our current system doesn’t yet seem to be fit for purpose.
The Guardian on Saturday 27 June reporting on the government figures said: ‘Of those who test positive, 70.3% were reached, with about three-quarters providing details for close contacts and the rest saying they had no recent close contacts. Of the contacts provided, 81.7% were reached. It is unclear what proportion are tracked within 48 hours or how many follow advice to self-isolate.’
What does this actually mean? My understanding is that for every 100 people tested 30 of them could not be told whether their results were positive or negative, presumably because of an error in their contact details – by accident or design? Of the 70 reached by the contact tracers only 52 provided details of their onward contacts, so a further 18 withheld information about their contacts presumably because they could not or would not reveal them. The article went on to say: ‘The most optimistic estimate for current performance is that 57% of contacts are being traced rapidly and isolating, but the true proportion is likely to be lower.’
Other countries have managed to set up and implement test and trace systems either using existing regional healthcare infrastructure or smartphone apps. What has been done in the UK? Both the NHSX app and the Isle of Wight test launched with fanfare have been quietly dropped. The testing and tracing is controlled by Public Health England using outsource agencies like Serco and Deloitte and a number of sub-contractors. This is supposedly to provide scale capacity, but in reality to bypass local healthcare networks which the government doesn’t think capable.
It reflects a serious failure to understand the purpose of the testing and the risk of getting it wrong. Speed is essential if local outbreaks of the virus are to be identified, contained and controlled effectively. To do this efficiently you need local resources and fast response teams. Call centres can’t do this, especially if they are missing 30% of those tested at the first attempt to follow up. Initial contact is made by phone but many people are suspicious of calls from unknown numbers, and those that do take a call are reticent to act being wary of scams by fraudsters.
The system appears to be unfit for purpose, yet for the government the story has moved on and our lockdown exit continues at a reckless pace with unsubstantiated reassurances about R numbers. Baroness Harding has been set up to run this but who is monitoring its effectiveness? No doubt the system will be audited eventually, but this is months away and this issue needs urgent attention. If the government is content with a test and trace system only 50% effective, then we are in a far worse situation than the public realise: there is a real danger of complacency.