Only half of people who develop coronavirus symptoms self-isolate for at least a week, according to government science advisers, raising urgent questions about the test-and-trace strategy aimed to contain future outbreaks.
The new system, which launched this week, requires people to self-isolate for 14 days if they are told by tracers that they recently came into contact with someone who tested positive for the virus.
But an April report presented to the government’s Scientific Advisory Group on Emergencies (Sage), said “rapid” research was needed on how best to get people to comply with self-isolation advice given that “only around 50%” abided by the rule when they developed a cough or fever, according to Department of Health tracking in England.
The revelations appear in the latest tranche of documents and the first minutes of meetings published by Sage. The minutes from 34 meetings held from January to May were released with other documents submitted to Sage by its modelling and behavioural science subgroups.
The minutes reveal a sense of rising anxiety at Sage as scientists saw the number of cases grow faster than expected, with the experts recommending on 13 March that household isolation and protecting older, more vulnerable people should happen “soon”.
Three days later, the advice changed: the committee heard there could be 10,000 new cases a day, prompting them to recommend further physical distancing “as soon as possible” adding that a “significant increase in testing” was needed.
The group of experts considered further documents on the track-and-trace system, with one report from behavioural scientists warning that they “anticipate major behavioural barriers” to people using the NHS contact-tracing app, that would prevent it from being the primary method of containing outbreaks.
They go on to warn that foreign powers will seek to capitalise on any weaknesses they spot in the UK’s response to the outbreak.
Many of the documents include redactions, mostly of names of people on the Sage secretariat and others who participated directly in the meetings.
Weeks before the lockdown was announced, on 25 February Sage held a prescient discussion about the importance of perceived fairness in reducing the chance of disorder, saying public compliance was “likely to be enhanced [by] a sense of collectivism”, and that “flash points tend to happen where there is a perceived lack of equity”.
A further meeting on 18 March said that evidence supported school closures on a national level “as soon as practicable to prevent NHS intensive care capacity being exceeded”, warning that the UK appeared to be a few weeks behind Italy in the pandemic curve. The advice added: “If the interventions are required, it would be better to act early.” Boris Johnson announced immediate schools closures in England that day.
The chronology of the minutes shows how rapidly events overtook planning. On 3 March, a Sage meeting said there was “currently no evidence that cancelling large events would be effective”, and that closing restaurants and bars “would have an effect, but would be very difficult to implement”. But only a week later, the next Sage meeting said the UK could have up to 10,000 cases, spread nationally.
Other points raised by the documents include:
The main No 10 representative was Ben Warner, a data scientist recruited to Downing Street after running the Conservatives’ election campaign model. He previously worked with Dominic Cummings on the Vote Leave campaign.
Concerns about the vulnerability of care homes, with Sage’s modelling subgroup warning that 90% of care homes having outbreaks “cannot be ruled out if current trends are maintained.”
The view that repurposed drugs are unlikely to deliver a “game-changing” breakthrough” for treating the virus.
A warning that the entire UK population may need flu jabs in the coming winter as the search for a Covid-19 vaccine continues.
The realisation that longer-term health problems are emerging, including “extreme tiredness and shortness of breath for months”.
A warning that creating “bubbles” for people to mix in would have mental wellbeing benefits but carry unforeseen risks and the potential for the virus to spread.
A request for pastoral support for advisers and more effective means of screening requests to Sage members, given that they would continue to work “under intense pressure” for many more months.
Government scientific advisers expressed caution about the efficacy of the planned track-and-trace system, which was rolled out across England on Thursday, saying that for it to work, around 80% of non-household contacts would have to be traced and isolated within 48 hours of the first person experiencing symptoms.
This would need about 30 contacts to be tested per case, the Scientific Pandemic Influenza Group on Modelling, which reports to the health department, said in meetings in April, adding: “Beyond that, benefits would be marginal.”
The documents are the latest to be released after No 10 came under pressure to publish the membership of Sage and the advice it provided to ministers. In April, the Guardian revealed that Cummings, the prime minister’s senior aide, had participated in Sage meetings. His presence at meetings “shocked” the government’s former chief scientific adviser, Sir David King, who said: “If you are giving science advice, your advice should be free of any political bias.”
The minutes show that Dominic Cummings attended six of the 34 meetings, mainly ones in later April and May, as a government representative. Another No 10 staffer, Ben Warner, attended 14. Warner is a data scientist recruited to Downing after running the Conservatives’ election campaign model. He previously worked with Cummings on the Vote Leave campaign.