One of the government’s most influential scientific advisers is warning that the loosening of lockdown may have already gone too far and that an urgent increase in coronavirus testing and faster contact tracing is essential to prepare for a resurgence in cases.
Writing in the Observer , Sir Jeremy Farrar, director of the Wellcome Trust and a member of the government’s Scientific Advisory Group for Emergencies (Sage), warns against complacency in the wake of local outbreaks that have forced lockdown measures to be reintroduced in some areas, most recently in Preston.
With growing concerns about the reluctance of Covid-19 sufferers to disclose their close contacts and warnings over continued gaps in testing, Farrar states there are signs that England is in danger of “heading in the wrong direction”.
“The gradual uptick in cases has shown us we’ve now reached – if not already exceeded – the absolute limits of easing restrictions,” he writes. “The R value, which tells you how many people will get the virus if in contact with an infected person, is close to 1. There are worrying signs that we’re in danger of heading in the wrong direction.
“Most urgently, we need to ramp up testing. We are not where we need to be. We must improve contact tracing, so we’re identifying more cases and providing better, faster data locally. We need to make it much easier for everyone to get tested, including those who have been in contact with cases or think they might be infected, whether they have symptoms or not.”
His warning comes as a series of concerns are raised about several elements of the country’s readiness to tackle the resurgence in cases. There is mounting evidence that thousands of care workers have never been tested or only tested once, with analysis suggesting deaths among those receiving care at home were above normal levels. Regular testing of all care staff in homes will not now be in place until September. There are also demands to extend the measure to all care settings, including those who receive care in their own homes.
A survey of care workers by Unison in July found that 18% of care home staff had never been tested. Of those tested, 46% said they had only been tested once. It found that across the care sector, 48% had not been tested. Of those who had been tested, 53% said they had been tested once.
Meanwhile, analysis from the Health Foundation thinktank has found that between 13-19 June, the most recent week of available data, deaths in care homes fell to habitual levels. In the same period, however, deaths in domiciliary care were almost double (184%) the average number in the previous three years.
Vic Rayner, executive director of the National Care Forum, said: “[Testing] is the only real way we have of understanding how the virus is manifesting. Without regular testing, you’re asking organisations to work with their hands tied behind their back.”
NHS Test and Trace will never work properly until everyone who is told to self-isolate can do so without fear of losing their pay or job
There are also growing demands to hand financial aid to those asked to self-isolate. In Greater Manchester, the track and trace system is only receiving 2.5 contacts per person, leading to suspicions that people are reluctant to give the names of contacts they know will not have the financial resources to self-isolate.
Alongside the TUC, the Labour metro mayors Andy Burnham and Steve Rotheram will on Mondaylaunch a new campaign for a simple scheme giving people financial help. They want self-isolating workers who are not able to work from home to be paid, with their employers claiming back their wages from the government, minus statutory sick pay. A payment scheme is demanded for the self-employed.
“NHS Test and Trace will never work properly until everyone who works who is told to self-isolate can do so immediately without fear of losing their pay or job,” said Burnham. “If people know they’re going to be out of pocket then they simply won’t do it. This has to be fixed without delay, and certainly before the schools go back next month. Failure to fix it would leave our poorest communities dangerously exposed.”
Frances O’Grady, the TUC’s general secretary, said: “Until ministers fix this problem, people will continue to struggle to follow official advice. Wherever possible, employers should do the right thing and pay workers their full pay. But the government must also ensure that every worker gets financial support.”
The most recent analysis by the Office for National Statistics suggests the rates of people testing positive for Covid-19 have risen since the lowest recorded estimate at the end of June, but that there is evidence they may be levelling off. Opinion in the scientific community is split over the current state of the virus.
Farrar’s warnings were endorsed by Professor Neil Ferguson, at Imperial College London. “As we go into the autumn with cooler weather and schools reopening, transmission is highly likely to increase, perhaps substantially. We need to build on progress so far to further improve testing, contact tracing and the effectiveness of control measures to contain local outbreaks.”
However, Carl Heneghan, professor of evidence-based medicine, Oxford University, said it was “a mistake to keep sending out cautions”. He said: “Two months after opening up, cases have remained very low. Nothing is going up in an exponential way and admissions to intensive care units are still low.”
Professor Mark Woolhouse at Edinburgh University also noted infections had not spread as anticipated and that many activities had turned out to be much less risky than expected. “It is now clear the virus does not transmit well outdoors, so the beach is a safe environment and many activities can be made even safer by paying close attention to hygiene, face coverings and social distancing. On the other hand, signs from Europe are not encouraging.”
Professor David Heymann, at the London School of Hygiene and Tropical Medicine, added that it was crucial the public understood that they were the ones who would have to deal with this pandemic. However, he played down fears of a second wave. “There won’t be a second wave in my view, though there will be resurgences in places not practising good preventative measures.”
A Department of Health and Social Care spokesperson said: “We will ensure all necessary preparations are in place to avoid a second peak that would overwhelm our NHS. And we urge the public to play their part too, by following the latest guidance. NHS Test and Trace is working closely with local authorities. Every day local authorities get test, case and contact tracing data, with further data shared with local directors of public health, to help control and manage outbreaks in their area.
“We are doing everything we can to ensure that tests are available for everyone who needs one. Any care home resident or member of staff with symptoms can immediately access a free test and we are issuing at least 50,000 tests a day to care homes across the country.”