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Covid-19: Test and trace system ‘not fit for purpose’ and must be decentralised, scientists say


By Awil Mohamoud
Reporter
9 June 2020

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The Government’s system of track and trace is ‘not fit for purpose’ and it must move from a ‘centralised’ model to a ‘local first approach’ for it to work, a group of scientists has urged. 

The current ‘centralised’ system makes it ‘impossible’ to reach at least 80% of those who need to isolate due to having had close contact with the Covid-19 infection – a target it said the Government needs to reach to ‘eliminate’ the virus. 

The Independent SAGE, a group of 12 leading scientists, chaired by the Government’s former chief scientific advisor, Sir David King, today released a report calling for urgent change of direction.

It has called for a ‘rapid transition’ to a local management system, led and coordinated by directors of health, with the support of local authorities and NHS organisations, including health commissioners, primary care, local hospital laboratories and school nurses. 

This would make the FTTIS (‘find, test, trace, isolate and support) model more effective and ensure there is a robust system in place for responding to future upsurges in infection, it said. 

Systemic shortcomings

The report has criticised the Government for initially deviating from the contact tracing approach taken by other countries, opting for an ‘untested’ centralised system and bringing ‘inexperienced’ companies into the fold. 

Last month, the Government announced £300 million funding for local authorities to develop their own test and trace services, with the help of GP practices, hospitals, charities and other local institutions. 

While supporting the Government’s decision to ‘at last’ involve local public health and community teams, the report said ‘there have clearly been problems in commuting responsibilities to them’. 

‘Additional funding has been made available but there seem to be major challenges in distributing the funds effectively,’ it said. 

Going forward, those local authorities ‘must have the power to act’, the group added. 

‘Although the Government did move rapidly to enact an emergency Coronavirus Act, this does not provide local authorities with significant additional powers. Rather, it removes many of their responsibilities to act in particular circumstances, presumably in recognition of the many pressures they face at this challenging time. 

‘In other countries, local Government bodies would normally have the power to impose temporary restrictions on movement or on opening of facilities. For the system to be operational, we need a rapid assessment of the powers of local authorities, and, where necessary, emergency legislation.’ 

Last week, data published by Public Health England and Cambridge University scientists suggested the ‘R’ rate had reached 1.01 in the North West, causing some schools in the region to delay their reopening. Yesterday, health secretary Matt Hancock though insisted the figure across the whole of the country remains below the ‘one’ threshold.

The Independent SAGE report also called for a ‘rigorous’ system to embed the FTTIS data flows into the NHS and local authority system, to ensure they can base their local response on real-time information. 

Lack of public trust

‘The success of a FTTIS system is based on trust’, but there is a shortage of it at the moment, partly due to a lack of accountability in the current system – something that could be improved with local control, the group has argued. 

For instance, it pointed to public concerns about confidentiality and security in relation to data, which is held centrally. Many people are worried about potential hacks and data being shared with private companies, especially in relation to the NHS contract tracing app

Using ‘local, familiar and trusted services’ would alleviate concerns ‘that there may be fraudulent use of the system,’ it suggested. 

The report also expressed concern over an ‘erosion of trust in Government in recent weeks’, which it said is ‘likely to have a major effect on compliance’ with FTTIS. 

Last month, several healthcare professionals and unions blasted the Government’s response to special advisor Dominic Cummings’ alleged lockdown breach, claiming it has potentially undermined the confidence of both NHS staff and the public. 

BAME communities, in particular, have experienced a ‘disproportionate loss of trust’, as ‘no attempt has so far been made to engage’ with them, the report said.

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