Tuesday, August 4, 2020

You think the UK coronavirus outbreak was bad? Just wait till winter: Study shows test-and-trace system is failing | The Register

Data modelling from UK universities shows that the nation could be heading for a massive second wave of COVID-19 cases unless the government ramps up its controversial test-and-trace system.

The study, published in The Lancet medical journal, found that a second wave could be avoided in the UK as schools reopen for a new year provided that both 75 per cent of people with symptoms were found and 68 per cent of their contacts traced, or both 87 per cent of people with symptoms were found and 40 per cent of their contacts traced. Those testing positive and their contacts are asked to isolate.

The test-and-trace programme in England was outsourced to Serco for £45m in June, despite the firm being fined for under-performance on other contracts.

The strategy was to build a smartphone-based app as part of what the government described as a "world-beating" system. Although trials started on the Isle of Wight, the proposed central database model for the app was abandoned in favour of the Apple-Google distributed approach. The app is expected no sooner than winter.

The researchers' estimates of the current efficiency of the English test-and-trace system, also outsourced to Sitel, suggest that about 50 per cent of contacts with those testing positive are being traced.

It is harder to judge how many with symptoms are being tested. Professor Chris Bonell from the London School of Hygiene and Tropical Medicine, whose team worked on the research, told the BBC it was probably too low. "It is not achieving the levels we have modelled. It doesn't look good enough to me," he said.

University College London also participated in the research. Their data modelling showed that if only 18 per cent of symptomatic adults are tested and isolated, and 68 per cent of their contacts are reached, the second wave would peak in December and could be 2.3 times the size of the recent epidemic.

The government's own figures show 81 per cent of the 4,242 positive cases referred to test and trace were reached and asked to provide details of close contacts. 81 per cent of those provided contacts, and 75 per cent of those contacts were reached and asked to self-isolate.

Some might be alarmed at the dire need for additional capacity in a vital plank of the government's COVID-19 strategy, but not health minister Matt Hancock. Last week he published a blog praising how technology was helping, not hindering, the health service's response to the pandemic.

Under the heading "How technology helped shape the pandemic response", he eulogised how "secure reliable data from the NHS COVID-19 data store has ensured that those leading the response to the virus in both the NHS and government have the data we need to manage the response in real-time."

Yes, that data store outsourced to Amazon, Google, Microsoft, and controversial AI companies.

Of the successes so far, Hancock gushed, "none of this would have been possible without the remarkable, can-do attitude to tech that has characterised the NHS's response to the pandemic".

He urged NHS workers: "Use email. Don't fax. Use smartphones. Not pagers. You don't need bespoke kit: use what works for you. If a rule or piece of local bureaucracy gets in the way of this, let NHSX know and we will fix it."

NHSX is the health service's digital arm, one of many bodies criticised for confusing the lines of responsibility for technology within the NHS in a recent National Audit Office report.

While Hancock may say he's confident, others are less convinced by the public/private sector mash-up that constitutes the government's pandemic response. Writing in The Guardian, Allyson Pollock, clinical professor of public health at Newcastle University, said: "Lack of timely, detailed data on people testing positive for COVID-19, including postcodes, is currently hindering the work of local authorities and public health departments."

She pointed out that in Blackburn, the focus of a COVID-19 outbreak, the tracing service is reaching only 52 per cent of all contacts. On that point, the local council appears to be taking matters into its own hands to compensate for shortcomings in the national system.

With schools set to reopen in four weeks, the UK is about to find out if Hancock's optimism and the government's "world-beating" test-and-trace system are fit for purpose. ®

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