WITH attention focused on Dominic Cummings, there is a real risk we do not focus on what really matters right now – are we learning nimbly and quickly from countries that have been more successful than us at tackling coronavirus?
First of all, full marks to the prime minister for aiming to set up a “world-beating” test and trace system in place by June.
No-one knew in January Korea and Taiwan would be the best at tackling coronavirus but now we do we are right to copy their approach.
But as I found out through my long time as health secretary, having the right plan is the easy bit – putting it into practice is much tougher. And on some of the crucial details, our plans still appear to be falling short of global best practice.
World Health Organization guidance is clear – anyone who has spent more than 15 minutes within a metre of an infected person should be quarantined for 14 days. Their health then needs to be monitored on a daily basis for coronavirus symptoms.
Most challengingly, anyone who tests positive needs to be persuaded to divulge who else they have been near when infectious – a delicate business when, as in deeply conservative Korea, some of the infections occurred in gay nightclubs.
That is perhaps why the WHO says contact tracers should come from the community in which they are operating.
But the dividends of doing this are clear: South Korea has had no more than nine deaths on any one day. Taiwan has had just seven deaths. Germany, with a population a quarter larger than ours, has had one third of our deaths.
Korea and Taiwan have not even had to go into a national lockdown. And with this system they probably never will, even if there is a second spike.
When that happened in Korea they quickly tested 65,000 people, worked out precisely where the virus was and stamped it out. So this approach is the key to getting our economy working and setting Britain’s businesses free.
Our strategy is broadly the same as South Korea but there are four areas where I worry we are falling short of their approach.
Firstly, are all close contacts going to be asked to quarantine? In February, Public Health England said some would be classified ‘low risk’ and not asked to quarantine or be monitored. In South Korea, every single close contact is asked to self-quarantine. We must do the same. Why take the risk?
Secondly, we are not planning daily monitoring of those who have been near a coronavirus patient every day. In many Asian countries, you are asked to input your temperature once a day on to an app – in China it is three times a day. If you don’t, someone contacts you to remind you to do so.
But Serco, the company contracted by the government to do this work, say their system involves regular check-ins only for those with symptoms or who have tested positive.
We need to be monitoring all close contacts proactively so absolutely no time is wasted in testing someone who develops symptoms. Then their contacts can be traced in turn to break the chain of transmission as recommended by the World Health Organization.
My third concern is the speed with which test results are being turned around. In Korea it is 24 hours. But one local care home had to wait a week for their results to come back.
If we really can pioneer a test where the result comes back in 20 minutes, that would address this issue. But whether or not we end up being able to do this, we need to replace an unpredictable two-day turnaround with a reliable turnaround of 24 hours or less.
Finally, I worry we are once again being too centralised in our approach. One of the reasons the ramp up of testing was too slow was because we kept it inside Public Health England.
Local government is full of public health experts who know their areas and are keen to use their skills to make such a system work. Yet the Association of Directors of Public Health say they are “disappointed” at the limited involvement local government has currently had.
This task is too onerous for one organisation to have all the answers and we need to tap into local knowledge and expertise wherever we can.
All of these issues can be addressed – many of them in time for the start of June.
But the best way to make sure they are is for the government to be totally open about their plan, publishing it in full, so it can be scrutinised and improved if necessary.