A centralised system will not help areas in the north most at risk of Covid-19 | World news

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If you live in Greater Manchester, the coronavirus restrictions have begun to feel less like a scientific imperative and more like a game of roulette. If you woke on Wednesday in the Bury council area, regulations prohibiting you from visiting friends and family were still in place. But 10 minutes down the road, in an area with the highest infection rate in the country, you were free as a bird. That was, at least, until the government changed its mind.

When ministers announced last week that more than a million people would be lifted out of the restrictions for the first time in a month, there was already increasing nervousness among local authorities. The decision was taken by Matt Hancock’s “gold committee” 24 hours earlier and based on evidence from the week ending 20 August, a week earlier, showing a fall in cases.

But more up-to-date figures suggested the virus was on the rebound and this became starkly apparent over the bank holiday weekend. Warnings from the Tory-run Bolton council and Labour-run Trafford council were not heeded until nearly midday on Wednesday, 12 hours after most people believed restrictions were lifted. It was, said local leaders, the latest snub in a summer of being ignored and overruled.

Bolton



Bolton now has by far the highest infection rate in England, at nearly five times the national average. Photograph: Rex

In the streets of Greater Manchester the virus took hold in the more deprived corners of Blackburn and Oldham in early July. It spread rapidly through the south Asian community, many of whom work in riskier, public-facing roles at the NHS coalface or as taxi drivers, takeaway workers and warehouse staff.

In other boroughs the profile of the typical carrier was different. Some, but by no means all, of Bolton’s cases are believed to be linked to a holidaymaker who went on a pub crawl instead of going into quarantine when he returned from Spain last month. By 31 August the virus had spread to almost every council ward covering its 285,000 residents. Bolton now has by far the highest infection rate in England, at nearly five times the national average.

In leafy Trafford, however, the infection centred on what the director of public health described as “the complacent white middle class”: younger, white, more affluent people who were out socialising but had the wherewithal to get tested and enough money in the bank to take the hit if they tested positive. Trafford aside, coronavirus remains a disease that disproportionately affects the poor and particularly those who cannot afford to self-isolate because they will lose income.

The government’s flagship test-and-trace programme, largely farmed out to contractors Serco and Sitel, failed to bring the virus under control. Only half of the close contacts of infected people were reached in areas with the highest infection rates in the country, as call-handlers based hundreds of miles away from the north-west were, perhaps unsurprisingly, rather remote from the already hard-to-reach communities where the virus was taking off.

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Where the centralised system failed, local authorities have tried to plug the holes by using council staff and volunteers to carry out shoe-leather epidemiology: going door to door and using community knowledge, language skills and hard-won trust to seek out and quash the virus, instead of relying on a faceless national system.

The confusion over lockdown capped a summer of frustration for local authorities in the worst-hit parts of England. Their directors of public health, whose day job is to stop the spread of infectious diseases, believe their work has been made harder by the over-centralised, top-down approach from Whitehall. And despite promises a month ago to take a more locally led approach, those closer to the ground say there is little sign of this happening.

Source: The Guardian
Keyword: A centralised system will not help areas in the north most at risk of Covid-19 | World news

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