‘It’s world-leadingly bad, is what it is’: the week Covid surged again in UK | Health policy

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For Alex, an NHS call centre worker, the signs that coronavirus was back in earnest came when his phone wouldn’t stop ringing.

Over the summer, Alex would log on at home to see 70 or 80 people in the queue for advice on booking an appointment for a Covid test. “You’d get answered in a few minutes,” he said. “Last week, that went up to about 100. By this week it was 1,500.”

On Friday morning, he logged on to see 2,120 contacts on hold, and a wait of more than half an hour for a response that might get the callers nowhere. “We’re selling callers wishes and hopes,” said Alex (not his real name). “We are grossly underprepared … customers are angry. They’re not mad at me, they’re mad at the system.”

The warning lights had been flashing in Downing Street, too, triggering an abrupt reversal of policy that coincided with a Brexit crisis of the government’s own making, leaving ministers fighting Conservative rebellions on two fronts.

All talk of the country tentatively heading towards some kind of normality began to evaporate last weekend as the reality of a Covid resurgence began to bite. With the UK recording nearly 3,000 Covid cases on Sunday, the highest daily total since May, the health secretary, Matt Hancock, concluded that he had to act.

“That Sunday when the numbers came out and it was that dramatic rise, that dramatic increase, things started moving quickly from that,” a Whitehall source told the Guardian. “It was: OK, we’ve got one data point here, we’ve got to look at this very carefully and get the message out.”

Hancock appeared on broadcast news bulletins to issue a warning about the “concerning” increase in the number of new cases. In messaging that would be echoed later in the week by the chief medical officer for England, Chris Whitty, he stressed the importance of preventing the UK from following the same path as other European countries that had failed to stop new outbreaks.

In the following days, officials examined the daily figures to see if the increase would be sustained. By Tuesday, Boris Johnson had concluded that the evidence was clear enough that a new approach was necessary.

On Wednesday, he revived the coronavirus press conference, flanked by Whitty and the chief scientific adviser, Sir Patrick Vallance, and set out a plan intended to offer clarity, simplicity and control after longstanding criticism that the government’s communications were confused. From Monday, with a few narrow exceptions, he said, gatherings of more than six people would be banned in the hope of avoiding a wider second lockdown.

Johnson emphasised that these steps were not a second lockdown but a necessary evil to avoid one. Still, the headlines the next morning warned of the cancellation of Christmas.

On Friday, the figures showed why ministers had begun to panic. The R number across the UK had risen to between 1 and 1.2, and the number of cases in England was estimated to be doubling every 7-8 days.

“It has felt, sometimes, like a lot of people just have their heads in the sand,” a senior NHS manager said. “Maybe this is a bit sooner than we hoped, but it was always going to happen.”

But if healthcare leaders and call centre workers alike saw the surge coming, and behavioural scientists largely backed the belated move to a simpler set of guidelines, some Tory MPs were anything but philosophical about the change.

And with parallel concerns about the government’s “moonshot” £100bn testing plan and the efficacy of the existing track-and-trace system, public and political faith in the government’s handling of the crisis faces perhaps its toughest test yet – at the very moment when its maintenance is most urgently required.

On Friday, Tory-supporting newspapers reported unrest in the cabinet, with Hancock said to have been the only member of the coronavirus strategy committee to have supported the “rule of six” decision – which was strongly backed by Whitty and Vallance.

“Even the PM was initially cautious about taking the limit all the way down to six,” the Daily Mail quoted a source as saying. “The majority view was that this level of social distancing will have a huge impact on people’s lives and the economy. But Hancock got his way.”

Sir Graham Brady, the chair of the influential 1922 Committee of backbench Conservatives, reflected the simmering discontent among MPs. He told the Guardian: “Parliament has been sitting since April and there is simply no reason why these measures cannot be put forward for proper debate, scrutiny and decision by elected parliamentarians. And it is high time the government recognise that. The ‘rule of six’ measures are a massive infringement of normal personal liberty and family life.”

The former minister David Davis piled in too. “I don’t know what the science is for the six-person limit,” he told the Guardian. He acknowledged that the government had reason to be concerned about the rise in the infection rate, but he asked: “Why six, not eight? How is that supposed to work? How are they going to enforce it indoors? I don’t think they can.”

To offer some hope, Johnson had referred to “Operation Moonshot” – mass testing on an unprecedented scale – as a feasible way to bring the crisis under control. But after the Guardian revealed the details of the plans, scientists and other experts mercilessly picked them apart.

And the cost? That £100bn figure, mentioned in two leaked official documents, would be twice the entire annual defence budget, and two-thirds of what the government spends each year on the NHS.

Dr David Strain, of the British Medical Association, said it was “unlikely if not impossible” to imagine 15m tests being available within the prime minister’s timeframe. Prof Sir David Spiegelhalter, the chair of the Winton Centre for Risk and Evidence Communication at Cambridge University, said statisticians were “banging their heads on the wall” at the idea, because even the best tests would generate enough false positives to require quarantine for millions.

If the moonshot fails to land, the government will have to rely on the existing testing system, which appears to be cracking under the strain of the recent rise in cases.

Though Hancock has repeatedly defended the service this week – and blamed the worried well for causing the backlog – the Guardian has identified people seeking tests in Blackburn, London, Leicester, Greenock, north Lincolnshire, Nottingham, Coventry, Cardiff and Devon who have all been told that their nearest available testing centre was in Inverness, the northernmost site in the country.

It was these problems that led the Labour leader, Keir Starmer, to warn that the system was on the verge of collapse.

Charlie Swarbrick, an 18-year-old student from Penge, was told to go to Malden, Esher, Inverness, Aberdeen, and Norwich City FC. “I thought: I’d rather stay home for two weeks,” he said. He did make the 12-mile journey to Esher but he received an unclear result. A week after he was exposed to the virus, he finally got a negative result on Friday, after finding an appointment in Greenwich.

Melonie Brown, from Walthamstow, north London, took her 13-year-old son to school on Tuesday, only to be called in to pick him up because of a cough. “The website sent me straight to Inverness,” she said. “So we tried from a different phone to see if there was a glitch, and that one was in Telford” – 155 miles away.

Not knowing what else to do, and desperate for her son to get back to school, she contacted her local MP, Stella Creasy. As it turned out, Creasy was able to point her to a closer testing centre – in Walthamstow. Brown took her son on Thursday and they queued for 10 minutes, with no need to book.

Later the same day, a Serco worker there told the Guardian he had no idea know why the centre was not showing up online for locals. “We have the signs [saying tests are only for people with symptoms], but we don’t turn anybody away,” they said, estimating that the centre was conducting about 400 tests a day. “By the time they leave, we get nothing but compliments.” The worker had a friend who had been told to go to Scotland – from Belfast.

It is understood the Department of Health is moving to fix the glitch by imposing a new 75-mile limit on searches for test appointments, while new laboratories are being added to process results. A spokesperson for the department reiterated that people without symptoms were not eligible for tests. They said: “NHS Test and Trace is working and our capacity is the highest it has ever been.”

David Davis, though, took a similar view to Starmer. “They keep saying it’s world-leading,” he said. “It’s world-leadingly bad, is what it is. They talk about this huge capacity … well, the capacity is obviously in Inverness. There’s a serious bottleneck in the laboratory, and that determines the capacity, so it’s a lot less than it’s claimed. So how are they going to fix that?”

At the call centre, meanwhile, Alex was sceptical that things were about to get better. “All we can tell people is just keep trying,” he said. Like most other people, his sense of the future is couched more in hope than expectation. Did he have any idea how things might get better? “Someone does,” he said. “Somewhere.”

Source: The Guardian
Keyword: ‘It’s world-leadingly bad, is what it is’: the week Covid surged again in UK | Health policy

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