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Less than 20% of people in England fully self-isolate when asked to do so, according to documents released from the government’s scientific advisory group for emergencies, which said mass testing would be of no use unless this percentage rose.
The report from scientists on Sage suggests they think there are limited benefits to mass testing, which was proposed in the leaked “Operation Moonshot” documents.
Boris Johnson viewed moonshot as “our only hope for avoiding a second national lockdown before a vaccine”, a leaked memo said. The £100bn plan for up to 10m tests a day were sent to Sage and the Treasury in August.
The minutes, from a meeting on 27 August of the Multidisciplinary Task and Finish Group on Mass Testing, make it clear that the scientists think mass testing is of limited use. They think it could have unforeseen consequences, such as stigmatising deprived areas where many people of colour live which turn out to have higher infection rates. “This has the potential to fuel existing racial tensions,” they warn, although, if carefully done, it could help bring in support for those areas.
But their biggest concern is that too few people are self-isolating already, even if they have tested positive. Mass testing “will require high rates of testing and self-isolation (> 90%) achieved equitably in any targeted population”, the minutes say.
“Around 20% of those reporting symptoms of Covid-19 in England report fully self-isolating by staying at home,” the minutes state.
“Rates of self-isolation from other members of a household is likely to be lower due to physical and other practical constraints. These rates may be even lower in those who are asymptomatic who receive a positive result on mass testing, given likely lower perceived risk of being infected.”
The poorest people are the least likely to self-isolate because they cannot afford to stay home, the scientists say. “Self-reported ability to self-isolate or quarantine is three times lower in those with incomes less than £20,000 or savings less than £100.”
Rich and poor alike say they are willing to self-isolate, so the issue is whether the household income is sufficient. Where it is not, more financial support is needed, the minutes say.
“This will require financial and other resources at levels that hitherto have not been made available in England as part of the existing NHS test-and-trace system. While paid sick leave has been judged an effective intervention to reduce transmission of Sars-CoV-2 across OECD countries, it does not include all workers, such as those on casual or zero-hours contracts, or gig workers. In addition, payment level and duration vary considerably across countries, with the level most often below gross pay.”
People self-isolating also need regular support and information and should get a daily text or phone call, the scientists say. They should have secure supplies of food and essential goods and employment protection so they have jobs to return to.
“Given limited experience in the UK with mass testing requiring self-isolation and quarantine at scale, it would be prudent to set up systems to detect and manage unexpected consequences as they arise,” the scientists conclude.
Regular surveys have been carried out to find out how many people are complying with the self-isolation rules but the government has not published them since May. At that time, 20% were not fully complying. Some would not stay home at all, while others might base themselves at home but go out to the shops or to exercise.
Prof Susan Michie, who is on the Sage panel of behavioural scientists, said she thought it was shocking that the numbers isolating were so low. “We are spending all this money on the testing and tracing. If people don’t isolate, what is the point?” she said.
Many people were not clear about the rules and did not understand they should stay home full-time and not mix with family or friends or go out to do essential tasks, such as buying food. “We have to give material support to people to adhere to the guidance and stop the mixed messaging. We have to have open and transparent information,” she said.
Source: The Guardian
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