Test and trace in the UK: how well are we doing? | World news

Is the test and trace system working properly?

Ministers say the UK has a greater testing capacity than other countries of its size, with 2.43 people tested each day for every 1,000 in the population. That compares with 1.15 in Germany and France, and one in Spain.

But critics say the coronavirus tests alone are not enough. First-class contact tracing is essential. People testing positive must be told to self isolate. Their contacts have to be reached and persuaded to stay home too.

In spite of all the efforts and upbeat ministerial statements, the percentages of people contacted, and their contacts reached, do not change much.

The latest figures show that 81.4% of people testing positive were successfully reached by the contact tracers and asked to provide details of the people they had associated with recently. That is an improvement on the 75.2% of the previous week.

But there was a marked drop from 77.1% to 69.4% in those contacts being reached by the tracing teams and asked to stay home. Those who are missed may be staying at home in families where there is already someone with Covid-19, but some will be out and about with the potential to spread the virus.

Has the focus shifted to the local hotspots?

Yes, quite markedly, and the test and trace scheme makes no apology for that. The organisers say there has to be a focus on the areas most in need, such as Bolton and Trafford, where there has been a surge in the infection rate. The priority is the areas of high virus transmission and the at-risk groups, by which they mean mostly care homes.

Testing at Edinburgh airport in May

Just over two people per 1,000 in the population are tested each day in the UK. Photograph: Murdo MacLeod/The Guardian

Are there shortages of tests elsewhere in the UK then?

Yes. While a TV campaign has been calling on people to get tested if they have any symptoms so the country can try to return to normal life, there are complaints that those logging in to the website to book tests at a drive-in centre are told there are none available or they are directed to a centre more than 100 miles away.

Government sources told the BBC that labs were “maxed out” because of high demand lately. The Labour MP for Gateshead, Ian Mearns, told the Commons there were only enough tests locally to meet two hours of current demand, yet cases in his constituency were rising. Last week home test kits ran out so no one could get them in the post.

The Department of Health and Social Care says it is increasing testing massively. Just announced is a new Lighthouse lab near Loughborough, where 50,000 tests a day should occur by the end of the year.

Dido Harding, who was running the test and trace scheme and now leads the new public health body replacing Public Health England, says they will have capacity for 500,000 tests a day in Britain by the end of October.

But these are not just tests for the virus – they include antibody blood tests, carried out as surveillance to establish how many people have already had Covid-19.

What else is being done to increase testing capacity?

Ministers see new technology as part of the solution. New types of tests are being trialled. The saliva test, which has already been piloted in Southampton, will be extended in Hampshire, the health department said.

No data on the accuracy of the “spit test”, which would be preferred by most people to the uncomfortable nasal and throat swabs, has been published. However, sources say they think it may be almost as good as the standard swab test – although there were too few cases of infection in the Southampton pilot to be sure.

The saliva test can be turned around in a couple of hours, so has a big advantage in speed as well as comfort. The health department is going to run a pilot in Salford of mass screening using saliva, conducting up to 250 tests a day. Because spitting in a pot is not invasive and quick and easy, it is thought it could potentially be used in settings such as schools and care homes to test everyone frequently for the virus, whether or not they have any symptoms.

Home test kit

Home test kits ran out in the UK last week. Photograph: Tolga Akmen/AFP/Getty Images

Why are the numbers testing positive increasing?

There is an upward drift in positive cases. Between 20 and 26 August, 6,732 people tested positive, an increase of 6% on the previous week. It’s not just due to an increase in testing, because tests declined that week by 1%.

It is thought that many of those testing positive are young people who are getting back to normal life, and returning to their work and social lives. They are unlikely to become very ill, but the worry is that, particularly in some communities where family bonds are very strong, they may pass the virus to older people who may become sick enough to need hospital admission.

This will become more than a slight worry as the colder months arrive and flu begins to circulate as well.

What is going wrong with contact tracing?

Contact tracing was traditionally done by local public health teams, when the issue was sexual health viruses or occasionally tuberculosis. Because the team participants were local they knew their constituencies and the whereabouts of the local communities most at risk; they were also more acceptable, compared with others, if they knocked on doors.

The test and trace system has been mostly a centralised operation, farmed out to private companies, such as Serco, using call centre employees. They have had mixed success for their efforts.

The “complex” cases – usually where there has been an outbreak in a care home or in an entire town, such as Leicester – have been referred to local teams again, with local public health ownership.

Contact tracers should be liaising with those in isolation or in quarantine after returning from a country with high Covid-19 infection rates, such as Spain.

However, some people have spectacularly slipped through the net, – such as the eight teenagers on a Wizz Air flight from Crete back to Luton on 25 August who tested positive. One of them told the Guardian he had been called by contact tracers more than once. But the airline said it had not been informed or asked for details of the 200 other passengers on the flight.

Source: The Guardian

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