Health

NHS leaders warn time is running out to establish track and trace strategy


Ministers today admitted a crucial coronavirus smartphone app will not be ready by June 1 as NHS chiefs warned ‘time is running out’ to launch a track-and-trace system to avoid a second deadly wave.

Security minister James Brokenshire said the software, which detects which users have been in contact with people who test positive for the disease, would be ready in the ‘coming weeks’.

But he insisted the contact tracing regime can still be in place by the hard deadline set by Boris Johnson, with plans to bring back schools, shops and businesses hanging in the balance as the economy goes into meltdown.  

The PM has hailed a 25,000-strong army of trackers recruited to identify the contacts of infected victims and prevent outbreaks. Similar schemes have controlled outbreaks in countries such as South Korea and Taiwan. 

But Niall Dickson, chief executive of the NHS Confederation – which represents organisations across the healthcare sector – warned the system was being put together ‘very late in the day’ and the draconian lockdown cannot be loosened without a ‘clear implementation plan’. 

Although Mr Johnson’s determination to launch the tracking system by June 1 was ‘very much welcome’, he added: ‘I think it is being done very late in the day and we really do need to get on with this.’

The new app has been tested on the Isle of Wight but its rollout has been delayed for weeks because of security flaws and it failed to work on all types of smartphone. 

It was also claimed yesterday contact tracers have been receiving shambolic and inadequate training and outsourcing firm Serco, one of the companies training them, was forced to apologise after accidentally sharing the email address of 300 of its recruits. One whistleblower said they are getting paid to sit around doing nothing for days on end and said they had ‘never been so bored in their life’.

Fears are mounting that the virus could take hold again if contact tracing does not come soon, as people vote with their feet on lockdown. 

Crowds took to beaches at many beaches and parks yesterday on the hottest day of the year so far, wit critics branding scenes at Southend, Brighton, Bournemouth and Tynemouth ‘a national disgrace’. 

A study of 90,000 people has found the proportion of Britons reporting ‘complete compliance’ with the lockdown rules has fallen from 70 per cent to 60 per cent over the past fortnight. 

On another day of twists and turns in the coronavirus chaos:  

  • Mr Johnson is facing a Tory revolt over charging an NHS surcharge to immigrant health and care workers, after the government U-turned and said families of foreign porters and cleaners who die from coronavirus will automatically be able to stay in the UK;   
  • The government has been accused of ‘euthanising’ MPs with health conditions by insisting they come back to the Commons rather than attend ‘virtually’; 
  • The chief of Heathrow Airport has confirmed that Public Health England is considering temperature testing for arrivals, despite ministers and science advisers arguing for months that it is not effective; 
  • Justice Secretary Robert Buckland became the first senior figure to acknowledge the Government had prioritised the NHS over care homes; 
  • The PM hinted he might reshuffle his top team following criticism of the Government’s handling of the crisis; 
  • Culture Secretary Oliver Dowden urged the BBC to think again about axing free TV licences for over-75s;  
  • A study by University College London found more than half of young adults are no longer sticking to the lockdown strictly;
  • Officials plan to give NHS and social care staff antibody tests revealing whether they have had coronavirus;
  • The Bank of England is considering using negative interest rates for the first time in its 324-year history;  
An NHS worker looks at information from the new tracking app, which is being trialled on the Isle of Wight

An NHS worker looks at information from the new tracking app, which is being trialled on the Isle of Wight

Visitors flock to Durdle Door in Dorset on a scorching day with sunbathers packed together, despite social distancing rules

Visitors flock to Durdle Door in Dorset on a scorching day with sunbathers packed together, despite social distancing rules

Boris Johnson yesterday set a ten-day target to deliver a virus tracing system that could allow the lockdown to be eased

Boris Johnson yesterday set a ten-day target to deliver a virus tracing system that could allow the lockdown to be eased

But the NHS' crucial app has been delayed and the contact tracers and  25,000-strong army of tracers  who will also find those ill or those who have been near them (graphic of process pictured) claim they are bored and poorly trained

But the NHS’ crucial app has been delayed and the contact tracers and  25,000-strong army of tracers  who will also find those ill or those who have been near them (graphic of process pictured) claim they are bored and poorly trained

It was the hottest day in the UK so far this year and the masses were out in force with deck chairs and towels on the beach. Sorrell Vince, 23 (left) from Northampton and Bethany Heatley from Preston enjoying the sun on Cullercoats Beach, Tynemouth

It was the hottest day in the UK so far this year and the masses were out in force with deck chairs and towels on the beach. Sorrell Vince, 23 (left) from Northampton and Bethany Heatley from Preston enjoying the sun on Cullercoats Beach, Tynemouth

St James' Park in London

Tynemouth beach

The lockdown was put in jeopardy yesterday by thousands of sunseekers who flocked to beaches (Tynemouth, right) and parks (St James’ in London) on the hottest day of the year

Niall Dickson, chief executive of the NHS Confederation - which represents organisations across the healthcare sector, wrote to Health Secretary Matt Hancock because his members were "concerned" over an apparent lack of a clear strategy

Niall Dickson, chief executive of the NHS Confederation – which represents organisations across the healthcare sector, wrote to Health Secretary Matt Hancock because his members were ‘concerned’ over an apparent lack of a clear strategy

Test, track and trace – TTT – means testing people for coronavirus, tracking the spread of the virus, then tracing the people with whom an infected person has come into contact. It is seen as the only way out of the crisis and to prevent a second spike in coronavirus cases.

Health officials began contact tracing for every positive diagnosis of coronavirus following the first confirmed cases in January. But widespread contact tracing was controversially abandoned in mid-March as the number of cases soared in the UK.

The app, which uses bluetooth to track what phone users have been in close proximity, has been lauded as a critical piece of the puzzle to implementing a South Korea-style system.  

But Mr Brokenshire conceded that it will not be ready by June 1, telling Sky News it ‘will be introduced in the coming weeks in parallel’ with the system employing track and trace staff.

He added: ‘Obviously, the priority being to get these track and tracers trained, in place, that is what the Prime Minister is very confident about.

‘We’re confident the system will be there, able to track and trace around 10,000 people on 1 June.’

The Government’s scientific advisers insist the system must be in place before any more restrictions are lifted. If the scheme is up and running in time some schools and shops could reopen as early as June 1. 

Rules limiting social contact could also be relaxed at that point, with a decision due at the end of next week. 

However, Mr Dickson told BBC Radio 4’s Today programme:  ‘I’m not saying it is impossible to do it, but I think there is concern among those at local level because we’ve seen – not occasionally, we’ve seen often – where national stuff is done with the best of intentions, but unless the local context is understood it doesn’t really work as well as it should.’

He added: ‘And I think it is only recently, to be brutally honest, that the Government’s rhetoric changed to recognise that to get this test, track and trace thing in place you not only need a national system, you not only need the app, but you also need to put at the centre of local plans local officials who understand about contact tracing – they do it all the time.

‘But you need to co-ordinate that.’ 

The lockdown was put in jeopardy yesterday by thousands of sunseekers who flocked to beaches on the hottest day of the year. 

Devon and Cornwall Police said roads in some resorts were gridlocked, despite pleas for families to stay away. ‘Any decision on the lockdown is conditional on advice that we can move forward without risking a second spike – we are not there yet,’ said a Whitehall source. 

‘Hopefully the test-and-trace system will give people confidence in the measures we are taking.’ Just 637 hospital admissions for coronavirus were reported on Tuesday and no new cases at all in London for the day before. 

That compares with around 1,000 a day at the peak of the pandemic. Experts cautioned that a lag in recording could see that revised upward however. 

The death toll rose by 363 to 35,704 on Tuesday while tests hit a record 177,216. Mr Johnson told the Commons the tracing scheme was almost ready, despite problems with a government app that was meant to help the process. 

HOW THE APP WILL WORK: STEP-BY-STEP 

  1. The user will download the app onto their smartphone once it becomes available in their area.
  2. To register someone must put in the first half of their postcode, which shows the town or borough they live in.
  3. They will then be asked whether they have a new, continuous cough or a fever – the two main signs of COVID-19. If no, nothing will happen. If yes, they will be told to order a coronavirus test. 
  4. The user will be told to keep their Bluetooth switched on at all times and the app will run in the background without them doing anything.
  5. When they go out, the app will keep a log of every time it comes within Bluetooth range of another phone with the app. This will be anonymous, with each app registered to a code rather than a person or address.
  6. If and when someone develops COVID-19 symptoms they will be helped to order a test through the app and every code that their app has logged a contact with will be warned of a potential infection in their network. The people with those codes will be told to self-isolate until the test result comes back.
  7. If the result is positive, anyone who receives an alert because they have been close to the patient will be told to self-isolate for at least seven days and to order themselves a test if they start to feel ill.
  8. If the result is negative everybody will be told to carry on as normal.

Notes: The app will rely on people being honest about whether they are ill.

It is not clear what will constitute a close enough contact for someone to be notified about possible COVID-19 infection. The general rule is if you are within 6’6′ (2m) of someone for 15 minutes or more, but the Department of Health said a ‘complex risk algorithm’ will decide.

‘We have growing confidence that we will have a test, track and trace operation that will be world-beating and yes, it will be in place by June 1,’ he said. 

The UK Government abandoned it in the middle of March because of a lack of testing capacity. Mr Johnson said the army of trackers would be capable of tracing the contacts of up to 10,000 new cases a day. Anyone who contracts the virus will be asked to detail all those they have had recent contact with. 

These people will then be advised to take a coronavirus test or self-isolate. Labour leader Sir Keir Starmer said the failure to conduct tracing for ten weeks had left ‘a huge hole in our defences’. 

Dame Angela McLean, the deputy chief scientific adviser, said on Tuesday that all the modelling for changes to the lockdown was based on a ‘highly effective track, trace and isolate system’ being in place. 

Infections expert Professor Hugh Pennington said Mr Johnson’s pledge of ‘world-beating’ tracing was good news’ but added: ‘It’s taken a long time. As to world-beating, we’ve been beaten by quite a few other countries’.   

Care homes and their residents were not prioritised for coronavirus testing at the outset of the pandemic, a senior minister admitted yesterday.

Hospitals were given first place in the queue for tests, Justice Secretary Robert Buckland said.

He acknowledged ‘there are things we could have done differently’ as Boris Johnson came under increasing pressure over the rising toll of care home deaths and the allegation that the Government cleared NHS wards of elderly patients by dumping them in the homes.

A care home chief said yesterday that in one case last month an ‘aggressive’ ambulance crew threatened to call the police unless a home took an ill but untested patient back.

People enjoy the hot weather at a crowded Bournemouth beach in Dorset, as people flock to parks and beaches with coronavirus lockdown measures eased and temperatures set to hit 82F (28C)

People enjoy the hot weather at a crowded Bournemouth beach in Dorset, as people flock to parks and beaches with coronavirus lockdown measures eased and temperatures set to hit 82F (28C)

People enjoy sunny weather on the hottest day of 2020 so far on the beach and promenade at the seaside in Weston-super-Mare

People enjoy sunny weather on the hottest day of 2020 so far on the beach and promenade at the seaside in Weston-super-Mare

Traffic on the approach to Woolacombe, Devon. Sun-seekers have been flocking to coastal hot-spots in the Westcountry in such numbers traffic wardens have reportedly run out of tickets

Traffic on the approach to Woolacombe, Devon. Sun-seekers have been flocking to coastal hot-spots in the Westcountry in such numbers traffic wardens have reportedly run out of tickets

Southend beach was absolutely packed as sun-worshipping Britons turned out to soak up the rays on the hottest day of the year so far

Southend beach was absolutely packed as sun-worshipping Britons turned out to soak up the rays on the hottest day of the year so far

Roads and car parks were crammed full as parking restrictions were lifted several days ago and thousands of people flocked to Sandbanks in Poole, Dorset, on the hottest day of the year so far

Roads and car parks were crammed full as parking restrictions were lifted several days ago and thousands of people flocked to Sandbanks in Poole, Dorset, on the hottest day of the year so far 

Residents and tourists enjoy the warm weather hitting Kent as Britain is set for the hottest day of the year so far. Sun seekers flocked to Margate to soak up the rays today with surrounding roads packed with cars

Residents and tourists enjoy the warm weather hitting Kent as Britain is set for the hottest day of the year so far. Sun seekers flocked to Margate to soak up the rays today with surrounding roads packed with cars 

The Althorp in Wandsworth Common, London saw people enjoying drinks on the Common opposite the pub, as a woman in PPE gear handed out pints

The Althorp in Wandsworth Common, London saw people enjoying drinks on the Common opposite the pub, as a woman in PPE gear handed out pints

People enjoy the sunshine in London Fields, north east London on May 20, 2020, with temperatures in the capital are expected to reach 82.4F (28C)

People enjoy the sunshine in London Fields, north east London on May 20, 2020, with temperatures in the capital are expected to reach 82.4F (28C) 

People soak up the rays at Bournemouth beach in Dorset, as Britons flock to parks and beaches as lockdown is eased

People soak up the rays at Bournemouth beach in Dorset, as Britons flock to parks and beaches as lockdown is eased

The people queuing up for beer looked to be ignoring the two-metre requirement as they topped up on drinks amid the hot weather

The people queuing up for beer looked to be ignoring the two-metre requirement as they topped up on drinks amid the hot weather

Apple mobility data shows that people across the UK are slowly starting to get back to work, with the amount of people driving, walking and taking public transport creeping back up towards baseline figures

Apple mobility data shows that people across the UK are slowly starting to get back to work, with the amount of people driving, walking and taking public transport creeping back up towards baseline figures 

The crowded scenes at Southend beach sparked backlash on social media, with one Twitter user writing: 'Is this what #StayAlert means if you live in #Southend? If so, it's not so bad after all... Lord help us'

The crowded scenes at Southend beach sparked backlash on social media, with one Twitter user writing: ‘Is this what #StayAlert means if you live in #Southend? If so, it’s not so bad after all… Lord help us’

Another Twitter user posted an image of Bournemouth beach, captioning: 'British public showing none of the "good common sense" at Bournemouth beach. Unfortunately, the council and police have no powers now. Second wave incoming surely'

Another Twitter user posted an image of Bournemouth beach, captioning: ‘British public showing none of the ‘good common sense’ at Bournemouth beach. Unfortunately, the council and police have no powers now. Second wave incoming surely’

HOW WILL CONTACT TRACERS WORK ALONGSIDE THE APP? 

The bulk of contact tracing work will be contracted out to at least two companies, including Serco, who are being asked to provide 15,000 call centre staff. 

They will designated specific areas of the country and will receive alerts when NHSX app users come into contact with suspected patients.

It is their job to phone these people and advise they self isolate and be vigilant about changes in their health and about social distancing. If they become ill, they will be tested.

If a contact becomes infected, the same process begins for them and their social network. The idea is to keep track of how the virus moves through social circles and to try to stay a step ahead of it and prevent wider spread. 

Ministers have also promised an additional 3,000 former doctors and nurses who have been recruited from the pool of retired NHS staff who volunteered to return to help during the pandemic.   

They will be able to provide medical advice to confirmed and suspected patients.  

The tracers will make a list of people considered to have been put at risk by the patient, and those people will be notified that they might have the coronavirus.    

The NHSX app would need more than 70 per cent of the UK population to download and use it for it to be effective. But ministers say physical contact tracing will make up for the shortcomings of the app if update is below 70 per cent.

NHS staff and carers will get antibody tests to see if they have had coronavirus from next week.

Ministers are expected to announce today[Thurs] that hundreds of thousands of frontline healthcare workers will be offered the blood tests which will reveal whether they have had the virus.

It is hoped the widespread testing will provide a picture of how many healthcare staff have had the virus, as well as reduce anxiety among those working on the frontline.

However, scientists do not yet know for sure that having the virus makes someone immune to it in future.

A source told The Guardian that the plan to provide blanket antibody testing would reassure NHS workers despite the lack of guaranteed immunity.

‘The intention is that NHS and care staff will get these tests in the first instance to see if they’ve had the virus, so that they can feel able to go back to work safely, knowing that they will have at least some immunity,’ the source said.

Two antibody tests were approved by Public Health England this week. Either the Prime Minister or the health secretary, Matt Hancock, is expected to make the announcement.

Priority will be given to frontline hospital staff working most closely with coronavirus patients, such as intensive care staff, those working on coronavirus wards and doctors and nurses in A&E units.

Those who test positive will be monitored to see whether their antibody levels drop over time and whether any of them fall ill again in order to help scientists better understand how immunity to the virus works.



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