A leading SAGE scientist has criticised the Government’s decision to abandon the word ‘isolate’ from its Test and Tract programme, claiming it will lead to less compliance.
Susan Michie, professor of health psychology at University College London, said isolating cases was the most vital part of the system and leaving it out of the title of the UK’s flagship scheme was ‘puzzling’.
Professor Michie, who is also director of UCL’s Centre for Behaviour Change and a member of the Government’s Scientific Advisory Group for Emergencies (SAGE), accused ministers of sending mixed messages.
Experts believe a fully functioning test and trace programme and high compliance from the public will be critical if the UK is to avoid a second wave of coronavirus as life gets back to normal.
Susan Michie, professor of health psychology at University College London and a member of SAGE, criticised the Government’s decision to abandon the word ‘isolate’ from its Test and Tract programme, claiming it will lead to less compliance
The NHS Test and Trace programme launched last week, but the crucial word ‘isolate’ has been left out of the title
But currently Britons who have been in close contact with infected patients are being trusted to self-isolate for 14 days, even if they show no symptoms, without being tested.
Professor Michie said her team at UCL had made it abundantly clear that straight forward, clear communications were needed to keep the public adhering to Covid rules as lockdown eases and compliance dwindles.
But there has been a ‘disconnect’ between the advice given to the Government and the public health messages being delivered, she claims.
Professor Michie told the House of Lords Science and Technology Committee today: ‘The other thing that is very puzzling to me is why the government has called it Test and Trace, when the World Health Organization (WHO) and many other countries call it Test, Trace and Isolate.
‘Because without isolation all of the rest of it is for nothing. We absolutely need the isolation. And if one doesn’t have it in the label of the system, it’s not communicating that this is a vital part of it.
‘We already know there are going to be really big difficulties with isolation if people are being asked to stay home for 14 days abd not go to work, this is a big financial penalty.’
Professor Andrew Hayward, director of the UCL Institute of Epidemiology and Health Care, told Peers today that the current test and trace system is not sufficient enough to see the UK through the winter
NHS Test and Trace launched without the new NHSX app, which uses Bluetooth technology to alert people when they’ve been close to a Covid-19 patient
What is the NHS Test and Trace system?
Anyone who develops Covid-associated symptoms is being told to self-isolate and get tested under the test and trace scheme.
Close contacts of those who are found to be positive for the disease are then told to quarantine for 14 days – even if they test negative and are not sick.
Boris Johnson’s government has hired an enormous army of 50,000 people who will attempt to make this huge undertaking possible.
Around 25,000 are contact tracers who will contact people who return positive coronavirus tests to grill them on their movements and their known associates.
The idea is to build a picture of who they have come into contact with and so who might be at risk of a) becoming ill and b) passing it on to more people.
Another 25,000 people in the scheme are testers, who will go out into the community and test these known associates.
Either way, these known associates will be under orders to immediately quarantine, even if the tests they return are negative.
Baroness Dido Harding, executive chairwoman of NHS Test and Trace, said the scheme was central to easing the lockdown further.
She said: ‘NHS Test and Trace is designed to enable the vast majority of us to be able to get on with our lives in a much more normal way.
‘We will be trading national lockdown for individual isolation if we have symptoms.
‘Instead of 60 million people being in national lockdown, a much smaller number of us will be told we need to stay at home, either for seven days if we are ill or 14 days if we have been in close contact.’
The UK’s coronavirus tracing programme will be split into two parts.
People will be ordered to self-isolate for seven days if they develop symptoms. Anyone in the same household will have to do the same.
Those people should then order a coronavirus test online or by calling 119. This will be available for residents in Wales from Saturday.
If a test is positive, that victim must complete seven days in isolation. If the test comes back negative, no one needs to self-isolate.
However, people with a positive test for Covid-19 will then be contacted via text message or email or by phone and told to answer questions.
They will be asked to share phone numbers and email addresses for close contacts.
For those under 18, they will receive a call from the team and a parent or guardian must give permission for the call to continue.
People who have been listed as a person with whom a coronavirus victim has had close contact will receive a text message or an email.
They will then be asked to self-isolate for up to 14 days based on when they last came into contact with that person.
Other household members do not need to self-isolate unless symptoms are present.
If they develop Covid-associated symptoms, all other household members should self-isolate and they should then order a test.
If the test is positive, self-isolation must continue for seven days. If the test is negative, that person should still complete 14 days in case the virus is not showing.
Test and trace requires people with symptoms to self-isolate and get tested. If they test positive their close contacts are then tracked down and also told to self-isolate.
The system is designed to break the chain of transmission as quickly as possible in order to squash potential outbreaks and stop them from escalating.
Professor Michie’s team at UCL has been feeding the results of behavioural studies into SAGE to help steer its own scientific advice to the Government.
But she claims there has been a ‘lack of transparency’ about what scientific advice is being used to guide policymakers.
She told Peers: ‘We’ve published many dozens of papers and they are presented to SAGE. But we don’t have any feedback as to where those papers go or whether the advice is used in any way.
‘I think this would be very useful in the future to have people actually track through, from all the committees, in what way advice is being used and by whom.
‘Certainly in terms of communication, the committee has published two or three papers on principles of good communication.
‘I think several behavioural scientists have noticed a disconnect between those principles of good communication and what we see both at the verbal presentations at the press conferences, and also the communication around the change from the ‘Stay at Home’ messaging to ‘Stay Alert.’
There is growing concern among experts that Britons will not comply with isolation rules without the incentive of a test to confirm if they have coronavirus.
The Government has insisted on a centralised testing programme and seems unwilling to delegate responsibilities to local health bodies.
Professor Andrew Hayward, director of the UCL Institute of Epidemiology and Health Care, told Peers today that a second lockdown would be inevitable in the event of another epidemic because the current test and trace programme is ‘not sufficient’.
Britons who report Covid-like symptoms are being tested under the contact tracing scheme, launched a fortnight ago.
But Professor Hayward said the Government will not have the testing capacity to swab enough people in winter, when respiratory illnesses are rife.
He added: ‘We can see that during a normal summer about 100,000 people a day would have new symptoms of cough or fever or loss of sense a smell.
‘And that rises to about half a million a day during winter, so there is an enormous scale to this testing issue that I don’t think has been truly appreciated.
‘If we are moving into a situation where we have a second wave during the winter -when we know we have way higher levels of respiratory infections – we will have way higher levels of people presenting with symptoms that could be Covid.
‘So we need to be able to ramp up testing capacity to way higher than it currently is if we are to pursue that strategy of test and trace as one of the main means of control.
‘We may need, probably will need, in a severe second wave to revert to lockdown. Because test and trace will not be sufficient.’
Ministers are facing growing criticism over their refusal to publish data showing how many people have been contacted by NHS Test and Trace so far.
Number 10 would only say the numbers will be released ‘shortly’ once the data has been verified.
A leaked document revealed that just 10,000 close contacts were provided by 8,000 people who were diagnosed with coronavirus in England last week.
The leaked document, seen by the BBC, gives a glimpse into how the crucial scheme is performing in its first week.
But the figures only account for Covid-19 cases in the community and do not include people who were hospitalised with the virus.
Professor Paul Hunter, an epidemiologist at the University of East Anglia, said: ‘I think at the moment this is still very new and the people working the system are only really just getting their heads around how it works. There will still be a lot of wrinkles in the system.
‘But I think that the number of contacts being only a little over a one per case is somewhat surprising I think and somewhat disappointing.’
‘There was a an unofficial pilot study in Sheffield, and they were reporting the fact they’re finding that often people were unwilling to tell people about their contacts.
‘So maybe there was an element of that but maybe it’s still gearing up and getting the system operating properly.’
Professor Hunter said the contact tracing was complicated and there might be some communication problems across different parts of Government.
The crucial test and trace system has been launched without the NHSX mobile app, which alerts people when they have come close to an infected person.
But Transport Secretary last week appeared to confirm the app won’t work perfectly when it is eventually launched nationwide to help halt the spread.
He responded to claims the app – considered the ‘cherry on the cake’ of Number 10’s flagship Test and Trace scheme – would be ‘imperfect’ and ‘clunky’ for several months.