Without a Trace

Whether a continuation of a first wave or second wave, COVID-19 is gathering force, but now with the wings plucked from the herd immunity proposition by the latest Imperial College, London research, ‘Covid-19 herd immunity theory dealt blow by UK research’ [Financial Times, 27th October, 2020]; a timely reminder has been sent to us that when the public is lectured by journalists, politicians and non-scientists about ‘the science’, they are appealing to indisputable authority, but principally as a shelter for their own – often politically motivated – opinions, and not as a reference to how cutting-edge ‘science’ is actually done. Currently ‘the science’ is required to work in that uncertain no-man’s-land between knowledge and ignorance, as it grapples with a new, perplexing and dangerous virus; a condition which is of course the real substance of science’s endless purpose, to understand that which is unknown; to close the mysterious gap between problem and discovery. In 2020  ‘the science’ still lags behind the ingenuity of a virus. This is a new virus, and ‘science’ does not posses all the answers. In short, science has not fixed the COVID-19 problem; because it does not yet possess the fix.
Until ‘the science’ has a compelling answer for us, in the form of vaccines or effective treatments, or the pandemic is a spent force, we are fated to rely on the established principles of the science and medicine we have; which focuses attention on the repository of accumulated knowledge and wisdom vested in our established public health services, because the acquired wisdom our ‘public health’ specialists and institutions possess is the sum of the knowledge and expertise available to us; won over many decades fighting the world’s epidemics and pandemics. The alternative is to follow mere speculators, or those with a vested interest, or those who offer the siren voice of a seductively easy, ready, unproved answer, with consequences we cannot imagine. The hard road offered by Public Health is what we have; and among its key tools to fight the virus, and find the quickest route out, is the critical investigatory mechanisms of an established and locally operated Test and Trace system, which Public Health specialists know how to manage, given only the required resources; using tried and tested mechanisms that are undisputed and vital to limiting the spread of disease through the population.
Attention is now being directed by the British Government almost anywhere other than on the new UK Test and Trace system which it chose to set-up, by attempting to apply inappropriate private sector, ‘market’ solutions to a complex, specialised public health problem, and to do so vexatiously, in the middle of a national crisis; which has led the Conservative Government to fail to protect the security and well-being of its people. The British Government has insisted doggedly on persevering with a private sector solution that is a costly failure and is unable to provide sufficient evidence that it works, long after it has demonstrably failed. We are now fated to require to make the best of a bad job; one that was never going to work. At the same time the successes of the surviving elements of local public health systems that remain and continue to provide local Test and Trace services, or Test and Protect (in Scotland), only serve to confuse public perceptions and distort the scale of the failure in national testing and tracing, or the gross misuse of both our financial resources and available expertise, to promote a system that relies on private sector outsourcing. Unfortunately we know the National Test and Trace system is failing. Even the Prime Minister has acknowledged its flaws in the House of Commons.
Test and Trace provides the bulk of the public health contact tracing resource, throughout the UK. Government financial resources and political support have been lavished on this privatisation of public health, following the run-down and dismantling of the pre-existing UK local, proven, secure public health system for handling epidemics, which had functioned perfectly well: but this was a public service which did not fit the pre-determined neoliberal, free-market privatisation ideology of Conservative British Governments sufficiently well; and in Downing Street, ideology comes before effectiveness.The financial crash in 2007-8 provided both the perfect storm and with the fog of multiple consequences that flowed from a banking system on the edge of collapse, provided for Conservative ideologues the perfect cover for a comprehensive neoliberal attack on well-run, taken-for-granted, vital public services like ‘public health’; conveniently allowing a new hardline, neoliberal Conservative government to distort the nature of the problem and use the thoroughly bad excuse of austerity to destroy the established, robust, local UK public health system, and with that blow strike down a large part of Britain’s front-line capacity to fight any future pandemic.
Operation Cygnus, a Government desk exercise conducted in 2016 to check the robustness of the public health system should a serious pandemic arise, demonstrated the scale of the policy blunder the Conservative Government had committed, and the inability of the system and resources now available to cope with the failure; the huge gap in resources and readiness that ruthless austerity had left. Dismantling the structural system of public health and running down almost £1Bn of stocks of equipment and disposables that had been stored and accumulated by 2010 specifically for an expected pandemic, was by 2016 proven to be disastrous in its implications. It made no difference. Ideology comes first. The Conservative Government responded by shuffling paper and doing precisely nothing of substance to fix the problem. The rest is history; we are all living with the consequences, and people are dying.
The failure to maintain the established public health system and the near £1Bn stock of supplies (including PPE) and to allow the emergency stocks to decay, while simultaneously dismantling the local public health structure will prove one of the most damning indictments of modern Conservative Governments’ abject failure to protect the security of the state, and the health and well-being of its citizens. This disastrous policy was executed over ten years, 2010-20 to protect the ideologically driven principle of austerity, to shore up public faith in the discreditable dogma of neoliberal ideology, already so ruthlessly exposed for its superficial, laissez-faire inadequacy by the banking collapse of 2007-8. Extraordinarily, the Conservative Government response from 2010 was to compound the folly; adopting mindlessly the neoliberal solution of austerity to counteract its own intellectual failure, which inevitably led to the disarming and dismantling of the established public health resource. The solutions of Conservative Government sponsored neoliberalism in the wake of the Crash not only failed the test of securing public health’s vital interests, but simultaneously failed to deliver its own promise to eliminate the deficit, or to have any effect at all on reducing the national debt; which actually doubled in any case, as was an inevitable consequence of the financial crash, even before the coronavirus crisis finally demonstrated the hollowness of neoliberalism: and austerity even failed in its economic purpose, to re-boot the economy, which stagnated; with austerity causing serious hardship to large numbers of people who played no part in causing the disaster.
In the event COVID-19 has already demonstrated through QE and Furlough, that deficit elimination and national debt reduction have now been jettisoned wholesale as even a remotely achievable objective in probably anyone’s lifetime (even if that objective was worthwhile), save as a disingenuous rhetorical flourish beloved of Conservative ministers; in order that the Government can provide the necessary resources to fight the pandemic, while eccentrically maintaining the virtue of neoliberal orthodoxy: but the surrender to the need for public spending even now manages only to be fumbled; the policy is far too late, and is now not enough. We are now intent on spending just enough to fail badly. The Government cannot even make up its mind, without still struggling with its own neoliberal ideology, by attempting to resist the proposition that spending should be for everyone in Britain, applied universally throughout the UK, and should not serve solely the Government’s first instinct – to meet the financial needs of South East England. It is as bad as that.
The BMJ has provided its own critical analysis of the disastrous reforms undertaken by the Conservative Government after the Crash to ‘modernise’ (privatise) the Public Health structure, from which this extract provides more than the tone: “Membership of SAGE and its national committees reflects England’s marginalised public health infrastructure. Reorganisation of public health in England, largely resulting from the Health and Social Care Act 2012, led to a critical loss of senior posts and staff. The Health Protection Agency, regional public health teams, and regional public health observatories were abolished, and the remnants incorporated into a slimmed down Department of Health agency, Public Health England. This new agency lacks an independent voice and clear public health leadership. England’s chief medical officer is no longer seen as the leader of public health. With these reforms, England’s new public health system was born critically flawed.” Ironically the Government now appears to have formed similar negative conclusions about its own creation, Public Health England; but with the obtuseness reserved it seems solely for neoliberal Conservatives, a conclusion reached for all the wrong reasons. Ideological dogma requires that only a private sector, outsourcing solution can be countenanced. Evidence of private sector, outsourcing failure simply does not count. The head of the failing Test and Trace operation, Baroness Harding has been appointed Head of the new National Institute for Health Protection, merging it seamlessly with Public Health England.
Sir David King (a past Chief Scientific Officer to Government) is now leading an ‘Independent SAGE’ which provides a clear critical challenge to Government policy, representing authoritative medical and scientific opinion on the British Government’s strategy for coronavirus. King regularly rehearses the virtues of the traditional, established, local British Public Health system and its proven protocols. He is also clear in his public statements on the failure of the Test and Trace system. The World Healthcare Journal, 16th October, 2020 provides an article, ‘Independent SAGE calls for an immediate circuit breaker’, within which King’s opinion of Test and Trace is quoted: “Independent SAGE has called for an ‘immediate national circuit breaker’ to halt the spread of Covid-19 as the Government’s three-tier system of restrictions is not enough to reverse growth. The panel of expert scientists, chaired by former chief scientific adviser Sir David King, set out a ‘six-week emergency plan’ to bring infection rates below 5,000 a day. At a live-streamed briefing, Independent SAGE outlined its blueprint for an ‘urgent reform’ of the failing test and trace system, which Sir David King described as ‘a national scandal’”. Notice the 20th October date of the article and the typical delay by Government before signalling the U-turn in policy to approve a full lockdown in England (announced on Saturday, 31st October, and even then only because the news was already leaked); too late, every single time. At the same time public health opinion earlier in October had generally been insistent on further action, the PM in Parliament was dismissing in exaggerated, hostile terms proposals put by Sir Keir Starmer, effectively promoting the same policy Boris Johnson would have the brass-neck to adopt only a few days later.
The dismantling of a proven public health structure led by local Public Health operations led to their general replacement by a proposed root-and-branch privatisation, with contracts to be given to companies which do not appear to have required to be public health specialists or possess established experience of test and trace, or of viral epidemics. The Government’s new, outsource sponsoring, quasi-privatised Test and Trace operation falls under the leadership of a management consultant with no apparent background in Public Health or medicine at all: Baroness Dido Harding. George Monbiot, Guardian, 21st October, 2020 has reported on the public health credentials of Test and Trace Senior Management in “The government’s secretive Covid contracts are heaping misery on Britain”, drawn, inter alia from information provided in the Health Service Journal: “Like so much surrounding this pandemic, the identity of Harding’s team at NHS track and trace was withheld from the public, until it was leaked to the Health Service Journal last month. Clinicians were astonished to discover that there is only one public health expert on its executive committee. There is space, however, for a former executive from Jaguar Land Rover, a senior manager from Travelex and an executive from Waitrose. Harding’s adviser at the agency is Alex Birtles, who, like her, previously worked for TalkTalk. She has subsequently made a further appointment to the board: Mike Coupe, an executive at another of her old firms, Sainsbury’s”.
Within Test and Trace, Contracts have been outsourced to private sector businesses like Serco, Sitel, G4S and others. For illustration, Serco’s Annual Accounts for 2018; chosen here because they are pre-pandemic and could be expected to reflect the knowledge, expertise and experience of public health that the operation actually possessed before 2019, provided this opening mission statement:
“Serco Group plc is a leading provider of public services. Our purpose is to be a trusted partner of governments, delivering superb services that transform outcomes and make a positive difference to our fellow citizens.
We gain scale, expertise and diversification by operating internationally across five sectors and four geographies: Defence, Justice & Immigration, Transport, Health and Citizen Services, delivered in the UK, Europe, North America, Asia Pacific and the Middle East.”
In the UK Serco notably paid £30m for healthcare contracts of Carillion, which recently collapsed; contracts which appear to have been for ‘facilities management’ for certain NHS hospitals. In the Serco Accounts reference is made to Government outsourcing of public services: “In last year’s Annual Report, we proposed ‘Four Principles’ for the governance of public sector outsourcing. Shortly after, the UK Government established a process to review the way it interacts with private service providers. This has been a very constructive process, run by the Cabinet Office and involving the supply side as well. Our Four Principles have provided, we believe, an important contribution to the development of policy, as well as playing a part in moderating the tone of public debate and establishing Serco as a thoughtful contributor to the debate including appearing multiple times in front of Parliamentary Committees”. I could not find a single reference in the 2018 Serco Accounts, to the term ‘Public Health’.
Sitel is a large US based corporation known, inter alia for providing call centre services. In its Group website it provides this description of what it does: “Simply put, we are people helping people – one experience at a time. We provide solutions to our clients’ customers via phone, chat, email and social media. As a global CX leader, we deliver 3.5 million unique experiences every day for 400+ clients through business process outsourcing (BPO), digital CX, training and talent management and CX consulting and analytics.” ‘CX’ generically, appears to mean ‘customer experience’. The Sitel UK website provides this description of what it offers in ‘Healthcare Customer Experience’: “The digital innovations which have revolutionized everything from banking to retail are now pulsing through the industry, bringing the promise of closer, clinical customer relationships, operational efficiencies and the insights needed to create new products and services.
However, many organisations must first overcome a number of challenges. Legacy systems and outdated processes are hindering the flow and analysis of data. This, in turn, makes it more complex to spot and react to trends, mitigate risk, automate and streamline processes, or identify the optimum areas for investment. Likewise, incomplete or stretched channel strategies mean companies are struggling to make a connection with their customers that aligns with their expectations – whether it’s providing comprehensive technical support for medical device users or personalized health insurance coverage that genuinely reflects a customer’s needs and their shared data. From frontline customer experience management to back office support, with Sitel Group’s help, you’ll be able to eradicate these barriers to innovation and seize available opportunities that technological, market and consumer changes are bringing to the industry.” I confess I find I am in some difficulty perceiving the contact of a person who tests positive of COVID-19, as a “customer”.
The BMA website provides this report, dated 11th September, 2020 titled: “Outsourced and undermined: the COVID-19 windfall for private providers”. The article refers to a range of private sector providers but identifies Serco and Sitel as providers in these terms: “The procurement of logistical and IT support for the test and trace strategy has been a hugely problematic area – with serious issues involving the use of the private sector, too. Serco and Sitel were awarded contracts valued at £108m to support the Government’s test and trace strategy – recruiting 25,000 contact tracers to work in remote call centres”.
Both Serco and Sitel have contracts with Test ant Trace; reviewed by Open Democracy, 11th August, 2020 in an article titled “Serco and Sitel to get more public money despite track-and-trace fiasco”. The report comments on the low level of contact tracing achieved: “The two outsourcing giants were contracted without public competition for an initial three months’ service from late May, with the contract being awarded just three days before it was due to start. Their operation has run into heavy criticism as it has been found to be contacting less than half of the contacts of people testing positive in recent weeks, and costing over £900 for each person traced.”.
The BMA has produced a paper that issues a challenging set of recommendations for the use of outsourcing public health to private contractors, which the BMA encapsulate in these bullet points:
“– A publicly funded, publicly provided and publicly accountable NHS
– The role of private outsourcing in England to be scrutinised in any future public inquiry on the UK government’s handling of the Covid crisis
– A substantial increase in funding for the NHS and local public health departments
– Transparency of private contractual agreements
– A more robust governance system under NHS control that has oversight of management and coordination of procurement.”
The privatised Test and Trace system has been handed a £12Bn budget, and it has failed to do the job to the level of effectiveness required. Chris Giles, FT 15th October, 2020 describes the investment in these terms: “The problem has been that the money was not spent well. Test and trace has been mired in crises since birth. This autumn, it has failed to deliver sufficient tests, been slow in informing people they have tested positive and allowed a spreadsheet error to miss almost 16,000 positive cases. Trust has evaporated to the extent that the UK’s scientific advisory group has assessed it was having at best a ‘marginal impact’ on transmission of the virus. There is a strong case to go further and say the £12bn has so far had a negative rate of return. By allowing people to believe the nation had built a world-class system, social distancing slipped, the virus spread and the country is again thinking about local or national lockdowns, with inevitable severe economic costs.”.
In a pandemic, failure of Test and Trace is not an option; but it is where we are. Appeals by apologists of an outsourced, privatised Test and Trace system will ‘come good’ if enough money is spent and enough time is served on the expensive education of the private sector in public health, cuts no ice. The virus is not offering to wait at Baroness Harding’s convenience. This is a pandemic, not a schoolroom; and JM Keynes venerable maxim has particular resonance here; ‘in the long term we are all dead’.
It is already forgotten that substantial sums were spent on developing an ambitious and complex initial Tracing App (world-beating in the favoured term of the privatisers) that would be the key operational tool for Test and Trace; a proposal that had not been the highest priority for investment in the conventional, well established policy channels of Public Health institutions, for pandemics; and the App, trialled on the Isle of Wight, simply failed the test. Much simpler but effective functional Apps have been developed with few fanfares and more success and almost certainly at a fraction of the cost, for example in Northern Ireland and Scotland. At the same time, The Times, 1st November, 2020 reported in ‘Software bungle meant NHS Covid app failed to warn users to self-isolate’ as follows: “The world-beating’ NHS Covid app, downloaded by 19 million people, has systematically failed to send alerts telling people to self-isolate after they came into contact with infected people.
Thousands were not contacted by the Test and Trace app, developed under Baroness (Dido) Harding, because it was set at the wrong sensitivity, the government has admitted.
For a month, the Department of Health and Social Care failed to use software developed to make the app work properly. Users whose ‘risk score’ should have triggered an alert were not contacted. As a result, a government source said, ‘shockingly low’ numbers of users had been sent warnings since the app was released on September 24”.
Eventually it has effectively, if reluctantly been conceded by the British Government that traditional procedures had been developed in their long-established local form in public health circles for good reason; test and trace required to be carried out principally using traditional labour-intensive methods. It is well established that these methods work best when command and control, management and execution are carried out by devolved, local and experienced, professionally led public health operations. Nevertheless, in an extraordinary decision; it appears overwhelmed by the extravagant hubris of neoliberal dogma (for it defies rational analysis), the British Government therefore deduced that instead of following proven precedent, this was the perfect time to establish a completely new, centralised, national, privatising-outsource driven Test and Trace institution, to be set up from scratch, in the middle of a pandemic crisis, without either showing or claiming evidential precedents for the success of such a cavalier and ostentatious gamble with the health of the nation. This is a definition of abject executive misjudgement. Clearly this solution could not do the job alone, even taken at it its own valuation. The Government effectively acknowledged the flaw in the centralised service in May, when it announced additional resources for local authorities: “Local authorities will be central to supporting the new test and trace service across England, with the government providing a new funding package of £300 million.”  (22nd May, 2020: GOV.UK Website Coronavirus (COVID-19)). This represents a mere 2.5% of the £12Bn financial Budget for coronavirus; if indeed the £300m was paid from this budget. The disparity between the financing and resourcing of the established, local, proven, professional public health provision, and the gold-plated private sector ‘punt’ led by Harding is stark. George Monbiot (Op. cit.) provides a critical summary: “The ‘world-beating’ test-and-trace system [Harding] oversees has repeatedly failed to reach its targets. Staff were scarcely trained. Patients have been directed to nonexistent testing centres, or to the other end of the country. A vast tranche of test results was lost. Thousands of people, including NHS staff, have been left in limbo, unable to work because they can’t get tests or the results of tests.” Monbiot provides sources for each point he makes.
It is critical in Test and Trace that the contacts are traced; a high percentage of contacts must be reached for the system to produce effective results. In Scotland a substantial local Public Health system survived the quasi-privatisation through the simple contingency of devolution; ‘Test and Protect’ thus provides a significant, and reliable part of the test and tracing system in Scotland. In England the Guardian, 11th October, 2020; “Plans to hand contact tracing to England’s local authorities ‘too late’”, reports on the contrast between the national, outsourced Test and Trace performance, and examples where a local system still operates: “The Local Government Association says local contact tracing systems have a 97% success rate at finding close contacts and advising them to self-isolate. The latest figure for reaching contacts within 24 hours of them being identified by NHS test and trace is 67%.”  Already the Government is recalibrating a U-turn, as it tries to incorporate a new dependence on local systems (without too many people noticing), while still propping up its neoliberal Test and Trace gaff. As with everything else possessing the leaden-touch of this Government; it is too little, too late. This is Britain in the time of Covid; the private sector contracts and outsourcing will no doubt go on. This has nothing to do with results, effects, consequences or evidence; this is far more important – this is Conservative ideology; Free markets and the private sector matter most, and will not be subject to any test. Meanwhile, the effectiveness of the test and trace system itself is less important than the ideology, even if the real value the system provides in results sinks, without a trace.

Comments (22)

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  1. Dougie Blackwood says:

    A fair description of a corrupt and venal government whose incompetence is exceeded only by it’s arrogant and patronising exaggeration of it’s own worth. Where are these criticisms in our investigative Main Stream Media? I saw a hint of criticism of the government from the BBC’s sycophant in chief, Laura Kuenssberg, today but there is nowhere the public outcry that is long overdue.

  2. Donald McGregor says:

    Thanks for all of that exhaustive (exhausting?) investigative info.
    I am an old child of the interweb tho but and can’t digest all of that in one sitting. An executive summary would be a fantastic addition.

    1. Anndrais mac Chaluim says:

      Here’s the substance of John’s argument:

      In response to the current public health emergency, we need to rely on the expertise of public health professionals.

      The UK government has chosen to rely instead on the expertise of private service providers.

      This decision accounts for the failure of the UK’s response to the current public health emergency.

      The problem is that, as a result of 40 years of neoliberal reform, our public health services no longer have the capacity to respond effectively to the current crisis.

      Ergo, we’re fucked.

    2. John S Warren says:

      Candidly I do not possess the time to do any more, nor the time to respond ‘below the line’; I have in the past tried diligently to do so, but have too often wasted a great deal of effort on trolls and disingenuous time-wasters. I do not for a moment place your request in that category, but must ask you to understand that there are limits to what I can do. I also believe that it is incumbent on members of a free, democratic society and who wish to preserve its values, that they too must expend some effort if they wish to protect it. In the first place may I suggest you simply follow some of the sources I have identified. In particular the George Monbiot article is both easy to find online, and is rich in easily followed sources.

      To answer your specific request I have extracted from my article a statement that I offer here as a hasty abstract or summary. It will have to do.

      “Attention is now being directed by the British Government almost anywhere other than on the new UK Test and Trace system which it chose to set-up, by attempting to apply inappropriate private sector, ‘market’ solutions to a complex, specialised public health problem, and to do so vexatiously, in the middle of a national crisis; which has led the Conservative Government to fail to protect the security and well-being of its people. The British Government has insisted doggedly on persevering with a private sector solution that is a costly failure and is unable to provide sufficient evidence that it works, long after it has demonstrably failed. We are now fated to require to make the best of a bad job; one that was never going to work.”

  3. Sue Robertson says:

    It’s a pity this article does not address the extent to which Scotland bought into the privatised contracts and to what extent we had a choice. I heard that university labs in Scotland offered early testing facilities but the Scottish Government showed no interest. It has been unclear all along how different Scotland really is.

  4. Wul says:

    The original App could, I am sure, have been created at almost no cost. Government could have asked computer developers, using open source code and working for free, to create a working tool. Many advances in science have already been created by volunteers working in this way.

    This would never do though. Only “Special”, “World-Beating”, “Big Business” can help us in times of crisis.

    1. Anndrais mac Chaluim says:

      Sorry, but why should people work for the government for free?

      1. Gordon McAdam says:

        Nobody said they SHOULD. It was suggested that the govt could “ask”. You might be surprised that some people actually do voluntary work.

        1. Anndrais mac Chaluim says:

          Aye, I know; I worked in the voluntary sector nearly all my working life. It used to do my head in, the extent to which the public sector sought to exploit volunteers as a source of cheap labour.

          1. Wul says:

            I’m not saying developers should work for free. Just that they probably would have responded willingly to the public health emergency. Even at a fewf hundred quid an hour, I’m sure the open-source development of a working app could have been achieved for a tiny fraction of what was “spaffed” by Boris.

            My real point was the app development did not have to be so expensive. It could have been produced very efficiently by developers and public health professionals working openly and collaboratively.

          2. Anndrais mac Chaluim says:

            Sorry, Wul; my mistake. I thought, when you wrote ‘Government could have asked computer developers, using open source code and working for free’, you meant… well, working for free.

            By the way, as I pointed out elsewhere, Protect Scotland’s tracing app has been developed by a private company in the Republic of Ireland, in partnership with Amazon Web Services, using tools provided by Google and Apple, and open-source software offered through the Linux Foundation. Of course, the bummer is that we had to pay them…

    2. SleepingDog says:

      @Wul, yes, and it could easily be an international collaboration, with distributed volunteer testing. Indeed there have been such projects, but I have not researched them and I have seen little corporate media coverage of them.

  5. SleepingDog says:

    If we had proper treason laws in the UK, the government would be up on charge, given the primary obligation to protect (if we had a properly codified constitution that spelt that duty out).

    Was going to query the characterization of the ‘ingenuity’ of the virus, but on second thoughts that does seem technically correct.

    So why do we not have open, public emergency planning, testing and drilling in the UK? The article goes a long way to explain this. There is little profit it in (if done by state and populace rather than consultants). The highly-centralised trend reduces the mandate of local government, and removes more activities outside its powers (mandamus and ultra vires). Thinking about bad things might spook ‘market confidence’ or whatever. Commercial confidentiality in government contracts is effectively the smothering spread of official secrecy to cloak world-beating incompetence and vice. But another significant aspect is, if we did have pandemic planning and climate change planning, these would call unwanted attention to unsustainable policies. And furthermore, people might ask why we don’t have nuclear war planning, and then we would be back in War Game territory and people thinking about why our governments are terrorizing us all with nuclear weapons, and how convenient these are for taking foreign (and some domestic) policy out of the democratic sphere of interest. So nuclear weapons can be deadly without even being launched.

    1. Anndrais mac Chaluim says:

      “Was going to query the characterization of the ‘ingenuity’ of the virus, but on second thoughts that does seem technically correct.”

      You think?

      I find that characterisation anthropomorphic.

    2. Anndrais mac Chaluim says:

      ‘So why do we not have open, public emergency planning, testing and drilling in the UK?’

      We do. When I worked for the British Red Cross, I served on the multi-agency emergency planning committees for five different local authorities and three different health boards. We identified and assessed local public health risks, made recommendations to government for the mitigation of those risks, planned joint emergency response to potential crises, and exercised those plans. Those risk assessments, emergency response plans, and performance evaluations were all in the public domain and open to public scrutiny.

  6. John S Warren says:

    It is relevant to note here that Sky News has reported this morning (Thursday, 5th November) as follows:

    “Just 59.9% of close contacts of people who tested positive for coronavirus were reached by NHS Test and Trace in the week ending 28 October, figures show. This is the second-lowest weekly percentage for the scheme so far – down from 60.6% in the seven days to 21 October. Meanwhile, coronavirus cases in England are up 8% on the previous week.”

    1. Anndrais mac Chaluim says:

      Aye, a paper submitted to and endorsed by SAGE described the test, trace, and isolate system as (of 21 September), ‘having a marginal impact on transmission at the moment’, owing to relatively low levels of engagement with the system, testing delays, and poor rates of adherence with self-isolation.

      At the same time, the Our World in Data research team from the University of Oxford says that (as of 14 September), at 2.76 tests per 1,000 people, the UK rate was ahead of most countries in the world, including the major European countries.

      We really need to make more of an effort to get tested when we experience symptoms and to adhere to public hygiene guidance when we test positive. And, of course, the labs, too, need to up their game to get the test results out in a more timely manner.

  7. John S Warren says:

    Sir John Oldham, who has direct experience of operating at a senior level in the Department of Health, has a medical background, is a non-executive director of the Care Quality Commission and currently is Adjunct Professor at the Institute of Global Health at Imperial College, has made a public statement on the UK Test and Trace System, on BBC Radio 4, ‘Today’. He provides confirmation of arguments I have made in the above article, especially on the critical failure of the UK centralised Test and Trace System, specifically on its failure as an outsourced service, compared with the performance of traditional, local public health services. I provide an extract as an addendum to my article. He argues that public trust in test and trace requires radical reform to be undertaken:

    “I’d probably get the resources for that by scrapping the failing central call centres. I think the whole system should be under the purview of public health, which gets us as close to the effective system we had before 2012 NHS reforms. I think they have demonstrated that they have the capability and effectiveness – they are running at 95% contact tracing; the national call centre is at 60%.”

    1. Anndrais mac Chaluim says:

      Yes, I remember Sir John writing in Wilmington Healthcare’s Health Service Journal (HSJ) For Healthcare Leaders back in the Spring.

      In his article, he was critical of a) the strategy of seeking a single solution across every area of the country, advocating an approach that would be more nuanced for the different points on the curve of each healthcare region and b) the creation of megahubs so that testing could be controlled centrally, by the NHS’s political bureaucracy, advocating a more agile project management approach.

      The nationalised model of a centrally controlled single testing regime would produce, he argued, inefficiencies not only in mass testing but also in subsequent identification, contact tracing and relevant quarantine.

      In the same article, he further argued that such a strategy as he was advocating requires leadership that has different skills from those possessed by public health professionals, who currently dominate decision-making.

      He wrote:

      “It needs a dedicated multi-skilled task force led by a person who understands supply chain formation, project management, swift and pragmatic decision making.

      “Such a leader would naturally corral [sic] the knowledge in the wider country that could be used. People are around in senior roles who have these skills, such as Andy Street (former managing director of John Lewis and now Mayor of the West Midlands) or Michael Barber (founder of Tony Blair’s delivery unit). We need them yesterday — for tomorrow.”

      Not exactly politically correct from an NHS point of view, but he does seem to support what I’ve suspected all along: that the current pandemic shows that we need more democratic governance of – and more pluralism within – our public health system(s).

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