Tuesday, March 24, 2020

The UK's boneheaded refusal to accept the World Health Organization's central recommendation on testing and contact tracing remains the missing piece of the jigsaw

First of all, credit where it's due - the government have moved much further than seemed conceivable a few short days ago when they were still talking openly about the desirability of sitting back and allowing 60%+ of the population to be infected.  What's been announced is really lockdown-lite, though, and experience from countries like Italy and France strongly suggests that people will exploit the weaknesses in the rules, and that even more stringent measures will then have to be brought in to achieve the intended effect.  You're still likely to see large numbers of people out and about in the morning as if the lockdown hasn't happened, and if challenged by the police they'll just claim they're out on their permitted 'one daily period of exercise'.  We'll just have to see if Boris Johnson is determined enough to close the loopholes in the way that will almost certainly prove necessary.

But an even bigger issue is the glaring contradiction between the government's actions and their words.  The Imperial College paper which proved such a turning point made crystal-clear that 'mitigation' (ie. an enormous managed epidemic) was no longer a viable strategy, and that 'suppression' would have to be attempted instead - ie. keeping the number of cases as low as possible by means of drastic social distancing measures, and then holding on for a vaccine.  The actions the government have taken over recent days are consistent with a suppression strategy, and yet their language remains that of mitigation.  Although Boris Johnson didn't specifically use the phrases "lower the peak" and "flatten the curve" in his TV address, he did use words that appeared to have a very similar meaning.  And as for the Blighty Knows Best duo of Vallance and Whitty, they've carried on talking without reservation about a mitigation strategy as if nothing has changed at all, while insisting that they're aiming for no more than 20,000 deaths - something that the Imperial paper adamantly stated would only be possible with a suppression strategy.  It really doesn't make any sense.

The obvious way out of this mess would be for the government and their advisers to drop their superiority complex and actually start listening to the World Health Organization's central recommendation of mass testing and contact tracing, which has proved so decisive in turning the tide on the epidemic in both China and South Korea.   Incredibly, this New Scientist piece reveals that the scientific advice the government has been receiving in recent weeks has completely ignored the whole concept of test-and-trace.  Not rubbished it, not advanced reasons for why it might not work, but simply ignored it.  The arrogance of taking it as read that the central recommendation of the relevant international body isn't even worthy of discussion is just breathtaking.

Instead the government apparently intend to eventually ramp up testing but without contact tracing, which makes no sense at all.  It seems the main purpose of the testing will be to attempt to prove Whitty's pet theory about there being a very large hidden number of asymptomatic cases out there, and if that happens to get those people back to work - ie. the 'solution' the government have in mind still appears to be a solution for the economy, not for people's health.  But let's hope a bit of common sense creeps in at that point.  Even if there isn't the manpower for proper contact tracing, it's not beyond the wit of man to find ways in which the public could do some of the work themselves.  If someone tests positive during the mass testing, they could be urged to have a friend or relative ring round their close contacts and suggest that those people should be tested as well.  In that way, the chains of transmission might gradually start to be broken.

Oh, and let's knock on the head Whitty's repeated 'truthy' claim that there's no point in any country trying to suppress an epidemic that is almost everywhere in the world.  The virus does not fly across oceans on its own propulsion - if it's successfully pushed back in the UK it could then be kept at bay with suitable quarantining arrangements until a vaccine arrives.  It's just a question of whether the will is there to actually get on top of this thing as the South Koreans and Chinese have done, or whether the government are still hankering after the impossible goal of 'managing' a mass epidemic with a mortality rate that Scotland's Chief Medical Officer now estimates to be 1.4% - much, much higher than Whitty 'confidently' predicted a couple of weeks ago on the basis of his dud modelling.

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For anyone who wants to know more about the crucial role that contact tracing played in stemming the Chinese epidemic, let me once again recommend this excellent interview with the WHO's Bruce Aylward.


  1. It seems that there is still a disturbing ambiguity about what the government is up to.

    And the mainstream media is not properly questioning or reporting it.

  2. Some have said the SC should do this. Can the SG do Test and Trace independently?

  3. Some Icelandic info re testing:


    "The first results of the 1800 voluntary tests on people with no symptoms, which started last Friday produced 19 positive cases, or about 1% of the sample....about half of those who tested positive are non-symptomatic,” said Guðnason. “The other half displays very moderate cold-like symptoms.""

  4. Enough manpower for contact tracing does not seem outside the bounds of possibilty. if someone is tested and found to have the virus, they can get a phone call that (a) advises them on what to do, and (b) elicits names, venues and phone numbers of those who they may have infected. The call centre then contacts the individuals on that list with advice on what to do. The technology for call centres and training systems, are well understood. There are probably actual commercial call centre with spare capacity at the moment, due to the business downturn,

    A self-organised system, as suggested by James, would also be worthwhile, but would not be able to identify trends or clusters in communities.

  5. Scotland continuing to test at 1.3-1.4 times the rate of the UK.

    Deaths per capita in Scotland climbing at a notably slower rate.

    I don't know the reasons for this, but things looking a bit better this side of the border.

  6. England is understaffed in all front line services and the people are refusing to adhere to the rules, they will die in multiples of thousands, the Met police have already admitted they haven't a chance of coping and that Boris Johnson is just doing a Trump like King Canute holding his hands up and telling the virus to go away because he told everybody in 12 weeks it would all be over so make it so

    England will descend into total chaos in three weeks time because they're not listening to the big daft clown shoe with scruffy hair and his shirt hanging out now that he's *got Brexit done* because now they're invincible, everybody sing, *there'll always be an England and blahblahblah free*

  7. Maybe when he takes that bloody pen out of his inside jacket pocket he will writ something down.... BUFFOON

  8. In New York people are queuing for up to 6 hours for a test and crowding all over each other as ambulances full of cases pass them by filled with patients who ignored the advice and went about in crowded areas

    Testing is dumb because people are dumb by thinking a test will mean they don't have it so won't get it

    False sense of security by the WHO for a PR exercise and just a dumb idea

  9. No,it is you that is dumb to come to such a stupid conclusion. The WHO do not recommend queuing up like that increasing risk of infection and then getting tested. It is Johnston and Trump going through a PR exercise. They are wanting to give conflicting advice so they can blame the public on their ludicrous herd immunity theory.

  10. Prince Charlzzz has contracted CV ..

    1. How come he got to the front of the queue for NHS testing? He doesn't seem to fit the qualifying criteria.

    2. Apparently he and his staff have traveled to his holiday home in the highlands.

  11. Sturgeon needs to get her finger oot and close the border..

    The people of Scotland need proper protection!!

  12. That would be great move forward. But does she have the power to do that?

  13. https://www.bbc.co.uk/news/uk-scotland-52036314

    Coronavirus: Scotland to set up its own expert group

    The Scottish government is setting up its own expert group to advise on tackling the spread of coronavirus.

    First Minister Nicola Sturgeon said the team would "supplement" advice from the UK-wide Scientific Advisory Group for Emergencies (Sage).

    1. Chief Medical Officer Catherine Calderwood suggested that the move could ultimately see Scotland pursue different policies to the rest of the UK.

      "The advice about suppressive measures has been all over the UK, because that's what we need to stop the transmission of the virus," she said.

      "But in time we will want to apply our own Scottish data to some of these advisory measures.

      "Perhaps it will not be appropriate to have all of the suppression measures in all of the country as we progress through the transmission of this disease and as we see how the capacity of our NHS is holding up."

    2. Oh for pity's sake, that's the last thing we need - LESS suppression than the rest of the UK. Before we know it Jason Leitch will be urging us to go to rugby matches again.

    3. Reuters 26 March: Spahn said Germany had conducted between 300,000 and 500,000 tests for the virus in the last week.

  14. The facility to register as vulnerable person in order to receive priority with grocery delivery does not exist in Scotland. Surely SG could do something about that? It's only a database behind a web site.

  15. This will get a few scenes in the coronavirus movies. Just fantastic.

    >More than 400,000 volunteers signed up in just 24 hours to support the NHS in helping vulnerable people who have been told not to leave their homes during the coronavirus crisis, writes my colleague Simon Murphy.

    >Four people per second enlisted in the government’s new volunteering scheme in the hours after the health secretary, Matt Hancock, launched a call on Tuesday for 250,000 people in England to help bolster the NHS’s response to the Covid-19 pandemic.

    >Overnight, the number of volunteers who had pledged support topped 170,000 but as the day went on the target was smashed. “That is already, in one day, as many people as the population of Coventry,” said Boris Johnson in the daily Downing Street press conference, as he provided the new figure of 405,000.

    >He thanked those who had signed up to help. “They will be absolutely crucial in the fight against this virus,” he said.

    >The overwhelming response has prompted the NHS to extend its target to recruit 750,000 volunteers in total. Those volunteers who have already signed up will start next week.