Unless we pass laws which support people to enable them to self-isolate properly, any improvements to test & trace will have marginal impact and cases will simply spiral out of control once again as we ease lockdown in December.

A short thread on what we can do and why
1/

Improving the currently poor rates of self-isolation is actually the key point, which many scientists, politicians, & commentators do still seem to be missing.

This requires good public health communication, proper support for those who need to self-isolate, & trust.
2/

Massive testing and tracing will only significantly reduce
transmission if positive cases isolate effectively. Yet
currently fewer than 20% of those who should isolate
are fully adherent.

I don't think I need to explain why it's so critical to improve these rates.

3/

Survey data shows intention to adhere to test/trace/isolate behaviours is higher than self-reported adherence: whilst 76% of people intend to share contacts, only 50% of people correctly recognise symptoms &
just 12% get a test, 18% isolate, & 11% of contacts isolate properly.
4

Self-reported ability to self-isolate
is three times lower in those who earn less than £20,000 per year or have less than £100 saved.

5/

The UK has one of the lowest proportions of pay
covered by statutory sick pay in Europe (29% compared to 100% in Germany), and millions do not qualify.

6/

An OECD review
showed paid sick leave is important well beyond its
core function to protect sick workers during a health
pandemic and subsequent economic crisis.

7/

SAGE and iSAGE agree that
individuals need to be supported properly for them to
isolate, advising a daily text or phone call, with provision of food supplies, essential goods and employment
protection, stressing solidarity and togetherness.

8/

In Senegal (& China & elsewhere), they offer isolated accommodation to anyone who needs it. https://twitter.com/ScienceShared/status/1268578015086358528?s=20
We could do this too (hotels), & it would go a long way to preventing spread within multigenerational households, where transmission often occurs.
9/

It is *over three months* since the ONS found that a lack of proper sick pay was highly correlated with care home outbreaks and *over three months later* we have still done absolutely nothing about this in England. https://twitter.com/danielhowdon/status/1278975372621762560

In the most vulnerable of settings.

10/

https://twitter.com/lewis_goodall/status/1322153186002718723?s=19
Wales has acted to change this in care homes, when will England? And when will we then follow SAGE, iSAGE and OECD advice and apply that across the board to improve self - isolation rates and therefore reduce rates of community transmission?

11/

Existing test-and-trace policies have deviated from
advice provided by SAGE and, without improving basic public health communication and giving support to self-isolate, any
improvements to the test-and-trace system will have
only marginal impact.

END
https://journals.sagepub.com/doi/10.1177/0141076820965533