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This afternoon, @CommonsPAC takes on Test and Trace.
This follows the @NAOorguk report in Dec and provides another layer of analysis that will feed into any future look back exercise into the gov's COVID-19 response.
However, it's also important to look forward.
https://twitter.com/CommonsPAC/status/1351107953466728448
This follows the @NAOorguk report in Dec and provides another layer of analysis that will feed into any future look back exercise into the gov's COVID-19 response.
However, it's also important to look forward.
https://twitter.com/CommonsPAC/status/1351107953466728448
We've repeatedly looked into T&T at the @HealthFdn, starting in Sept where we took an in depth look where T&T had got to and how it got there - the journey so far. https://www.health.org.uk/publications/long-reads/nhs-test-and-trace-the-journey-so-far
Then in early Dec we published a short analysis @TheLancet, asking the question, is T&T exacerbating inequalities?
In it, we highlight that cases and contacts living in more deprived areas are less likely to be reached by T&T call handlers. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32593-9/fulltext
In it, we highlight that cases and contacts living in more deprived areas are less likely to be reached by T&T call handlers. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32593-9/fulltext
Finally, our performance tracker takes a regular look at how the system's working. https://www.health.org.uk/news-and-comment/charts-and-infographics/nhs-test-and-trace-performance-tracker
In all these, we make the points that T&T needs to do all it can to avoid widening the inequalities that have been exacerbated by COVID-19, and that reaching people is very different to people actually isolating. https://www.gov.uk/government/publications/covid-19-review-of-disparities-in-risks-and-outcomes
As the repeatedly quoted CORSAIR study shows, the proportion of cases fully complying with isolation may be just 1 in 5, and for contacts its even lower. https://www.medrxiv.org/content/10.1101/2020.09.15.20191957v1
The study also showed that people from more deprived areas were less likely to report complying with isolation - these are people more likely to be on low paid work/zero hours contracts, have caring responsibilities - essentially people who can't afford to take the time off.
The same logic applies for willingness to get tested, engage with contact tracing, and report contacts - people simply not being able to afford to take time off (as @deb_cohen @BBCNewsnight reported on all last week)
Therefore looking forward, it's really important that more support is given to people who are asked to isolate, eg
- expanding isolation payments
- proactive provision of essential items/food
- making available alternative accommodation for those unable to safely isolate at home.
- expanding isolation payments
- proactive provision of essential items/food
- making available alternative accommodation for those unable to safely isolate at home.
Essentially, people need to be able to isolate without fear of significant negative impact on their work, income, family, or caring responsibilities.
And whilst widespread asymptomatic community testing using rapid tests (lateral flow devices) is seen as one way out of the lockdown cycle, huge care needs to be taken to ensure that they don't exacerbate inequalities yet further.
LFDs should have a v important role in identifying otherwise unknown cases, but any complex individual level policy like asymptomatic testing (particularly if being offered to people to use at home) may likely exacerbate rather than narrow inequalities.
Therefore, any community testing rollout needs to be closely evaluated for impact on inequalities (e.g. by socioeconomic group, by ethnicity) so that differences in either use or impact are identified early and mitigated.
Local Directors of Public Health will also have an important role in supporting local people to benefit from rapid community testing, esp in deprived communities. Therefore, DsPH need to be involved from start and have resource to support effective and equitable roll-out. /end
