Leicester exposes the scandal of privatised testing failure

The chaotic return to lockdown in Leicester is exposing the scandal of privatised ' test and trace' failure that lies at the heart of the UK Government's failure to manage the Covid-19 crisis.

In a report today, the Financial Times has exposed that the lack of warning about the rising tide of infections in Leicester can be blamed on the fact that the results of the privatised 'Pillar 2' testing of the wider population are not being shared openly and quickly with local health authorities.

The 'Pillar 1' tests being reported in Leicester - those carried out in hospitals on people with a clinical need and health workers - seemed to suggest there was nothing to worry about. The FT explains that the city was thought to have had just 80 new positive tests for the fortnight up to 26 June. But then Matt Hancock announced there had actually been 944!

Taken from the FT via the Leicester Mercury 

Of course, the people of Leicester knew already that something wasn't right. Five schools in the city had closed due to coronavirus outbreaks. There had been further outbreaks at food processing sites like McVities and Samworth Brothers and other factories where it appears physical distancing was not being properly followed.

But, scandalously, the data wasn't there to prove it because still no proper "find, trace, test, isolate and support" system has been put in place - despite it being a necessity stressed by independent SAGE and other public health experts.

Hancock has also been forced to admit that, despite his Government's attempts to assure parents that it is safe to drive all children back to school in September, the testing results indicate that school aged children have been infected and are likely to have transmitted the virus too.

Of course, this isn't going to be just an issue in Leicester. The FT article also warns of similar peaks that are only being revealed through the  'Pillar 2' data in Yorkshire and the Humber and the East Midlands too.

But what the FT haven't stressed is the reason for this failure - because the blame lies with the capitalist profiteering that they defend. However, that conclusion has been spelt out in a damning article in the British Medical Journal.

In the report, Peter Roderick, Alison Macfarlane and Allyson Pollock spell out firstly how cuts have reduced the number of public health laboratories from over 60 to just 9. Even these are now operated through Public Health England operating as an agency, separate from the NHS. That separation of testing and reporting from local NHS Services is a key part of the reason why, unlike countries that have successfully tackled the Covid pandemic, 'test and trace' is still not functioning properly.

Instead of using and developing existing public health facilities, the Government chose to award contracts for the 'Pillar 2' testing (through home testing kits and drive-in centres) to commercial companies, and not even to ones with a proven track-record. The same disastrous approach has also been followed for contact tracing.

The Report explains that:

• As far as can be worked out, testers at regional sites are provided by Sodexo and Boots; some sites are operated by Deloitte. Serco, G4S, and Levy provide facilities management. Randox provides home testing kits, the logistics for which are provided by Amazon;
• Pillar 2 samples are analysed by the four new “lighthouse labs,” which involve AstraZeneca and GlaxoSmithKline, even though both state that “diagnostic testing is not part of either company’s core business";
• Randox analyses the samples from its home test kits, with a contract for £133m. This compares with the £86.9m provided to PHE for infectious disease, surveillance, and outbreak management in 2018-19. In all, 67,000 Randox tests are reported to have been sent to the US for analysis because of lack of capacity, but 29,500 results were found to be invalid and needed to be redone.
  

In the light of the news from Leicester, this conclusion is also particularly revealing:

• It is unclear what happens to many test results, in particular whether they are fed back to individual patients’ GPs. Several hundred thousand tests are reported not to have been linked to NHS records, missing confirmed cases. There is also no indication whether results are made available to staff doing local contract tracing. The chief medical officer for England is reported to have apologised to local authorities for not having detailed data from tests conducted by Deloitte. It is unclear whether PHE has timely access to test outcomes.

In short, the Leicester lockdown is exposing how privatisation, profiteering and the break-up of public services is to blame for the abysmal failure to address the Covid-19 epidemic.

To prevent more lives being lost, and more  livelihoods disrupted, trade unionists and local communities have to demand that testing and tracing is taken out of the hands of these failed profiteers and publicly run, locally integrated and democratically managed through the NHS and Local Authorities - taking into account the urgent actions recommended in the BMJ report:

Williamson's back to school plans - unsafe for public health and children's well-being

The Government’s plans for a full return to schools in September make crystal clear they have no interest in our safety or the genuine education needs of our children.

While the real dangers to public health are unfolding in Leicester, reports have been leaked which show that the Tories are gambling that children won’t spread infection in the classroom. But the scientific evidence still suggests children can transmit the virus to each other – and back to their families - even when they aren’t showing symptoms themselves. It will be those most at risk – particularly working-class and BAME communities – that again stand to lose the most.

Without an adequate test, track, trace system in place to really protect against outbreaks, schools have had to take what precautions they can to slow widespread transmission of the virus. Most have been operating with “bubbles” of the same children always being taught together. That way, if there is an infected pupil or staff member, the risk is hopefully restricted to that group and their contacts.

Up to now, those “bubbles” have been limited to a maximum of 15 children, but Education Secretary Gavin Williamson wants that increasing to a full primary class of 30 or more. In secondary schools, they propose teaching within full year groups of perhaps hundreds of students. Simple statistics shows that massively increases the risk of transmission. But there are to be no face coverings and no “physical distancing that would require extra space or make it impossible for all pupils to return full-time”.

The other steps Williamson is recommending just shows he has no idea about education. He wants children sat in rows, facing the front, mainly learning English and Maths. If students or parents object to this Dickensian world, schools will be expected to have a focus on ‘persistently disruptive’ pupils and parents will be fined if their children aren’t in school.

Staff and their unions are understandably weary after a long term of teaching in difficult conditions and having to battle a callous Government. But the Coronavirus is showing that it isn’t about to give up any time soon. Nor must the trade unions!

We have to stand firm and refuse to implement plans that are so blatantly unsafe for public health and children’s well-being.

Independent SAGE confirms testing and tracing still “not fit for purpose”

The Government, assisted by their media allies, are piling on the pressure to get schools fully opened for September. It’s clear that they want to abandon any effective social distancing so that full classes are packed into classrooms. They expect staff and parents to ignore the obvious risk of infection being spread and schools becoming the “institutional amplifiers” of the virus, as independent SAGE have previously warned.

Yet the key part of any public health plan for a genuinely safe return to schools and to workplaces in general is still missing – effective testing and tracing. Independent SAGE issued a damning report on June 18 that confirmed that the existing contact tracing arrangements are simply “not fit for purpose”.

‘Five Tests’ Still Not Met

Independent SAGE’s latest Report re-emphasises that “a strong Find, Trace, Test, Isolate and Support (FTTIS) system underpins the safe reopening of our economy and our lives without letting the pandemic spread out of control” and that “the situation is becoming increasingly urgent as social distancing measures are relaxed against scientific advice”

The NEU have highlighted earlier warnings from independent SAGE about wider school opening. Now the Union needs to do so again about the ongoing failure by the Government to meet the Union’s “5 tests”.

“Test One" rightly demanded that the case count shows a "sustained downward trend and confidence that new cases are known and counted promptly. And the Government must have extensive arrangements for testing and contact tracing to keep it that way".

"Test Three" called for "comprehensive access to regular testing for children and staff to ensure our schools and colleges don't become hot spots for Covid-19”.

Neither of those tests have been met – yet they remain essential for schools to be able to fully re-open with safety for both staff and the wider school community.

Testing and tracing “chaotic and haphazard”

The drive back to schools is being justified on the basis of falling rates on infection and mortality. Thankfully, yes, the numbers in the UK are clearly well below what they were at the ‘peak’ of the pandemic, but it is far from certain that they are low enough to drastically reduce social distancing measures without risking a second wave of the virus. More to the point, without an effective testing regime, how can schools and communities be sure what actual case levels are? Without effective contact tracing, how can any outbreak be controlled?

As Independent SAGE state, “lockdown has come at great cost, both financially and in terms of the health and wellbeing of those particularly vulnerable … at some point, we must reduce these restrictions. However, to do so, we must try to find every new case, test them, trace their contacts, and then ask the new case and their contacts to isolate for two weeks to prevent further spread, with the support they need to continue with their lives in these new circumstances”.

Independent SAGE make their levels of concern clear:

“The actual number of daily and weekly cases in the community is unknown because testing has been chaotic and haphazard”

“We have no idea how many people contacted are actually isolating and what health and other support they are receiving. Nor do we know how many contacts go on to become symptomatic and subsequently test positive”.

“Out of 200 tracers at my agency we have only had four contacts to call between us in four weeks. There is no data, test results are not being passed to tracers. It’s an absolute scandal” - Anonymous contact tracer during ISAGE public consultation

Income and accommodation for those being asked to isolate

Again, independent SAGE are clear in their advice:

“The willingness of people to report symptoms, especially at an early stage, will be affected by the practical implications of doing so … Equally, people will be less willing to provide names of contacts if they fear that these will be disadvantaged in terms of employment, housing or immigration issues. However, the greatest problems are likely to be at the stage where contacts are asked to self-isolate, particularly as they will likely be feeling physically well” (Remember, as the Report points out, around 40% of those infected will never get symptoms).

“Many BAME and deprived families live in multigenerational families. These families need to be supported and provision for alternative accommodation should be made available for multigenerational families, key workers and those who are homeless. This will also need to include provision for food and essential amenities. If individuals are to comply with isolation, employers will also need to ensure that those isolating are paid during isolation and do not suffer financial hardship”.

Using the Crisis to widen privatisation

The Government have been using the crisis as an opportunity to strengthen the grip of private interests in running public services, instead of prioritising public health needs. Their latest plan to employ low-paid tutors hired through selected private agencies, rather than increasing school funding directly through Local Authorities, is all part of the same agenda.

Independent SAGE are highly critical of SERCO’s performance saying it “raises serious questions about the efficiency and value for money of the contracts and highlights the vital role being played by the public health teams in track and trace”.

It also points out that “the lack of PHE tracing and testing capacity to cope with a large pandemic was noted back in February. Rather than an immediate investment in existing systems, there was a 3-month delay before the announcement of a new Test and Trace system on 27th May – during which time the UK suffered one of the highest death rates in the world”.

Independent SAGE’s recommendations

The Report makes three recommendations “to build a protective shield against further outbreaks or, worse, a second wave”.

Firstly that “testing and tracing alone using a centralised system alone simply will not work. We need local involvement and ownership using our existing public health and primary care teams, GPs, local hospital laboratories, school nurses and environmental health officers to ensure we can respond quickly to outbreaks and to build local trust”.

Secondly, sustainable “Find, Test, Trace, Isolate, and Support (FTTIS) as recommended by the World Health Organisation” including “GPs should be involved in testing hubs and ordering of tests as quickly as possible and results returned within 24 hours for the system to work” and “Rapid isolation of cases and contacts is critical” and “Successful countries provide facilities available for those asked to isolate including food and finance for vulnerable groups, and appropriate guarantees from employers. Clinical support for monitoring the health of suspected cases, cases and contacts in the community is vital”.

Thirdly, “the system must link data into the NHS immediately, especially local public health general practices. We need community feedback and strong governance to protect privacy”

Point the finger at the Government, not the unions

Independent SAGE’s warnings about the ongoing lack of a properly functioning ‘Find, Test, Trace, Isolate, and Support’ system needs to be a key part of the NEU’s counterarguments against the reckless drive to a full return in September.

Instead of the public being encouraged to blame the unions for simply doing their job - to protect staff and community safety - the unions should be encouraging the public to place the blame squarely where it lies – with the Government and its failing private sector allies.


The Full Report can be read here:

https://www.independentsage.org/wp-content/uploads/2020/06/FTTIS-12.42-160620-names-added.pdf

UPDATE: 22/06/20

Independent SAGE has also issued further concerns, via Twitter, about the proposed reduction of Social Distancing measures from 2m to 1m - see below:

Tories forced back - but NEU ‘5 tests’ are still to be secured

Following news of another retreat by the Tories over full reopening of primary schools, Socialist Party in Schools has issued this leaflet today. It can be downloaded here.

Tories forced back - but NEU ‘5 tests’ are still to be secured      

The hard work of countless union reps and officers and the ‘only when it’s safe’ campaign has helped force the Government back. Most primary schools in England have failed to open as widely as the Tories had intended. Now they have been forced to backtrack on plans for all primary pupils to return to school before the end of term too!

Organising around the National Education Union's insistence that wider opening will be unsafe unless our '5 tests' are met has been central to forcing the Tories back. That stand has helped recruit thousands of new members and persuaded many existing ones to come forward as workplace reps. Now we must maintain that stand.

That clear position and campaign has influenced the decision taken by many Local Authorities to advise further postponement of wider opening - some now until late in June at the earliest.

With the Tory drive to end lockdown risking a further increase in infection rates, alongside continuing chaos over testing and tracing, the public health need for further delay will only become more obvious.

Against this background, any attempt to suggest that it’s now time for unions to negotiate a safe wider return would be a huge mistake. Yes, we've pushed the Tories back from their original plans, but our ‘5 tests’ are still far from met.

For the safety of our colleagues and our school communities, let's continue to organise around a clear and principled stand and insist that safety comes first.

Stand Firm for School Safety

Survey results from the National Education Union (NEU) estimate that 44% of schools did not open further at all on 1 June, with the North-West having the lowest rate at only 8%. About a fifth (21%) opened to some more year groups but less than the four asked for by the Government - nursery, reception, Year 1 and Year 6. But about a third (35%) did.

A delayed return has been achieved in many areas, but wider school opening is still putting school communities and staff at serious risk. We have to stand firm - until our '5 tests' are met, schools should continue, as they have been throughout lockdown, to safely support only those with the greatest need in school, while staff support the majority of students at home online. 

Let's expose the hypocrisy of a Government that has cut school budgets over years but now suddenly pretends to be concerned about 'disadvantage'.

They are ending free school meal vouchers while still failing to deliver on their promises to provide additional laptops and broadband for families who need them to access online learning. Instead of forcing the low-paid back to work, they should be guaranteeing the wages of those who have no access to childcare. They should be funding the summer play schemes lost under their spending cuts and providing books and other resources for families in need.

Of course, the Tories will continue to apply pressure on parents, schools and staff to try and engineer their reckless return. Some schools will do as they are told while others, particularly where staff and parents are well organised, will continue to put safety first.

United opposition would have been easier to achieve if the Union had clearly declared nationally that, with the 5 tests still not met, no school was safe for wider opening. But the struggle to defend staff and community safety has to continue, even if it now has to be school-by-school, area-by-area.

Staff must continue to be supported to assert their rights to either refuse to return to, or, once experience exposes the serious danger they face, to leave an unsafe workplace.

Unions must fully back members who, in line with Section 44 and other safety legislation, are acting together to defend safety.

Why wider opening is unsafe until our ‘Five Tests’ are fully met

"Test One" demands that the case count shows a "sustained downward trend and confidence that new cases are known and counted promptly. And the Government must have extensive arrangements for testing and contact tracing to keep it that way".

Thanks to Government incompetence and its reliance on its private-sector backers, "Test One" is being failed on every key point.

The "R" rate seems to be rising and calculated to be above the critical 1.0 figure already in the North-West and South-West.

Test results often still take days to be returned - seriously undermining tracing and isolation procedures that rely on speedy intervention before more people are infected.

The contact tracing arrangements themselves are still far from working reliably - and might not be until September.

Those failures, and the resulting danger of a "second wave" of infections and deaths, have meant some Local Authorities, notably in the North-West, have rightly sounded the alarm and pulled back from wider opening of schools. Where local Public Health officials claim their local conditions are safe, unions should demand their modelling for others to verify. 

"Test Two" calls for appropriate physical distancing and PPE in schools.

Under the PPE at Work Regulations 1992, employers must provide suitable personal protective equipment unless they can adequately control risks by other means. Yet few schools are providing PPE, leaving pupils and staff in the farcical situation where they are expected to wear masks on the bus to school, but take them off when they are in class!

Schools have a duty to reduce risks as much as they can, and unions have been checking the risk assessments provided to them. But while precautions being taken, such as removing play equipment and minimising physical contact, may help prevent infection risks, they will also have consequences for children's well-being. The new school environment will be strange and confusing for many youngsters.

The main guideline being followed to minimise the risk of virus transmission is the setting up individual 'bubbles' of 15 or fewer children who should stay together with the same staff. But with physical distancing impossible to consistently achieve with younger children, it's almost inevitable that if one child brings the coronavirus into that 'bubble', then the remaining children, and their staff, may well be infected. Reports of transmission within schools are already emerging.

Under pressure, the Government has had to accept that there is no way to cram even more primary children into the same school building without increasing group sizes. Even the Tories knew they couldn't get away with that!

Where secondaries open to more pupils on 15 June as planned by the DfE, you'd hope that teenagers might better understand why they should enforce distancing within school. However, as modellers have warned, they are more likely to spread infection to a wider group of friends outside the school gates.

"Test Three" calls for "comprehensive access to regular testing for children and staff to ensure our schools and colleges don't become hot spots for Covid-19.

Many infectious individuals, particularly children, don't show obvious symptoms. Many staff are therefore fearful that they might be unknowingly bringing the virus home to their families.

Some reassurance would be offered through easy access to weekly testing to screen for Covid-19 infection, regardless of whether an individual is showing symptoms. But testing has simply not been made widely available yet in this way.

The lack of regular testing isn't just a danger for staff. As independent SAGE experts have warned, "the impact of placing many children in one place could lead schools to become 'institutional amplifiers', if children without any symptoms go unnoticed until an adult becomes symptomatic".

With infection rates still too high, there is also too high a risk that the virus will be spread from schools into the wider community and back again.

“Test Four” calls for isolation protocols to be strictly followed when a case occurs.

DfE guidance just isn't good enough. It confirms that a child or adult showing symptoms should be sent home to isolate but says that the rest of the staff and pupils in their class should carry on as normal until a case is confirmed by a positive test result. But with the processing of test results taking days, by that time any infection could be widespread.

Unions must insist that, as a minimum, the whole class and its staff all immediately isolate until, hopefully, a negative result is returned, and the school as a whole should be closed for a precautionary deep clean.

If a positive result is reported by a child, parent or staff member, then there must be testing and closure of the whole school and reopening only when unions and parents consider it safe.

“Test Five” states that "vulnerable staff, and staff who live with vulnerable people, must work from home".

Too many schools are putting staff under pressure to work when they feel themselves, or their relatives, to be at risk.

Where schools refuse to allow staff to work from home, then this must not be left as an individual issue*. Unions as a whole must declare that this refusal means the school has failed to acceptably account for risk overall and the press and public alerted.

Communities on the march against racism need to know which local schools are refusing to protect Black Asian and Minority Ethnic staff who feel at risk.

*Update on "Test 5": In this evening's NEU call for secondary reps, there was discussion about how Section 44 doesn't only cover a danger to yourself - but to others too. 

Section 44 (1) (e) extends the protection against detriment to "circumstances of danger which the employee reasonably believed to be serious and imminent, he (or she of course!) took (or proposed to take) appropriate steps to protect himself OR OTHER PERSONS from the danger".

So, for example, if your Head insists that staff who feel they are at greater risk come into school instead of being able to work from home, this does not have to be left as a concern only for those colleagues. It is a breach of NEU "Test Five" and means the school would be failing our overall checklist too.
The Union has issued model letters today to allow staff to express their support for colleagues at higher risk - such as Black colleagues - which hopefully can prove sufficient.

However, if it turns out that the only way to avert the serious danger to these colleagues is for other individuals to refuse to go into work in order to make sure the workplace does not open at all, then your Head needs to be made aware that Section 44 (1) (e) includes that right.

 

Guidance on checklists and Section 44

I have produced this presentation from information on the NEU website to give advice on the use of checklists to demonstrate why your workplace is likely to be unsafe if it opens more widely without the Union's '5 tests' having been met. 

It also summarises the information on the website about your rights if faced with 'serious and imminent danger' in your workplace, including model letters to send Heads.  

The presentation can be downloaded as a file here, but pictures are posted below:

Trade union organisation pushes back Tories over wider pupil return

Faced with parental distrust and organised trade union opposition, the Tories’ plans to implement a wider phased return of children into England’s primary schools from 1 June have run into widespread resistance.

With decisions varying widely from area to area – and even from school to school – it’s difficult to judge exactly how far the Government have been pushed back. It’s certainly been by a long way.

When even the compliant BBC News report there’s been a “mixed picture on turn-out”, it’s safe to conclude that the plans to widen opening to all Nursery, Reception, Year 1 and Year 6 pupils have failed to materialise in most schools as yet. Government “ambition” to go further and bring all primary year groups back before the summer holidays seems even less likely to be achieved.

Responding to union warnings about the risks to public health, dozens of Local Authorities issued statements raising concerns about Government plans. Some, although nowhere near enough, went further and gave clear advice that wider opening should not be implemented at this stage.

Tory-controlled Lancashire County Council’s statement summed up why their own Government’s proposals are so reckless: “The test and trace programme is not at a state of readiness to respond to Covid-19 community setting outbreaks in a timely manner … Furthermore, we are not confident that adjustments to the current measures of the lockdown policy will not risk a second peak of infections locally”.

Lancashire County Council's letter opposing opening on 1st June

As the clock ticked down to 1 June, the chorus of concerns from public health experts grew louder. Even members of the Government’s own SAGE committee broke ranks. For example, Jeremy Farrar, director of the Wellcome Trust, tweeted “Covid-19 spreading too fast to lift lockdown in England … TTI [Test, Track, Isolate] has to be in place, fully working, capable dealing any surge immediately, locally responsive, rapid results & infection rates have to be lower”. But this is, of course, exactly what the trade unions, led by the National Education Union, have been saying for weeks.

Under mounting pressure, some schools have opted to only open to fewer additional pupils than the Government wanted for now. Others have decided to delay wider opening entirely for at least a week or two while they consider the health risks – and the level of opposition - further.

Even where schools did open, if press surveys were correct, perhaps half of parents will have opted, where they could, to keep their children at home for now. That will be particularly the case in places where local parents have organised campaigns to back up the unions’ slogan of “not until it’s safe”.

But it has been the opposition of the school staff unions, led by the National Education Union, that has been key to pushing the Tories back. By insisting that schools can’t be safe for wider opening until our public health-based ‘5 tests’ are met, the pressure has been put on the Government to deliver on their responsibilities, rather than expecting schools to somehow muddle through.

Where local union branches and school workplace reps have organised with the most determination, the opposition has been the greatest. They were working solidly throughout the half-term week up to 1 June speaking to members, organising meetings, lobbying Heads and councillors. Where this has been done effectively, hardly any primary schools have opened more widely on 1 June.

While the pupil return has been slowed, the overall picture is uneven. The Tories hope that numbers will increase further and resistance falls away. However, that means overcoming the opposition of staff in the best organised schools, including those in the secondary sector who aren’t due to start a phased wider opening until 15 June.

The next two weeks in this battle are going to be critical. Some primary schools, and some in the trade unions too, hope that delaying wider opening until 8 or 15 June will give time for testing and tracing to be properly embedded. 

However, the Government’s record throughout this crisis can give no school employee or parent any confidence that the NEU’s ‘5 tests’ will be met anytime soon. The confusing messaging over easing the lockdown means that, instead of falling, infection rates may start to rise again.

National testing and tracing plans still appear to be in chaos. There has certainly been no sign of school staff being given access to “regular testing” as the NEU demands. The Government itself admits that social distancing is impossible to maintain with younger children. The virus will spread between them. Regular workplace screening, including to those without symptoms, will at least give staff some reassurance that they are not bringing it home to their families.

NEU members must insist that all the other union ‘tests’ need to be met too. A guarantee that staff who are concerned about their vulnerability, and those living with vulnerable relatives, can continue to work from home is a significant part of those tests. This is particularly a concern for many Black staff.

The united demand has to remain that a wider return is “unsafe until the tests are fully met”.

But schools are going to be under increasing pressure to submit to Tory plans even though that threatens the serious danger of a ‘second wave’ of the virus. In order to protect themselves, and their school communities, it is inevitable that more staff are going to have to assert their health and safety rights under Section 44 of the Employment Rights Act. Already, where staff have threatened that they will apply those rights together, employers have been forced to reconsider their plans.

The NEU website has been updated with advice explaining both the legal responsibilities on employers and the rights of employees faced with a ‘serious and imminent danger’ to either leave, or refuse to return to, an unsafe workplace. It also contains model letters to send to Headteachers, based on the ‘5 tests’ and union checklists, for staff to sign together, asserting those rights. That information needs to be disseminated and discussed as widely and as quickly as possible.

Union strength, backed up by parental opposition, has already had an effect. For the safety of our colleagues and our school communities, let’s stay strong and insist that safety has to comes first.