The scientific evidence mounts: children DO transmit Covid-19

As the school year came to an end, official opinion was increasingly of the view that schools would be able to open fully again in September with only very limited safety measures in place. We were told that case numbers would continue to fall over the holidays and that, in any case, it seemed likely that schools and schoolchildren didn’t play much of a role in virus transmission. Those of us who warned this might be mistaken would have loved to have been proved wrong. Unfortunately, as each day passes, it seems official opinion has, sadly, been over-optimistic.

The controversy over quarantine on returning from European holidays has revealed the concern that remains across Europe about infection rates increasing once lockdown measures are relaxed. That’s also a pattern that’s revealing itself globally, notably in Israel, Australia and Japan. There are now also the first signs that case numbers are starting to rise again in the UK too.

Yet, when SAGE, the official scientific advisory group to the UK Government, released its latest analysis about reopening schools on 24 July, in their view, “given the low risk of transmission between children”, there was no need to recommend facemask use and no suggestion that the previous limits on class sizes, to enable greater physical distancing, needed to be maintained.

A closer look at SAGE’s appendices, however, shows only a limited research basis on which to draw such a significant conclusion. They pointed to a Dutch contact tracing analysis that suggested most adults were infected by other adults, not children. However, other Dutch epidemiologists had already criticised their methodology. SAGE also pointed to a study of a school in a Paris suburb that a found no evidence of onward transmission from children. However, they failed to mention another study in the same area that concluded that high school children COULD transmit the virus.

Yet one of the contact tracing studies cited in ‘Annex A’  – but not referred to in SAGE’s full Report – should have already started to set doubts in SAGE’s minds (if, of course, these were objective minds and not ones trying to find evidence to back up the Government’s economic imperative to make sure schools were fully open to provide full-time child-care). This is an Israeli study from June 2020 taken across over 600 households that showed that, yes, children had a lower relative infectivity than adults but not at any significantly lower level – perhaps 85%.

In the last few weeks, the global research basis has been growing – and the evidence that children, and schools, contribute to viral transmission is growing rapidly. For example:

• A study from South Korea, shows household transmission was highest of all age groups for those aged 10-19
• Research from Germany continues to show that there is little difference in “viral load” between children and adults.
• In Israel, where infection rates have been rising sharply since lockdown measures were relaxed, a report on a recent outbreak shows widespread transmission took place within the school. The highest infection rates were amongst 13-15 year old students.
• In Victoria, Australia, where infection rates are also now rising, an outbreak in a school was linked to substantial transmission amongst senior students after they returned to face-to-face learning
• Another contact tracing study from Trento, Italy, has reported transmission from children to adults with children in the 0-14 age group showing the greatest infectivity.
• A study from the United States has indicated a correlation between how quickly different states closed their schools and the rate at which mortality rates then fell
• A report on a recent outbreak at a children’s camp in Georgia, USA, where there appears to have been widespread transmission amongst attendees. Of those tested, 51 out of 100 6-10 year olds tested positive and 180 of the 409 11-17 year olds (see table below).
• A study from Chicago, USA finding that children younger than 5 with mild to moderate COVID-19 have higher amounts of SARS-CoV-2 viral RNA in their nasopharynx than older children and adults

Of course, the science is still developing and research and reports are open to debate and review. But, the weight of evidence is now mounting up. Given the health risks of infection, surely advice should at least be based on the “precautionary principle” that minimises risks as much as possible? That’s exactly the approach recommended by the Harvard T.H. Chan School of Public Health in its advice on reopening schools in the US.

The advice from Harvard is in sharp contrast to the inadequate guidance issued by the DfE in the UK. They conclude that “It is reasonable and prudent to assume that COVID-19 transmission may occur between children and from children to adults in reopened US schools”. They recommend that students wear face masks and that staff wear masks for close work and face shields when at front of class. They also  make other recommendations that echo those of the NEU’s “5 tests” including the reduction of class sizes in order to maintain physical distancing, stressing the importance of diagnostic viral testing and official advice on closure, cleaning and contact tracing if there is a case in a school.

The Harvard advice also calls for authorities to “provide necessary supplies and support systems to continue remote education for students staying home” and to “advocate for high-risk students and staff to have access to effective remote learning or work”.

Of course the situation in the UK is not exactly identical to the US, but the risks from the virus are the same across the globe.

What all of this research confirms is that the DfE guidance – recommending that schools open with full classes, no effective physical distancing and no PPE – is looking increasingly reckless. Trade unions and parents must urgently demand that advice is withdrawn and replaced with a strategy that recognises – and properly mitigates against –  the real risks that schools could spread infection within school communities.

Inadequate NEU Guidance on September Opening abandons the '5 tests'

For the DfE to produce unsafe guidance on behalf of a Government determined to have all schools fully opened in September, regardless of the scientific evidence or the risk to public health, should come as no surprise. But for the NEU to send out, belatedly, guidance that abandons its previous ‘5 tests’ - and instead restricts itself to the parameters of that DfE guidance - is a major disappointment. It is a mistake that needs to be urgently corrected.

The NEU’s ‘5 tests’ have not been met = there should be no full return at the start of next term

Further wider opening in September should begin only with a phased introduction of more students. Some ‘blended learning’ - both in school and remotely from home – will have to continue for some time yet.

The pressure on union leaders to buckle under the pressure from the media - and politicians of both main parties - to accept full opening in September is enormous. However, unions need to stand firm and protect their members.

The outbreak in Leicester has confirmed, if further proof were needed, that the NEU’s ‘5 tests’ have not been met; that schools and young people contribute to the transmission of the virus; that testing, tracing and data sharing systems remain shambolic; and that infection rates are at risk of rising upwards again.

Just some of the recent conclusions from 'Independent SAGE'

With the 5 tests not met, unions should be insisting that full opening is unsafe at the start of September. Instead, a precautionary approach should be taken, monitoring the risk of increased infection rates from both wider schools opening and the ending of lockdown measures more generally.

Such an assessment of risk would have to conclude that any further wider opening should only be based on a phased introduction of more students, with some ‘blended learning’ – both in school and remotely from home - having to continue for some time yet.

As the NEU’s ‘10-point Education Recovery plan’ states, this must be resourced by Government and with low-income households given the resources they need to learn at home, including access to books, laptops and internet access. Schools will also need the funding to employ additional staff to provide that learning with safe reduced class sizes, directly employing supply staff to assist. Schools should also operate a ‘recovery curriculum’ focusing on well-being.

However, and I believe wrongly, the latest joint union guidance sent out by the NEU fails to propose either phased opening or reduced class sizes. [It only suggests that schools should have “an alternative plan in case, for any reason such as a renewed local lockdown, full opening cannot take place at the beginning of September”].  The union advice should call for a phased opening more generally – and unions must also oppose the fining of parents who do not believe that schools are yet safe enough for their children to attend.

PPE at Work Regulations 1992: ‘employers shall ensure suitable PPE is provided … ’

Under the law, all staff should be provided with face masks. If it is felt that teaching and learning is too difficult in those circumstances, then other means to reduce risk that are at least as effective must be adopted.

The joint union guidance has been issued too late in the term to give reps and local officers time to adequately negotiate with employers. It is also very long – yet fails to focus on key aspects of health and safety legislation, particularly Regulation 4 of the PPE at Work Regulations 1992 [This key legislation is linked to in section 6 of the joint guidance on PPE but its contents are not spelt out for reps’ attention.]

These regulations state clearly that “every employer shall ensure that suitable personal protective equipment is provided to his employees who may be exposed to a risk to their health or safety while at work except where and to the extent that such risk has been adequately controlled by other means which are equally or more effective”.

School staff are only too aware of the contradiction between the advice being issued about the importance of wearing face masks to reduce droplet and aerosol transmission in indoor spaces like shops, especially where there is limited social distancing – and the apparently magical lack of the same precautions being necessary in classrooms!

The latest joint union guidance certainly mentions PPE, but only in particular circumstances: when supervising a child with symptoms; one that may spit or cough; for specific staff like Early Years and SEND settings;  for staff previously deemed to be extremely clinically vulnerable, clinically vulnerable (including pregnant women) or otherwise at higher risk, or who have vulnerable family members, who are returning to work in school.

These are certainly all situations where PPE should be provided. However, the protection will only be of limited value to staff at risk if they are the only staff wearing PPE. Others around them, which could include an asymptomatic child or adult breathing out droplets, really need to be wearing a mask too.

If, and scientific opinion seems to be hardening on this, face masks reduce the risks of viral transmission indoors, then, under the Regulations – and they state ‘SHALL’, not ‘should’ – staff should ALL be provided with masks. Students really need to be as well. However, if it is felt that teaching and learning is too difficult in those circumstances, then the law says other means to reduce risk that are at least as effective must be adopted.

PPE at Work Regulations 1992: “… or adequately controlled by other means”

Until the ‘5 tests’ are met, risks should be controlled by maintaining the same maximum group size of 15 as now

If PPE isn’t going to be provided to all – or thought to be a workable solution in a school environment - then what alternative means are schools going to follow that are at least as equally effective?

The NEU’s previous “Test 2” rightly called for “appropriate physical distancing and levels of social mixing in schools, as well as for appropriate PPE … locally negotiated at school-by-school and local authority level”.

With infection rates still high enough to cause concern, negotiated safe physical distancing and small fixed ‘bubbles’ of pupils to limit social mixing could provide that alternative - alongside reliable testing and protection for those at risk. But, from September, none of these will be in place under the new DfE guidance. The joint union guidance should be sharply exposing that failure – but it isn’t! That has to be corrected.

Up to now, DfE guidance had recommended social distancing and small ‘bubbles’ to minimise the risk of onward transmission, with group sizes not exceeding fifteen. Under the new guidance for September, the DfE are proposing full class sizes and ‘bubbles’ that are as large as a whole secondary school year group – in other words, hundreds of students mixing together. (Of course, friends meeting outside school, contacts on transport to school and at the school gates, and having siblings in different years, are further risks too).

Both the scientific advice – and some simple maths – shows that expanding ‘bubbles’ and class sizes in this way makes physical distancing within the confines of a classroom impossible and greatly increases the chance of an infected individual spreading transmission across the whole ‘bubble’.

The latest joint advice does not sufficiently challenge this risk. It suggests bubbles are kept ‘as small as possible’ – but proposes a maximum of one class in primary and KS3, and half a year group in KS4. But that is still agreeing that schools should double existing ‘bubble’ sizes – much more than that with KS4.

There is no mention of maximum class sizes in the joint union guidance – despite previous union guidance acknowledging that even class sizes of 15 did not really allow a physical distance of 2m between tables in most classrooms.

Until staff can be secure in the knowledge that infection rates are falling and test and trace procedures are in place to keep them that way – as set out in the NEU’s ‘5 tests’ - surely risks should be controlled by maintaining the same maximum group size of 15 as now? As stated above, that would mean schools would need to introduce more students only on a phased basis at first, maintaining ‘blended learning’ to also support teaching and learning.

What about the ‘5 Tests’ and functioning ‘Find, Test, Trace, Isolate, Support’?

The abandonment of the original NEU ‘5 tests’ in this new joint guidance must be reversed – and full support given to members jointly refusing to return to a workplace they believe poses a serious and imminent danger.

The NEU paid a lot of attention to the warnings and evidence being provided by Independent SAGE when it was recommending a wider opening of schools be delayed from 1 June. Unfortunately, the latest joint guidance suggests union officials are no longer giving that scientific advice the attention it deserves.

Independent SAGE have since produced a series of detailed reports criticising the ongoing failure in the privatised testing and tracing regime, the lack of integration and data sharing with local NHS services – so badly exposed in Leicester – and the withdrawal of support for those who have been shielding.

A serious weakness with the latest joint union guidance is that it fails to reflect that scientific concern and also no longer maintains the demands originally set out in the NEU's ‘5 tests’.

It repeats the DfE’s weak call for staff and students who have been in contact with a pupil showing symptoms “to be reminded to wash or sanitise their hands”. But where is the call for immediate testing of at least those contacts, if not the whole school – in line with the NEU “Test 4” that called for “protocols to be put in place to test a whole school or college when a case occurs”?

It asks reps to make sure schools are engaging with NHS Test & Trace process but says nothing about the fact that those processes are failing to function properly – so also failing to meet the NEU’s original “Test 1” that demanded these systems were all working reliably and extensively.

It asks if the school “will follow DFE advice on sending home anyone who have been in close contact with confirmed cases” but does not warn reps anything about the warnings from Independent SAGE about the risks arising in the mean time because of the length of time that test results are taking to be returned.

What has happened to NEU “Test 3” that would give staff, particularly those at risk, the reassurance that some other employers are giving staff returning from lockdown of “comprehensive access to regular testing”? Unions need to be loudly making that demand for regular workplace testing on behalf of their members in schools.

The new joint guidance asks vaguely about control measures to contain any outbreak but fails to insist that schools should be closed if an outbreak occurs. Unions should instead be  challenging the DfE guidance for full opening that advises that “whole school closure based on cases within the school will not generally be necessary” and that there would need to be at least "two or more confirmed cases within 14 days" for them to even consider it a possible outbreak.

It asks for schools to carry out individual risk assessments for staff who are clinically extremely vulnerable, clinically vulnerable or at increased risk, or who live with them, but no longer insists on the previous NEU ‘Test 5” that “vulnerable staff, and staff who live with vulnerable people, must work from home, fulfilling their professional duties to the extent that is possible.”

Without making it clear, the new joint guidance abandons the previous ‘5 tests’ set by the Union, even though none of them have been met. That must be challenged by NEU members and the previous position reinstated – along with full support to members jointly refusing to return to a workplace if they reasonably believe that it poses a serious and imminent danger.

September opening of schools: Not safe until NEU ‘Five Tests’ met!

Download this latest Socialist Party in Education bulletin as a pdf here

Union strength has shown it works. By standing firm and insisting on firm risk assessments based on the NEU’s ‘5 tests’, backed up the threat of members asserting their rights under ‘Section 44’, school reps and local officers have largely prevented a reckless return to wider opening this term.

But the real test is yet to come. Johnson and Williamson are determined to push through a full opening in September, despite the clear risks to staff, especially those at higher risk, and to the safety of the wider communities our schools serve.

The NEU Executive needs to meet urgently and confirm that: 

1. Our policy remains - “Not safe unless 5 tests met” - and they aren’t yet met for September. 
2. Members acting together to protect health and safety will be fully supported by the Union.

What needs to be done for September to be safe

NEU “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".

Thankfully, for now, the case counts are falling but, with the lockdown being lifted, will that still be the case in September? The ONS are already reporting that numbers of new infections have stopped declining in recent weeks.

When the data is shared properly, Independent SAGE have recommended that the threshold used in Germany of 50 cases per 100,000 population over a seven day period is used as a trigger. Leicester has not been alone in exceeding that figure - other outbreaks will occur.

Independent SAGE have produced a series of damning reports into the effectiveness of existing test and trace systems. They say testing and tracing is taking far too long and data needs to be linked up with local NHS services.

School risk assessments alone cannot secure safety if test and trace is not in place. We have to demand it is.

"Test Two" calls for appropriate physical distancing and PPE, locally negotiated with schools & local authorities.

The DfE guidelines for full school opening in September are shamefully inadequate. Union guidance can’t only reflect what the DfE says - it has to go much further.

Just as the Union warned, the Leicester outbreak has shown that schools can become ‘institutional amplifiers’ of the virus as it is brought into schools by pupils and then spread between them and back into the community.

The contradiction between the increasing evidence of the benefits of wearing face masks in indoor spaces and the complete lack of PPE in most schools - despite the clear duties to provide them set out under the PPE at Work Regulations 1992 - is another real cause for concern.

The return of all pupils creates a whole new set of risks - far greater and more difficult to solve than those that have been assessed up to now for more limited opening. Reps must insist on a completely new risk assessment, and proper consultation and agreement on measures being taken to adequately address those risks. Given the lack of opportunity for real consultation now, and the extent of issues still to resolve, not least around the safety of large ‘bubbles’ of students - let alone the full ‘5 tests’, no school should be reopening fully at the start of next term.

"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. Staff are therefore fearful that they might be unknowingly bringing the virus home to their families. Some workplaces that are reopening after lockdown have been providing employee testing. School staff, working indoors without physical distancing, should be provided with the same reassurance too through testing, regardless of whether they are showing symptoms.

“Test Four” calls for a whole school/college to be tested when a case occurs and for strict isolation protocols.

The latest DfE guidance just isn't good enough. It only suggests wider groups of pupils might need to self-isolate if “schools have 2 or more confirmed cases within 14 days” and even then that “whole school closure based on cases within the school will not generally be necessary”. For NEU tests to be met, we must insist on much tighter protocols.

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

In September, huge pressures will be piled on staff who feel themselves, or their relatives, to be at risk. They could be faced with a choice between health and their incomes.

No individual member must be left to fight alone. If this test is being failed by a school, the whole union group must say that management have failed to acceptably account for risk overall. Unions should call on members to act together to defend their safety - and that of others.

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: