Health News at Your Fingertips

The Local Government Association says today’s test and trace performance figures show that its officials do a much better job than the national contact tracers working for NHS test and trace (a service provided by private contractors). This is from Ian Hudspeth, chair of the LGA’s community wellbeing board.

Councils’ public health teams are using their unique expertise and understanding of their communities to reach those who cannot be contacted by the NHS test and trace system, including speaking other languages. These figures show they are having much more success at reaching complex close contacts of positive cases.

Many councils have launched, or will shortly launch, their own locally-supported contact-tracing arrangements. However, to maintain and improve upon their local efforts, they continue to need prompt information on who they should be trying to contact as soon as possible, along with the right resources.

Hudspeth is referring to the number of close contacts reached in so-called complex cases. See the final chart in the post at 12.59pm. The national contact tracers deal with normal cases (called non-complex ones), but when there are outbreaks in institutions like hospitals, local public health officials take over. (These are called complex cases but arguably they are less complex – because the contacts all tend to be in the same place.)

NHS Test and Trace has published its weekly performance figures. They are here (pdf) and they show that, on two of its main indicators, performance is getting worse. Testing times are improving, but they are still way off the target set by the prime minister.

Here are the main points.

• The number of people testing positive is now four time as high as it was at the end of August. In the week ending 23 September a total of 31,373 new people tested positive for Covid-19 in England. That was a 61% increase on the previous week, and four times the level in the last week of August.

• The service is still far away from delivering all test results within 24 hours, as Boris Johnson, although there has been a recent improvement. For all pillar 2 tests (ie, tests taking place outside hospitals – which means most tests) 16.9% of results were received within 24 hours in the week ending 23 September, up from 10.3% in the previous week. For in-person tests (local test sites, mobile testing units and regional test sites), 38.1% of results were received within 24 hours compared to 28.2% in the previous week. The government now prefers to focus on the percentage of test results delivered the following day, and in the latest week 70.6% of in-person tests results were received the next day, compared to 52.9% in the previous week. But Johnson did tell MPs on 3 June that he would get “all tests turned around within 24 hours by the end of June, except for difficulties with postal tests or insuperable problems like that”.

• The service is getting worse at reaching the people referred to it because they have tested positive. The contact-tracing service has two roles; it must contact the people referred to it because they have tested positive to ask about their close contacts, and it must then speak to those contacts to ask them to self-isolate. In the week ending 23 September only 71.3% of people referred to the system were reached. That is the second week in a row that this figure has gone done – last week it was 80.8% – and it is now close to the proportion achieved when the service launched. The target is 80%. The graph illustrates the scale of the problem.

• The service reached 71.6% of the close contacts of people who tested positive in the week ending 23 September. This is down from 76.3% in the previous week, but above the 69.9% for the week to September 2, which is the lowest weekly figure to date. The target is 80%.

Matt Hancock has finished his statement to the Commons.

Turning back to Brexit, this is from Bloomberg.

And this is from Michel Barnier, the EU’s chief Brexit negotiator.

But in the UK government sources are playing down the significance of the EU’s decision to launch legal proceedings. They say it is normal for the EU to be engaged in infringement proceedings against member states. There were 800 of these cases open last year, they say, and on average there are 29 against each member state.

In the Commons the SNP MP Steven Bonnar asked Matt Hancock if he accepted that the decision by Dominic Cummings, the PM’s chief adviser, to ignore lockdown rules earlier this year was encouraging more people to break the rules now, with the result that more people were at risk.

Hancock said he did not accept that there was a link.

In the Commons Matt Hancock, the health secretary, has received repeated complaints, from MPs from all sides, about the way the compulsory 10pm closing time operates. Several have asked him to provide the scientific justification for the rule. In response to Greg Clark, the Tory chair of the Commons science committee, Hancock said that people were less likely to obey social distancing in pubs after 10pm. But he told Clark the policy was being kept under review. He said:

Of course, we keep this under review and of course we’re constantly looking at how we can improve these policies, but I think we’ve got to look at both sides of the evidence to try to get this right.

Another Conservative, Jeremy Wright, suggested that hotel bars could be exempt for residents, because bars were a valuable source of income. Hancock said he would look at the idea, but that there were advantages in ensuring “clarity” in the way the rules operated.

Hancock also told MPs there enough flu jabs were available for everyone in a priority group who needed one. But people did not need to get them before December, he said.

There are enough flu jabs for everybody who needs them in a priority group.

would stress that this is a roll-out, nobody needs to have a flu jab before the start of December, you can have it in September or October, it will then cover you for the winter, and so we are rolling it out and more appointments will become available in good time.

We’ve got 30m jabs in total, that is more than we’ve ever had before, it is almost double what we have typically had in the past and those are available.

Here is a statement from Angela Eagle, the Labour MP for Wallasey, on the new restrictions for the Liverpool city region. She said:

We have asked for the government to urgently provide the evidence and data behind these decisions to introduce stricter measures.

The government are using local lockdowns as a first response to a rise in cases without putting in place any increased testing.

The test and trace programme so far has been woefully inadequate and is not sufficient to deal with localised outbreaks.

The £7m announced today for local councils to deal with the increased restrictions is simply not enough and Labour MPs have called for a far more substantial financial package to be introduced for the area, especially with the ending of the furlough scheme.

I completely understand the need for additional measures to be brought in, but the government’s chaotic approach risks people’s livelihoods and their lives.

Yesterday local authorities in the region said in a joint statement that so far the coronavirus crisis had cost them more than £350m.

Labour’s Jonathan Ashworth also asked Matt Hancock about today’s Guardian story about how Deloitte, which is involved in helping to run the NHS Test and Trace service, is selling separate contact-tracing services directly to local health officials in the UK. Robert Booth’s story is here.

Ashworth said councils should be getting this anyway and the fact that Deloitte was seeking to sell these services was “an utter scandal”.

But Hancock said:

Deloitte have done an incredible job in helping us to put together the contact tracing and the backward contact tracing that we have, and of course they should offer their services to local councils too.

On the one hand he says local councils should have more impetus and more involvement in the contact tracing and then when a company with great experience in contact tracing comes forward to offer their services he criticises them. He can’t have it both ways.

In his response to Hancock, Labour’s Jonathan Ashworth, the shadow health secretary, said he was concerned about the way the 10pm compulsory closing time was working. He said:

We know that sustained contact, especially in crowded, poorly ventilated spaces is a driver of infection and pubs and bars an obvious risk.

So I heard what he said about the 10pm rule, but my concerns relate to everybody leaving the pub at the same time. What action will he take so we don’t see a repeat this weekend of people piling out into city centres, packing out public transport, sometimes all piling in to a supermarket to buy more drink?

In his opening statement Hancock told MPs that today React study from Imperial College (see 10.04am) showed there were early signs that the R number (the reproduction number) may be falling.

He also said he was not willing to allow the virus to “let rip”. He said:

It is critical that the whole country acts together now to control the spread of this virus, so please for your loved ones, for your community, and for your country – follow the rules and do your bit to keep this virus under control.

By its nature, this virus spreads through social contact and so it’s had a terrible impact on the hospitality sector, who in good times exist to encourage that very social contact that we all enjoy.

We’ve had to take difficult but necessary decisions to suppress the virus. The only alternative to suppressing the virus is to let it rip and I will not do that.

Hancock said there would be no changes to measures in West Yorkshire, West Midlands, Leicester, Lancashire or the rest of Greater Manchester.

Hancock also told MPs that the rules for Bolton would be aligned with the rules for Manchester.

We’re also aligning the measures in Bolton with the rest of Greater Manchester and I’d like to pay tribute to David Greenhalgh, the leader of Bolton council, for his constructive support and the Bolton MPs for all they’ve done in support of Bolton.

That implies that pubs will be allowed to reopen in Bolton. Hancock is addressing an anomaly highlighted by, among others, Andy Burnham, the mayor of Greater Manchester two days ago.