Don't overburden NHS Test and Trace, chief medic warns

Speed of test turnarounds is critical, Chris Whitty says, as he also warns it would be "stupid" for scientists to interfere in minutiae of policy decisions
Chief medical officer Chris Whitty and government chief scientific adviser Sir Patrick Vallance, who were grilled on the evidence behind the second coronavirus lockdown yesterday. Photo: Yui Mok/PA Wire/PA Images

The government’s top medical adviser has called on ministers to allow the NHS Test and Trace to focus on quickening the processing of tests for people with coronavirus symptoms this winter, and to overburdening it with additional testing programmes.

Appearing before the Science and Technology Committee of MPs alongside government chief scientific adviser Sir Patrick Vallance yesterday, chief medical officer Chris Whitty said reducing the wait was the major contribution that the system could make to cutting infection rates. “To reduce [the infection rate] R, test and trace systems need to get the results back as fast as possible; the faster they do, the bigger the effect on R,” Whitty told the MPs.

His comments come as after a series of promises from government about coronavirus testing in the UK, including health secretary Matt Hancock’s “moonshot” plan to have millions of people tested by next year, and a recent plan to begin a mass-testing pilot in Liverpool,  which is being rolled out by NHS Test and Trace through a partnership with Liverpool City Council and the Ministry of Defence.

Although Whitty was not commenting on any particular pledge, he added: “One of the reasons that I, amongst others, am keen not to always have test and trace asked to do yet more things is this shortening of the time is a critical part of [getting the R rate down].

“We must try and reduce those times, because that’s how test and trace has its biggest impact.”

Whitty did say he expected test and trace would have the capacity needed to test people who displayed coronavirus symptoms over the winter, which he said would be especially important in a season where respiratory viruses like flu, which have comparable symptoms, will be prevalent.

But while he said current testing levels are “significantly greater now than it was at the beginning of the month”, he would not give an exact figure, saying to do so would be up to NHS Test and Trace.

‘Lockdown a decision for ministers’

During the two and a half-hour session hearing, the advisers repeatedly stressed that decisions on when to implement lockdowns or other coronavirus measures, and which measures to implement, were for politicians to make.

They were being quizzed on the evidence behind the decision to impose national lockdown restrictions in England until 2 December at the earliest.

Asked whether modelling of the lockdown’s impact meant he expected to recommend the measures be lifted on that date, Whitty said: “The decision of whether to lift restrictions on 2 December is not a modelling decision; it is, rightly, a decision for ministers and parliament… we must provide technical data and helpfully interpret it as best we can, but it is for ministers and elected politicians to make those decisions.”

The two advisers also stressed several times that scientific advice was only one element that ministers must take into account when deciding how to proceed, and that it was not for SAGE to model the economic effects of particular interventions.

‘Stupid’ for advisers to act as proxy for policy process

Whitty and Vallance refused to be drawn on trying to justify individual measures included in the national lockdown that comes into force tomorrow – stressing that it was important to have a “package of measures” that curbed interactions as much as possible.

“We haven’t got good evidence on the exact value of each intervention on ‘R’,” Vallance said.

“We produced a paper [at SAGE in the summer] suggesting what that might be in different areas, but really said ‘Look, this is not an exact science at all.’ And therefore, I’m afraid, it’s a rather blunt instrument.”

Asked if the Scientific Advisory Group on Emergencies had made specific recommendations to government about children’s sport, for example, the chief scientist said: “We don’t go down to that level of individual activities.”

The two advisers also explained that determining the likelihood of transmission at any given event was not likely to give a complete picture of the risks associated with it.

Pressed on why children’s outdoor sport will be banned, despite evidence that outdoor transmission of the virus is relatively low, Vallance said: “An entire package that takes into account everything including interactions around events [not just during the events themselves] become quite important… and then it’s for policymakers to decide what policies they want to adopt as a result of that.”

Illustrating the point when asked why places of worship would not be allowed to hold formal gatherings under the lockdown, Whitty said: “There is some very weak data to imply that even if a place of worship has been incredibly good about being Covid-secure, by bringing people together, people can congregate outside and do things which do lead to transmission.” He noted that these were “anecdotal” reports, not “scientific fact”.

Whitty later added: “If Patrick and I end up trying to unpick quite complicated packages that have been put together, that way disaster lies for everybody. So we have to give broad principles, which we have done… and then packages have to be put together, which are very difficult to do. I think everybody who’s doing this is balancing really difficult things and it’s not our jobs to make their lives even more difficult.

“What I think is stupid for us to try and do is try and act as a proxy for a process in which we should not be interfering at that level of detail, it would be very unhelpful to the process if we were to try and do so.”

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