Coronavirus: Data needed quicker to target local outbreaks, say doctors
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The government must provide vital data more quickly to local authorities to help them deal with Covid-19 spikes in their areas, doctors say.
The comments from the British Medical Association follow criticism about the length of time it took to get testing data to officials in Leicester.
The city is the first to experience a local lockdown, after a rise in coronavirus cases.
PM Boris Johnson said data had been shared with all local authorities.
But Labour leader Sir Keir Starmer told Prime Minister’s Questions that officials in Leicester had only received full figures on Thursday, and there had been a “lost week whilst the virus was spreading”.
The prime minister said the government had first acted on what was happening in the city on 8 June, but “unfortunately it did not prove possible to get the results seen elsewhere”.
He added that “where necessary we will put on the brakes” by introducing local lockdown measures.
The BMA, the union representing doctors in the UK, said ministers needed to be more open and transparent with Covid-19 data and about how regional spikes in infections will be managed in the future.
Its members have expressed concerns about the prospect of a second wave of the virus, “heightened by local flare-ups”.
BMA council chair Dr Chaand Nagpaul said providing local leaders with up-to-date information was “vital” in containing outbreaks, particularly as a contact-tracing app is not yet in place.
He said the prime minister had talked about a “whack a mole strategy” to tackle local outbreaks but this would be no use if the people leading the response “are not given the most accurate up-to-date data possible”.
Leicester’s seven-day infection rate was 135 cases per 100,000 people – three times that of the next highest city – but it took 11 days for the decision to extend the lockdown to be made, the city’s mayor Sir Peter Soulsby said.
Shadow health secretary and Leicester South MP Jonathan Ashworth has said more guidance is needed on lockdown rules in the city.
Across the rest of England, the lockdown is set to ease further on Saturday with the reopening of bars, restaurants and hair salons, but the BMA said it wanted the government to set metric “trigger points” for when action will be taken to reintroduce local and national restrictions.
The BMA said this metric should consider not only the regional reproductive number or R rate – the number of people that one infected person, on average, will pass the virus on to – but also the proportion of the population currently infected.
It also called on the government to:
- share “timely, comprehensive and reliable information” to those managing new cases at a local level
- give “clear, consistent guidance” to the public that strict social distancing and infection control measures must continue to be adhered to
- guarantee supplies of personal protective equipment (PPE) to areas impacted by local spikes
A government spokesperson said it had been working closely with local partners, providing the resources and tools needed to take swift action to deal with any new local spikes in infection.
It remains one of the most baffling aspects of the current approach.
Local authorities have not routinely been given information about their residents who test positive.
Even though they are intrinsically involved in the system as the local arm of the contact tracing service, councils have only been getting what the national system deems appropriate.
They have been asked to chase up the so-called complex cases – where people test positive in care homes, prisons or schools – so they get that information quickly.
But they have not been given real-time information about individual residents who test positive.
Local directors of public health say it has hampered their ability to look for patterns and clusters developing. In theory, the national system should do this, but why not have a second pair of eyes? Especially one that knows the local situation much better?
This is beginning to change – data sharing agreements have just been signed with local authorities and Public Health England has now set up a system that should do this in a comprehensive and speedy manner from now on.
But the fact it has not already and the experience of those on the ground in Leicester – where cases were going up for a number of weeks – suggests local outbreaks developing in the community may not yet have been spotted as quickly as they should.
Business Secretary Alok Sharma told BBC Breakfast “you can always improve on these things” when asked if the Leicester response had been too slow, but said local authorities had access to digital dashboards with local data.
Labour MP Yvette Cooper tweeted it was “incomprehensible” that health authorities in Wakefield, West Yorkshire, had been trying to get hold of local data on swab test results of the wider population but had not been able to.
Under the local lockdown, announced on Monday evening, non-essential shops in Leicester have been forced to shut and schools have closed, except for vulnerable pupils and children of “critical workers”. People are also being advised not to travel in or out of the city.
The measures will last until at least 18 July and apply to the city centre and a number of suburbs.
Sir Peter criticised the government and PHE for being too slow to share testing data with the city’s officials – saying city officials had tried to get figures “for weeks”.
- Leicester’s new lockdown rules at a glance
The Department of Health has since announced a data-sharing agreement has been reached with local authorities which will give them access to the number of people testing positive in the community in their area.
But Prof Azeem Majeed, from Imperial College London, said the country had been slow in areas of its Covid-19, response and said the data-sharing agreement “should have been in place some time ago”.
Further local outbreaks ‘inevitable’
Announcing the lockdown on Monday, Health Secretary Matt Hancock said Leicester had “10% of all positive cases in the country over the past week”.
Bradford, Barnsley and Rochdale have all seen 45 or more cases per 100,000 people in the last week.
The government has, since May, said it would use local lockdowns to counter “flare-ups”.
Imperial College London’s Prof Neil Ferguson, who used to advise the government before resigning over a lockdown trip, told BBC Radio 4’s Today programme it was “inevitable” there would be further local outbreaks and said the high rates of the virus in Bradford and Doncaster were “clearly of concern”.
“Those are areas, where not as high as Leicester, but they have some of the highest numbers of cases per 100,000 of the population, which is the relevant measure, so they’re clearly of concern,” he said.
The Department of Health said as of 17:00 on Monday, 43,730 people had died with coronavirus in the UK, an increase of 155 on the previous day.
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