The vaccine roll out accelerates. But testing still remains a vital part of the Government’s strategy.

13 Jan

Now that vaccines are being administered across the UK at astonishing speed, with approximately 2.8 million doses given so far, it’s easy to believe the light at the end of the tunnel is here in the global battle with Coronavirus.

Ideally, it is. The best case scenario is that the vaccine quickly protects everyone who needs it, while reducing the virus’s transmission in the population. 

Even better would be if the vaccine provides long-lasting immunity, as opposed to people having to get inoculated on a regular basis (creating a health risk and huge logistical challenge, especially if the virus mutates and new vaccines are needed).

While we find out these details – and we should have some answers over the next few months – there’s been less talk about NHS Test and Trace, and mass testing, the systems the Government has spent enormous sums on to keep the virus at bay while there’s no vaccine.

Paradoxically, as the vaccine roll out gets under way, NHS Test and Trace has become stricter, updating its definition of “close contact” so that users have to log more details of who they’ve been within two metres of.

Not least because the system has been quietly improving, with a record figure of 493,573 contacts identified in the week ending December 30 – up from 407,685 the previous week. In short, this will lead to an increase in the number of people who need to self-isolate.

The Government is also devoting huge resources to mass testing, with Matt Hancock announcing on Sunday morning a programme of “lateral flow” devices to help detect asymptomatic cases. 

A total of 317 English local authorities will be able to deliver this, with the army deployed to Bolton to help next week. Pilot schemes are also being used by businesses, such as John Lewis and others in manufacturing, retail and food.

While these systems aren’t perfect – there are still lots of criticisms around their capabilities – the point is that they’re being developed and improved, in spite of the vaccine, which is celebrated as our get out option. So why is this the case?

The first explanation is simply that the Government needs every resource possible right now to fight the mutant variant of Coronavirus. Chris Whitty, England’s Chief Medical Officer, has warned that we’re about to go into the worst weeks for the NHS, so it’s no wonder that we’re readying multiple systems.

Then there are more depressing long-term considerations, such as whether the vaccine runs into trouble. Perhaps immunity does not last as long as we thought it would, or a new strain of the virus comes along for which there is no vaccine yet, and so forth. This is when Plan B, C, D, E and a whole alphabet of other options becomes vital.

Worse still, there could be another pandemic in the future. That’s why the Government can better justify spending eye-watering sums on this infrastructure, which we may be grateful for later.

The difficulty with all this is that the Government has had to build testing infrastructure while we’re in a pandemic, as opposed to before, so it has discovered flaws in its systems in the worst possible way, perhaps part of why test and trace has cost £22 billion.

No doubt there will eventually be questions about why it – along with many other governments – lacked preparedness in this area, unlike South Korea and Taiwan, who had contact tracing in place. Yes they built their systems in response to MERS and SARS, respectively, but the signs were there to the international community that this infrastructure was worth considering.

Either way, the focus on testing isn’t going away any time soon.

London’s Nightingale hospital comes off “standby” mode – as these sites face their biggest test yet

12 Jan

In recent months, the Government has been forced to defend itself over the Nightingale hospitals, the medical sites it set up in the spring to support the NHS through the Coronavirus crisis, which have been noticeably empty, and sometimes deactivated, across the pandemic.

While their emptiness should be a good thing, many have wondered – more so now that the NHS is under huge strain and with the emergence of the new Coronavirus variant – why this extra support has not been used much, if at all.

It is estimated that the Government spent £200 million in total on seven sites in England, but the most publicised Nightingale hospital (in London’s ExCel) closed a month after treating 57 patients. Inevitably there were questions about whether this was a good use of resources.

When Matt Hancock was grilled on this matter in December last year he said that these hospitals were never intended as the first port of call, and were in fact “there in case they’re needed.” Stephen Powis, NHS England Medical Director, has echoed this sentiment, calling them “our insurance policy, there as our last resort.”

So it is troubling that today the London Nightingale field hospital has been opened up again, albeit as a “rehab unit” to treat those recovering from Covid and other conditions.

The Nightingale in Exeter has been off “standby” mode since November, when it started taking patients from the Royal Devon and Exeter NHS Foundation Trust.

Nightingale hospitals in Manchester, Bristol and Harrogate have also been used for non-Covid patients.

And Northern Ireland is seeing a similar rise in demand, where the Nightingale Hospital in Belfast is being prepared for use as intensive care patients increase.

That being said, across all Nightingale hospitals there is no consistent snapshot of how they’ve been used, as so much is determined by the nature of the virus and how it spreads across the country.

At the other end of the spectrum is Sunderland’s Nightingale Hospital, a 460-bed facility, which has not treated a single patient and does not expect to as of yet.

It’s a similar story in Wales, where the health authorities decided to dismantle its 2,000-bed field hospital which was created at the beginning of the pandemic, instead moving to smaller sites, which are designed to support existing hospitals.

In England, however, the signs are there that this infrastructure will be more relied upon, particularly given the dire warnings from Chris Whitty, England’s Chief Medical Officer, about the challenges over the coming weeks as the NHS battles a much more transmittable version of the virus.

One of the biggest challenges ahead will be whether the Nightingales have enough staff to support the upscaled infrastructure. NHS professionals have complained that there simply aren’t enough nurses and doctors for them. Hancock has previously said the Government “built more capacity within the NHS” to cope with growing cases, but how this translates to reliance on the Nightingale hospitals remains to be seen. Tragically, the next few weeks are likely to be their crucial test.

More restrictions considered, as compliance with the “stay home” message drops. But which measures can be strengthened?

11 Jan

This week the UK has had some of its worst rates so far in its battle with the Coronavirus. The number of patients in hospital now stands at over 32,000, and the country has also seen its highest daily toll of 1,325 deaths.

The NHS has now reached the “most dangerous time” in its history according to Chris Whitty, England’s Chief Medical Officer, with firefighters having to help London ambulances respond to emergency calls. Just anecdotally, it seems there’s much more footage of nurses and doctors on our TV screens compared to during the first wave, speaking out about how dire the situation is.

In answer to this, the Government has escalated its Coronavirus measures and launched a public awareness campaign to encourage people to comply with the latest lockdown rules. Whitty has been doing the media rounds to get the message out; over the weekend he wrote for The Sunday Times of the “material risk of our healthcare services being overwhelmed within 21 days” without intervention, and he has also taken part in a TV advert asking people to stay at home.

Nadhim Zahawi has also been on the television, asking people to behave in the coming weeks, and at today’s 5pm’s press conference Matt Hancock drove home the message that it’s “Your actions now that make a difference”, encouraging the nation to “follow the rules”. Ministers clearly hope that if they say it enough the public will start to comply. But there are signs that this will not be the case.

Paradoxically, as the crisis reaches its worst stage – with a mutant strain of Coronavirus and the NHS clearly about to reach breaking point – people are getting more relaxed about their own, and others’, safety.

One piece of data that indicates this comes from Citymapper, a transport app, which tracks how much people walk, cycle, or take taxis in London, Manchester and Birmingham. In the first lockdown, mobility fell to less than 10 per cent of pre-pandemic levels, and now it has fallen to just under 20 per cent. There have been other signs of falling compliance, such as the below:

What does this mean for the Government? Boris Johnson has never wanted to use draconian measures, hence why he was one of the last leaders in Europe to order a lockdown in the first outbreak.

At various points in the crisis the Government has tried to resist strengthening restrictions or adding any more rules to those we now live with. Michael Gove, for instance, previously said face masks in shops should not be made compulsory in England, only for this to eventually happen.

As complaints about how the Government has managed this crisis grow louder – as they are now – it almost always adds a harsher measure.

Given the ferocity of the second wave, it wouldn’t be surprising at all if ministers go further, especially after Johnson said today “if we need to tighten [the rules] we will.”

It has also been reported that Cressida Dick, the Metropolitan Police Commissioner, recently took part in a meeting of the Covid O committee, which sets new measures, indicating a growing requirement for more policing.

But where could the Government tighten restrictions? This is perhaps a more pertinent question than if it will do this in the first place.

One suggestion has been outdoor exercise, which people are currently allowed to do with another person under the guidelines. That could come to an end.

Another idea could be scrapping support bubbles, although the Government has apparently ruled this out. No doubt it would be an extremely unpopular move given the misery single households have faced under lockdown.

Keir Starmer has also said nurseries being opened “needs to be looked at”.

Many of the decisions will no doubt depend on data about how the virus spreads. It would make sense to see tighter regulations in supermarkets, for example, as Public Health England identified them as one of the most frequent exposure settings for those catching Coronavirus.

The Government has, at least, given itself leeway to move the current restrictions, as well as laying the foundations (media messaging) for harsher measures – a common tendency in this crisis – so that the public will be prepared.

What happens if even stronger restrictions don’t work is a question for another day…

2021 and the race to normality. Post-vaccine hospitalisation and transmission data are key to reopening the economy.

2 Jan

With the advent of 2021 (happy new year!) and the Oxford vaccine finally receiving approval, many of us are wondering a simple – but difficult to answer – question: how soon until life gets back to normal?

Boris Johnson has said that Britain will “open up” by Easter. But many people want the Government to move much faster now that it has the tools to do so, and not least because of what’s happening in Israel.

The country has been administering its population with the first dose of the Pfizer/ BioNTech vaccine at the rate of 150,000 people per day, with it on track to have 10 per cent of its citizens covered by the weekend.

While the UK has some of the best figures in this regard, it looks comparatively slow next to those above. Take the stats for England in the week ending December 27, when 243,039 people received vaccinations, with the total number of recipients standing at 786,000 since December 8.

To add to the pressure for Matt Hancock, the Chief Executive of AstraZeneca said the company could supply two million vaccines per week, so all eyes are on the Government to see if it can distribute these – especially as pressure on the NHS continues to grow.

Can the Government do it? Clearly getting millions of vaccines out is no walk in the park, from arranging huge numbers of appointments at short notice with some of the oldest and most vulnerable members of the public, to having to monitor people afterwards for 15 minutes (to check for adverse reactions). But there are areas that the Government can quickly improve upon.

There are, for instance, huge bureaucratic barriers for vaccinator volunteers, who have had to provide 21 pieces of evidence, such as Prevent Radicalisation training, to help out with Coronavirus efforts. With over 25 million people on the priority list for a vaccine, there’s never been a better reason to cut the red tape.

The Government will also be expected to smooth over manufacturing inefficiencies, which have been blamed for a discrepancy in the number of Oxford University and AstraZeneca vaccines expected for the NHS this year (30 million doses) versus the reality (530,000) – a gap that need to be closed quickly to bring down hospital admissions.

To the Government’s credit, it has risen to enormous challenges throughout this pandemic. Ministers were able to ramp up Coronavirus tests from nothing to hundreds of thousands per day, in an achievement that is often overlooked, and there are signs of vital progress on the vaccine front.

British military medics have been put on standby to vaccinate up to 700,000 people per week, and the Government has also switched its inoculation plan. Originally, the idea was to give two doses 21 days apart, but now a two-dose vaccine will be administered as one jab initially – to give as many as possible of the vulnerable some protection (with a second dose administered four to 12 weeks later).

Although some GPs have been unhappy about this idea, the UK’s chief medical officers have defended the strategy, writing in a joint letter: “We have to follow public health principles and act at speed if we are to beat this pandemic, which is running rampant in our communities, and we believe the public will understand and thank us for this decisive action.”

It’s innovation, as much as speed, that the Government needs to speed up its vaccination programme. No idea is off limits, with many people already placing suggestions on Twitter – even that pubs could be used as vaccination hubs – to get the UK moving faster out of lockdown.

In order to ease restrictions, the Government is working towards two goals. First, it needs to rapidly cut down hospitalisations, so that the NHS is no longer overwhelmed, which will mean it’s far safer to lift measures.

The second is to achieve population immunity, meaning “the virus has nowhere left to run.” Scientists have predicted that we could need anything from 60 to 80 per cent of the population vaccinated to achieve this, although it ultimately depends on what the next few months tell us about transmission. The ideal scenario is that the vaccine not only protects vulnerable members of society, but quickly stops the spread of the virus. This could have a dramatic impact on when restrictions go.

In the mean time, it makes sense for the Government to hold Easter up as the date for reopening the economy, not least because it will be warmer then – with less scope for people mixing indoors (where the virus spreads more easily). The Government no doubt feels more confident, based on last year’s seasonal patterns, that it will be easier to open then, vaccine or not – and plans to phase out the furlough scheme in April. Until then, ministers will have one of the busiest new years on record trying to make “Operation Get Back to Normal” a reality.

Bill Bowkett: The pandemic has shown the value of localism. But the Government seems to be ignoring this lesson.

31 Dec

Bill Bowkett is a MA Newspaper Journalism student at City, University of London. He is a former editor of the University of Kent’s student newspaper InQuire and has worked as a researcher in Parliament for Sir Oliver Heald MP.

New year’s resolutions are always a fitting tradition. The Romans birthed this trend with the worship of Janus – the two-faced God of beginning and end. Back then, citizens gifted presents to their enemies. In return, Janus would forgive those who confessed their sins.

And lo, two millenniums later, the sun rises in 2021 and a chance to start anew. When news of a vaccine was announced back in November, an ending to this Covid-19 impasse looked imminent. But as the last few weeks have proven, hopes of a ‘social reset’ have been quashed.

New tiering measures meant Christmas was cancelled for families across England. Those that were hoping to spend some time with nanny and pappy last week had their plans shattered because of rising cases, particularly across the south-east. Not to mention a new mutant strain.

This year has dealt multiple blows, but these authoritarian restrictions leave a bitter aftertaste like a par-boiled Brussel sprout. Each of us who have sacrificed our freedoms in the name of public health – and were promised family festivities and an imminent return to normality – have been betrayed.

Serious questions continue to be raised about No 10’s handling of the crisis. But it seems that voters have had enough and have made their intentions clear: they want to take back control.

A recent survey by community network Locality showed that out of 2,000 adults polled, half lack faith in central government to make the right decision for their local community. Moreover, 56 per cent said that they wanted more local decision-making powers.

For all their efforts, this overbearing administration has failed to deliver on multiple fronts. Contract tracing has left thousands of infected individuals missing from the national database. Testing targets are repeatedly being missed at a cost of billions to the taxpayer. And with thousands of shops, pubs, and restaurants forced to close at this, the most wonderful – and profitable – time of the year, the economic forecast looks grim.

Funny that. The Conservatives usually pride themselves on being the party of localism. Yet, they certainly have enjoyed the powers given to them in the Coronavirus Act.

Just a fortnight ago, Education Secretary, Gavin Williamson, threatened Greenwich and Islington councils with legal action if they failed to keep schools open (even though keeping children in class, with days left until the end of term, was illogical).

Why the government is acting in this manner is anyone’s guess. They wish to be in command, yes. But this is not a job they can face alone. With anxieties of a third national shutdown on the horizon, we need new grounds for optimism.

Where should change come from? The answer is centred on those who are normally responsible for wellie bin collections and allotments. Because in 2020, local government has stepped up big time.

Take Leicester, the first city to go into local lockdown back in June. Authorities chose to ditch the NHS Test and Trace App. They used their own methods that applied local insight, calling residents over the phone and knocking on doors. Shortly after results started to show, and cases dropped in the short space of time the initiative was running.

The same goes for the West Midlands where Andy Street, the region’s metro mayor, said piloted tracing identified between 98 and 100 per cent of cases. Remarkable.

And in Sunderland, the council and local Mack’ems are looking towards the future, with the two working on a draft neighbourhood plan that aims to combat health inequalities.

The pandemic has changed the way citizens think about where they live. It has anchored us closer to what happens on our front door – whether that be civil associations working to deliver essential goods, or local authorities setting up support networks to care for our most vulnerable. Localised planning has made a positive difference (certainly a breath of fresh air to the ruckus coming out of Westminster).

With all that being said, if there is one New Year’s resolution the Prime Minister should make that will help the country in the long run, it is sharing the balance of power in England — and a comprehensive devolution framework that meets the needs of those closest to our doorstep.

Rishi Sunak’s “Shared Prosperity” funding announced in this month’s spending review – allocated to local authorities to help stimulate growth – should be spent by independently-minded legislators, not those in London. No conditions, ifs, buts, or maybes. As the Northern Powerhouse think tank director, Henri Murison, said, the government should not “top slice” funds and “pocket it in Whitehall for their own programmes”.

And like in the summer, authorities in England should have lockdown abilities returned so as to have the same power-status as the rest of the home nations. A hyper-localised approach means decisive action with local residents and businesses in mind. That also means control over mobile testing in places like care homes where the Health Secretary Matt Hancock recently announced £149 million of additional funding.

All aspects of life are going to bear the brunt these next few years, if not decades. The Tory’s manifesto pledge to ‘level up’ left-behind Blighty will invariably be set back amid Britain suffering the worst recession in history, as well as having the worst regional inequality in the developed world. Frankly, these are tasks beyond the executive’s capacity.

Radical thinking is needed to disperse fiscal and political responsibility away from high office, whilst also retaining accountability to those who govern. Therefore, a bottom-up approach holds the keys to our destiny – a meaningful partnership based on forward-thinking – because this epidemic impasse cannot last any longer.

Each new year brings the opportunity to resolve, and 2021 is no exception. If the frontbench continues as they are doing right now, we will continue to get the same. It is time to change our current trajectory. Time to give power back to the people.

Sunak is our panel’s minister of the year

28 Dec

In 2019’s end-of-year survey, ConservativeHome panelists named Rishi Sunak as their “One to Watch for 2020“, and what a sound assessment! 2020 has seen Sunak catapulted from relative political obscurity to fast becoming a household name. He has been a consistent favourite in our Cabinet Survey ratings, so it is no surprise that he is our minister of the year.

Clearly people have been impressed with Sunak’s management of the Coronavirus crisis, from his introduction of the furlough scheme, to the inventive “Eat Out to Help Out” discount, all within his first year of being Chancellor. He has shown himself to be remarkably calm under pressure, dealing with one of the worst financial crises in history, while working to make Boris Johnson’s “levelling up” and “green revolution” ambitions a reality. Sunak’s ascent and likeability factor have recently been documented by Lord Ashcroft in his book Going for Broke: The Rise of Rishi Sunak.

As part of our survey, we also gave respondents the opportunity to name other ministers they felt had performed well this year, represented in a worldcloud below:

 

 

 

 

 

Liz Truss came out as the most popular by far (in short, she came second in our minister ratings), gaining 50 per cent of the “Other” vote. Having secured trade deals covering 61 countries, along with her recent “Fight for Fairness” speech, it is no wonder that the Trade Secretary has gained such popularity.