Test and Trace has been messy and expensive. But let’s not write it off yet.

11 Mar

NHS Test and Trace, the Government’s system to test and then locate people with Coronavirus, is – as usual – not having a good week. It started when Meg Hillier, Chair of the Public Accounts Committee, said the programme had failed to make a “measurable difference” in stopping Coronavirus transmission. Furthermore, she warned that “British taxpayers cannot be treated by the Government like an ATM machine”, in reference to the programme’s huge costs.

Soon after, Nick Macpherson, permanent secretary at the Treasury until 2016, Tweeted that Test and Trace “wins the prize for the most wasteful and inept public spending programme of all time. The extraordinary thing is that nobody in the government seems surprised or shocked. No matter: the BoE will just print more money.”

Then there were the newspaper write-ups, none of which were particularly flattering. “Test and trace has been a costly failure”, read one headline, and others followed in the same vein, detailing the staggering costs of Test and Trace – £22 billion and counting, with some consultants paid more than £6,000 per day to work on it.

The truth is, of course, that there have been a lot of issues with Test and Trace since it began in May 2020. From when the NHS’s Test and Trace app did not work, to technical glitch that meant almost 16,000 Covid-19 cases were lost in England, it’s been problem after problem, and no doubt there will be more to come. Yes, the cost is enormous and the UK might regret the whole thing one day.

Even so, it seems to me that some of the criticisms levelled at this project have become hysterical and unfair. Test and Trace, in fact, has been turned into the villain of the Coronavirus crisis – along with Dido Harding, who manages the programme – in a way that’s making it harder to decipher its actual efficacy. The criticisms may even exacerbate some of the issues contact tracers have had (more on this later).

Some of the most dramatic claims about Test and Trace have come from Labour, whose MPs have been particularly preoccupied with Serco, one contractor for the programme. Jeremy Corbyn said that parliament had used £37 billion to pay Serco for a “failed Track & Trace system”, and Rachel Reeves complained about the “Government’s outsourced, Serco-led Test and Trace system.”

Full Fact, the UK’s independent fact checking organisation, has set out the reasons why Corbyn and Reeves’ claims are “misleading”, as Test and Trace uses many public and private contractors, and it is actually testing that “accounts for the vast majority of the programme’s costs”. Full Fact also points out that £37 billion is the budget for Test and Trace, not how much has been spent. But one suspects the demonisation will continue…

In all of this, hardly anyone has praised the Government’s ability to upscale testing. Early on in the crisis, the media called for ministers to get “more tests” at every opportunity, and this was the World Health Organization’s advice too. The Government rose to the challenge, and has managed to conduct 1.5 million tests a day (!) this week with over 98 million Coronavirus tests having now taken place, an amazing achievement. Who would know, though?

The Government has also made vital progress in tracing the contacts of those who have been infected with Coronavirus. Figures for the week of February 18 – 24, showed that 129,243 people were identified as coming into close contact with another who had tested positive, and that when communication details were available, NHS Test and Trace managed to reach 96.3 per cent of close contacts.

These are very encouraging figures, but one of the problems with Test and Trace is to do with compliance. Research by SAGE in September showed that only 15 to 30 per cent of people self-isolated after being told to by contact tracers. The Government then offered £500 to support people who are on low incomes and would struggle if made to stay home, but Harding said in February that between 40 and 20 per cent of people contacted are still not fully self-isolating.

There are all sorts of reasons that people do not want to comply, and this isn’t a problem just limited to the UK incidentally. But I imagine this is not helped by the media’s determination to deem Test and Trace terrible. Anyone reading these headlines day in and day out might think “hmm, sounds bad. Might not bother then.”

The less interesting story is that Test and Trace has been slowly improving and that it’s expensive, but important, as it can also be used for future pandemics. The reason why it has had so many problems is that it’s been doing a “test drive” in the middle of a pandemic. The Government’s biggest fault is not creating this type of infrastructure in advance. South Korea’s contact tracing system was built following the MERS outbreak in 2015, and ready to go when Coronavirus turned up. Our leaders had the warnings.

Ultimately, some of the criticism directed at Test and Trace reminds me of that which was directed at Kate Bingham when she was Head of the UK’s vaccine taskforce. We have to be careful about coming to conclusions and demonising Harding in the same way. We have no idea what the programme could eventually look like.

It also has to be said that the whole reason we are doing Test and Trace in the first place is because of the UK’s lockdown approach. Test and Trace was our escape route before the vaccines came along. It’s easy to write it off, but some of the criticisms seem to be coming from the same people who wanted to lockdown, and demonised anyone (mainly lockdown sceptics) who warned about the costs. Indeed, when Hillier warned “British taxpayers cannot be treated by the Government like an ATM machine”, I thought to myself: well, welcome to 2020-now. This is the route we’ve chosen, so let’s not give up yet.