Thread by @StephenGrey

Boris Johnson said UK's then £12 billion Test & Trace service could b vital 2 “ensuring that we do not have a second spike this winter”

It didn’t work. Why? An investigation w/
@AndyMacaskill @McNeill_Tweets @stecklow @reuterstommy @Journotopia

1/18

reuters.com/investigates/s…

First - to be clear – the Second Wave cannot be blamed on any one factor. Nor are other countries faring well.
But our investigation found that contact tracing in England has so many flaws, some experts doubt it stops almost ANY transmission. 2/18

The story of Britain’s Wave2 story with cases in Northern England (see this picture from September) – from there the infection spreads South
Riffing on Game of Thrones, many had noted darkly that “Winter’s Coming” – but the spike began much earlier, in Autumn. 3/18

The British government’s failure to share data on COVID-19’s spread concealed what one health expert called an ‘iceberg’ of infection -- and relaxation of lockdown too soon. e.g. hidden cases in Manchester only emerged publicly after Government published community tests 4/18

The North is still suffering the worst – facing weeks more of lockdown, people cut off from their families; businesses in real troublel. And this is where deaths in Wave2 are so far concentrated 5/ 18
COVID deaths since September: (Source PHE API)+>

It’s the chaos in contact tracing that’s astonishing. This retired surgeon, local tracer, knocks on a door in Halifax, meets patient, is told of SIX contacts inside home – but is banned by national rules from talking to them – or following cases onwards. 6/18

The Government told us – without evidence – contact tracing “breaking chains of transmission” – and tracers reaching “the vast majority of ppl testing positive and their contacts.”

But – AT BEST - fewer than 1/2 of contacts are told to self-isolate. And there’s more … 7/18

We found most “contacts” located by Test&Trace are simply other members of a sick person’s own HOUSEHOLD. These are people supposed to be isolating already. As Hancock has admitted, contact tracers sometimes “bombard” homes to reach all family members. 8/18

The national “contact tracing” service – outside genuine work of local outbreak teams – is hardly contact tracing at all. No detective work. Focused on household contacts. As one Public Health Director put it, “more like a reminder service or something. Like a Library .." 9/19

While UK says it reaches “vast majority” of contacts – it reaches ½ a non-household contact per covid case – while a weekly UK survey by @LSHTM shows people had 2-4 non-household contacts EVERY DAY in July-Aug, and 4-8 in September. 11/19
cmmid.github.io/topics/covid19…

Tracing in England is also far too SLOW: It takes tracers average of six or seven days from when someone gets sick to reach those contacts. @Reuters finds that many people withhold the names of their contacts, and there is rarely a detailed follow-up investigation LINK 12/18

As SAGE warned , contact tracing must be fast – but we found it takes an average of at least SIX days from getting sick with COVID19 to your contacts being reached.

Why should it be so fast? Bcs ¾ of transmissions are within 2 days before or after onset of symptoms. 13/18

SAGE paper (April): successful tracing requires "c. 80% of non-household contacts of symptomatic cases to be traced and isolated rapidly, ideally w/in 2 days of symptom onset ...would require around 30 contacts traced per symptomatic case. Beyond that, benefits wd be marginal.”

Why does so long to contact trace? Infection starts 1-2 days before symptoms, plus 2 days to get tested, 3 days for result to flow to tracers, +1 day to trace. Some causes: use of home kits, lab delays, glitches in multiple computer systems.. 15/18
reuters.com/article/us-hea…

IN the beginning, SAGE warned that data lags meant that measures to stop pandemic might not happen soon enough. But @Reuters found it’s still taking an average of three days for cases to be published – and only a little faster to reach contact tracers. 16/18

Delays are not as bad as they were in September– but still too long. Here’s how publication delays vary over time. 17/18

Local public health teams from PHE and councils ARE doing vital work vs outbreaks but you would never know it. PHE publishes little detail of its work. Unsung heroes are “quarantined” from going public and sharing lessons learned. 18/18