Thread by @globalhlthtwit

Today we lost 1820 of our citizens. Many of these deaths could have been prevented. I plead with our Secretary of State @MattHancock and @CMO_England to make changes to our community protective shield as follows: (1)

Face the data with humility. Latest data show only 32% of in-person test results were received within 24 hours...Way too slow. For all routes combined, 18.3% of tests from all test sites were received within 24 hours of a test. (2)

Since Test and Trace launched, 97.8% of all contacts managed by local health protection teams have been successfully reached. Performance of call centres is much worse. The % reached within 24h of the case that reported them reaching the contact tracing system fell to 67.7%. (3)

We should expect many more contacts than have been identified by call centres. And those contacted by call centre or online are simply asked to self-isolate. No follow-up. No link with primary care. No offer of local help. (4)

The MOST important statistic is not measured: compliance with 'self-isolation'. Surveys conducted have shown only 18.5% comply. And many of the poorest groups won't go for a test because they fear being asked to self-isolate. Why? (5)

They fear isolation because up to 80% of people fail to receive the £500 promised to support their family during isolation for 14 days. A payment to cover 14 days on a living wage would cost £980. We are asking families to go hungry to stop spreading infection. (6)

Every country that successfully closed this pandemic down supported their people with living wages, bills paid, local monitoring of symptoms and isolation, and local support with shopping and food. They know that the details of local public health support matter. (7)

It is not too late to do this. We shall have circulation of this virus for many more months. Almost two thirds of people in ICUs are under 65. So please change the test, trace, isolate system. Here are three things you can do now: (8)

A. We must have local testing system which gets 90% of the results back within 24 hours. Surely we can do better...mobile centres in many other nations get the results back within 6 hours. (9)

B. We should close call centre contracts and move resources to local public health and primary care. Immediately. To match Chinese coverage we need 45,000 pandemic community workers to assist with contact tracing, and to monitor and support isolation. (10)

We had 750,000 volunteers, including retired Doctors, nurses and administrators. They could do a great job as volunteers or on minimum wage. They are willing to help. Use them. (11)

C. Finally we must promise £750 to people asked to isolate, with a further £230 if they comply with isolation. They should receive the payment within 2-3 days of being asked to isolate. Local teams can monitor compliance + details of people asked to isolate, to avoid fraud. (12)

We can lock down this virus and prevent the carnage of death we have seen today. We may need a pandemic reserve team of community workers trained for future pandemics. Countries who suppressed did not need national lockdowns. We can do the same. (13)

We face a double dip recession. China is growing at 6.5% higher than before the pandemic. Creating a protective community shield will save lives, protect the NHS and get people back to work. Please, please do it. (14) @MattHancock @CMO_England @BorisJohnson