Covid: Can Test and Trace save us from this Friday feeling?

Tom Clarke

Former Science Editor

It used to be the weekend, but now all I have to look forward to on a Friday is the weekly Covid-19 statistical update. And the numbers are as relentlessly depressing today as they have been since the start of September.

Cases continue to rise across nearly all of the UK, faster in some places than others, but rising all the same. If there is any glimmer of good news in today's data-dump from the Office of National Statistics is that the rise isn't getting any faster. 

Last week there were an estimated 433,000 people with the virus in England - equivalent to about 1 in 130 of us.

It's about 1 in 180 in Wales and Scotland and around 1 in 100 in Northern Ireland. The number of cases is roughly doubling every two weeks.

There is a faint hint that the speed of the growth of the outbreak might be slowing, but the trend is weak and as likely as not to pale into statistical insignificance by the time next Friday's update comes around.

So don't start making big plans for Christmas just yet.

The daily data released by the Department of Health is no use for inferring long-term trends due to the time it takes for cases to be catalogued and deaths recorded.

But it does serve to reflect another grim reality of the unspectacular but steady rise in cases: 224 more deaths logged today

Health workers wearing full personal protective equipment on the intensive care unit at Whiston Hospital in Merseyside Credit: PPE

It's the kind of number we've not seen regularly since May but that we will see again, and again, as some of those being infected in increasing numbers now progress to severe disease and die.

It's some comfort that people in intensive care with Covid are far more likely to survive now than they were during the first peak in the outbreak, but a cold one given the ONS data show a continued increase in cases among the over-70s who are twice as likely to die as those aged 60-69.

Making the Friday feeling even less cheery are yesterday's statistics from the government's Test and Trace service that are getting worse as quickly as the epidemic grows. 

Many experts are asking whether the system is, or indeed can, make any meaningful difference to the current rise.

A key indication is comparing the testing data with the ONS survey. The government's statisticians sample households at random, so pick up asymptomatic cases as well as symptomatic ones. Only symptomatic cases are eligible for a test so only they come to the attention of test and trace. 

The Test and Trace app was finally launched at the end of September. Credit: PA

Comparing those numbers, points out Prof James Naismith at the University of Oxford, shows fewer than half of the Covid cases in the UK are being picked up by test and trace. The system is then only identifying around 7% of their contacts within the crucial 24-hour window and 20% of their contacts ever.

"The system has given a birds-eye view of the pandemic and done very little to halt it," said Prof Naismith.

But that, Test and Trace insiders tell me, is unfair.

Outbreaks at Universities have successfully been curbed by testing and contact tracing of students they say.

Also, some regional outbreaks like a rise in cases in Herefordshire and Norfolk were identified and brought under control by the system. 

But the case numbers in the main outbreak zones of the north west, north east, Yorkshire and the Humber show it certainly hasn't worked there.

The increase in turnaround times for testing (now only 15% of in-person tests come back within the 24 hour deadline) make that job even harder.

Turnaround times will improve I am told. By the end of next week test and trace will hit its target of 500,000 tests a day bringing additional capacity to the demand of a growing outbreak.

As far as contact tracing goes, that too is in hand say the Test and Trace team. With centralised call centre staff struggling to reach contacts, contact tracing is being rolled out to teams of tracers within local public health teams. Evidence is they will have a better hit-rate than the Serco- and Sitel-run call centres. But the transition to a new system has not gone smoothly and many contacts are currently being missed as a result. 

Despite their challenges the Test and Trace system contacted twice as many people last week as they did the week before.

However, given the growth in the outbreak, that will have to improve significantly. Some local authorities in Tier 3 areas are demanding control over the contact tracing system themselves. 

Last week, the head of the testing and trace system Baroness Dido Harding said it was never intended to be a "silver bullet." 

People can easily be forgiven for thinking otherwise, or even for thinking it would be a golden bullet, given its £12billion (and counting) price tag and some of the "world beating" political rhetoric around it.

So while it might be making a bit of an impact, the best advice for this Friday night is keep washing the hands, covering the face and keeping some space, because we're currently out of bullets, silver or otherwise.