Local Covid-19 data needed quickly to target outbreaks – doctors

Giving local authorities accurate and up-to-date data on spikes in coronavirus cases could help save lives, leading doctors have said.

The British Medical Association (BMA) implored the Government to ensure that local leaders were given timely information about cases in their area to help contain the spread of the virus.

It comes after ministers faced criticism for the handling of the surge of cases in Leicester.

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Leicester goes back into lockdown
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Leicester goes back into lockdown
A person wearing a protective face covering boards a bus on Bowhill Grove in Leicester, where the localised lockdown boundary cuts through. A local lockdown has been imposed following a spike in coronavirus cases in the city.
The Walkers crisp factory in Leicester after the company confirmed that there have been 28 positive cases of Covid-19 at the site.
A worker wearing a face mask at the Walkers crisp factory in Leicester after the company confirmed that there have been 28 positive cases of Covid-19 at the site.
Bowhill Grove in Leicester where the localised lockdown boundary cuts through. A local lockdown has been imposed following a spike in coronavirus cases in the city.
LEICESTER, ENGLAND - JULY 01: A man walks past a masked mannequin standing outside a butchers shop in the Birstall area on July 01, 2020 in Leicester, England. Ten per cent of all the recent UKs Covid-19 deaths occurred in Leicester, which became the first British city to be put into regional lockdown on Tuesday night. (Photo by Darren Staples/Getty Images)
Belgrave Road, Leicester�s Golden Mile as Leicester returns to Lockdown amid a spike in Coronavirus cases in the city
Belgrave Road, Leicester�s Golden Mile as Leicester returns to Lockdown amid a spike in Coronavirus cases in the city
A funeral procession leaves a house on Brandon Street off Belgrave Road in the Golden Mile area of Leicester as Leicester returns to Lockdown amid a spike in Coronavirus cases in the city
Belgrave Road, Leicester�s Golden Mile as Leicester returns to Lockdown amid a spike in Coronavirus cases in the city
Quiet streets in Leicester City centre as Leicester returns to Lockdown amid a spike in Coronavirus cases in the city
Quiet streets in Leicester City centre as Leicester returns to Lockdown amid a spike in Coronavirus cases in the city
Quiet streets in Leicester City centre as Leicester returns to Lockdown amid a spike in Coronavirus cases in the city
Quiet streets in Leicester City centre as Leicester returns to Lockdown amid a spike in Coronavirus cases in the city
A man wearing PPE in the Spinney Halls area of Leicester, after the Health Secretary Matt Hancock imposed a local lockdown following a spike in coronavirus cases in the city.
A man wearing PPE in the Spinney Halls area of Leicester, after the Health Secretary Matt Hancock imposed a local lockdown following a spike in coronavirus cases in the city.
A police car on Gallowtree Gate in Leicester after the Health Secretary Matt Hancock imposed a local lockdown following a spike in coronavirus cases in the city.
Leicester City Mayor Sir Peter Soulsby speaks to the media in Leicester City Centre as speculation grows about a localised lockdown in Leicester
A Coronavirus testing station has been set up in Victoria Park Leicester
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The BMA urged the Government to share "timely, comprehensive and reliable" information to all those involved in the management of new cases at a local level.

It also called for clarity about how regional spikes will be managed in the future.

Dr Chaand Nagpaul, chairman of the BMA Council, said: "The Prime Minister has talked about a 'whack a mole' strategy to tackle local outbreaks, but this is no use if the people leading the response on the ground – be they public health teams or local leaders – are not given the most accurate up-to-date data possible.

"This is crucial to allow swift action and to protect lives and the health service, and something that is not happening right now.

Coronavirus - Tue Jun 30, 2020
A Covid-19 testing centre set up at Highfields Community Centre in Leicester (PA)

"This is all the more important given that the 'world leading' test and trace app is not in place, meaning local leaders and teams armed with up-to-date information will be vital in containing spread of outbreaks."

Ahead of further lockdown restrictions being eased at the weekend, the BMA made a series of demands from the Government.

These include the use of set "metric trigger points" at which action will be taken to reintroduce local and national restrictions, which would take into consideration the regional reproductive rate – known as the R rate – as well as the level of infections in communities.

It also stressed the importance of clear public health messaging that social distancing and infection control procedures should be adhered to.

Meanwhile, leading health academic Professor Sir Chris Ham urged the Government to give local leaders control over NHS Test and Trace.

In an opinion piece published in The British Medical Journal, Sir Chris wrote: "A crisis on the scale of the Covid-19 pandemic requires a national response. But in a country as large and diverse as the United Kingdom, where the impact of the virus varies between areas, a national response is insufficient.

"Local leadership is also essential, drawing on the expertise of devolved governments in Northern Ireland, Scotland and Wales, local authorities, NHS bodies, and many other public sector agencies.

"A major weakness in the Government's handling of the crisis has been its failure to recognise and value local expertise."

He said that the people who have been in contact with those confirmed to have the virus have been contacted by regional teams of Public Health England and local health protection teams.

This raises "serious questions about the value for money" of the national telephone based service, he said.

"In the case of contact tracing, most of the work is now being done by regional teams in Public Health England and local health protection teams led by directors of public health employed by local authorities," Sir Chris wrote.

"Recent statistics show that in its first three weeks of operation, NHS Test and Trace reached around 113,925 people who were in contact with those who tested positive, of whom around 90 per cent were traced by Public Health England and local health protection teams.

"The remainder—amounting to just 12,247 people—were reached by the national telephone-based service run by Serco and Sitel, which employs around 25,000 staff. This raises serious questions about value for money in the use of public resources in a contract reported to be worth up to £108 million.

"In my view, bringing these staff under the control of local authorities is overdue."

Sir Chris, former chief executive of the King's Fund health think tank, concluded: "Local leaders, including devolved governments and elected mayors, are much better placed than the Westminster government to engage their communities in limiting and responding to future outbreaks.

"To do so effectively, these leaders must be given control of test and trace to rectify the flaws in the Government's ill judged design."

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