Covid-19: Track and Trace System

Lord Bethell Excerpts

Thursday 18th June 2020 Lords Chamber

[Baroness Anelay of St Johns]

To ask Her Majesty’s Government what progress they have made with the implementation of the COVID-19 track and trace system.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

My Lords, this country has gone from 2,000 tests a day to 200,000 tests a day, with capacity to trace 10,000 indexes a day. We took 39,000 antibody tests yesterday and we are dramatically reducing turnaround times. The “test and trace” programme is a remarkable national asset that protects us from this virus through diagnosis, research and surveillance. I am very proud of the remarkable collaboration of the NHS, PHE, universities, the private sector, the military, local government and many other inspiring colleagues.

[Baroness Anelay of St Johns (Con) [V]]

What impact do the current lack of a nationwide NHS Covid-19 app and the statement by the director-general of the biosecurity centre that they do not expect to reach full operating capability until the end of the summer have on the Government’s decision about when and how to ease lockdown conditions?

[Lord Bethell [V]]

My Lords, the current low level of prevalence of the virus means that the pressure on automated tracing devices such as the app is less heavy than it would be under other circumstances. The biosecurity centre is already making a massive difference to co-ordinating our local response to the disease. We have made terrific progress so far and our management of lockdown measures will reflect that fact.

[Baroness Young of Old Scone (Lab) [V]]

Statistics on the first full week of operation show that less than 58% of the contacts of confirmed symptomatic cases are traced and say that they will self-isolate—it is difficult to know whether they do so. “Test and trace” tracks only contacts of symptomatic cases, and the ONS infection study shows that only one-third of total new infections are symptomatic. Will the Minister admit that “test and trace” is resulting in the isolation of an ineffectively small proportion of the contacts of all new cases and will not prevent a second wave of the disease?

[Lord Bethell [V]]

My Lords, last week’s figures suggest that 67% of people who tested positive for coronavirus were reached by our contact tracers. This figure is rising every week. The epidemiological logic is that a system such as “test and trace” will never be 100% ubiquitous or track everyone who carries the disease—asymptomatic infection is a part of this terrible disease. However, it can have a profound effect on its spread and break the chain of transmission. That is why we have invested in this infrastructure and why we appealed to the British people to comply with the isolation protocols.

[Baroness Jones of Moulsecoomb (GP) [V]]

When will the people of the Isle of Wight be allowed to stand down in terms of the app that they have been guinea pigs for, and to concentrate on a wider “test and trace” and their own recovery?

[Lord Bethell [V]]

My Lords, we are enormously grateful to the people of the Isle of Wight for their collaboration on the pilot. There is no question of them needing to stand down. Other measures for “test and trace” are working extremely well on the Isle of Wight, and both the pilot app and the manual “test and trace” have helped break the chain of transmission. We remain extremely grateful for their support.

[Lord Ribeiro (Con) [V]]

My Lords, six weeks ago, the contact tracing app was launched on the Isle of Wight, since when, the emphasis has shifted from the app to the use of 25,000 call centre workers to identify the contacts of people testing positive for Covid-19. What lessons have we learned from countries such as Australia, Singapore, Italy and Switzerland, which all launched contact tracing apps, and is the purpose of the “test and trace” app to help end this pandemic or to protect us from the next?

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[Lord Bethell [V]]

My Lords, we are in regular contact with many of the countries that are working with apps. Two things are crystal clear. The opportunity of using automated technologies to create extra tracing contacts is enormous, and we are working extremely hard to chase down that opportunity, but the technical challenges are also enormous. We are working very closely with our tech partners and with other countries to develop the best possible app, particularly for a moment when the prevalence in society might increase, for that is when the mass automation delivers its unique advantage.

[Baroness Walmsley (LD) [V]]

My Lords, can I press the Minister on his answer to the noble Baroness, Lady Young? In the first week of “test and trace”, over 8,000 cases were referred, but the ONS said that there were 33,000 cases. If only a quarter of cases are being referred, how does the Minister think that we will ever stamp out this virus? When will we get more widespread asymptomatic testing and tracing?

[Lord Bethell [V]]

My Lords, the epidemiological maths is as the noble Baroness describes, but our focus on symptomatic cases does not mean that the system does not work. Taking out more than a quarter of infected cases is a massively important and impactful event. Asymptomatic testing has started in healthcare and social care workers. It is making a big difference in both those forums, where prevalence is higher than the community prevalence, and we will be learning lessons from those schemes.

[Baroness Blackwood of North Oxford (Con) [V]]

My Lords, a key priority of “track and trace” is to monitor the emergence of localised hotspots and intervene before wider community transmission can occur. Local authorities and public health officials have expressed concerns that they do not have the powers to deliver swift local interventions and that a top-down approach might be too slow. Can the Minister say what process is in place to prevent community transmission when “track and trace” finds evidence of such localised hotspots?

[Lord Bethell [V]]

My noble friend is entirely right that local action is central to an effective response to Covid-19. We are working extremely hard through the JCVI to take the intelligence from our testing programme to identify hotspots when they occur and to move resources to those areas to support local directors of public health and local infection officials with the resources they need, whether in terms of testing or surge control of the disease.

[Baroness Coussins (CB) [V]]

My Lords, the Government have translated Covid-19 advice and information into a number of languages, but can the Minister assure me that proper mechanisms and a budget have also been built into the “track and trace” system for the use of interpreters where needed—by that I mean professionally qualified human beings, not a down-the-line Google Translate service—so that no one from any minority group experiences delayed or inadequate instructions about contacts or isolation, which could be damaging at best and fatal at worst?

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[Lord Bethell [V]]

I pay tribute to the perseverance of the noble Baroness on the issue of interpreters. She is entirely right that marginal communities are incredibly important in this process and can be like rockpools when the tide recedes—left as areas of infection if we do not focus on them effectively. That is why we are working extremely hard to identify those communities that might be left behind and to use resources such as interpreters to ensure that the message gets through.

[Baroness Wheeler (Lab) [V]]

My Lords, the ambition of the Minister, reported yesterday, to get a national “track and trace” system going before the winter is in marked contrast to the hype and promises of the test trial launched in May, when Matt Hancock promised that where the Isle of Wight leads, Britain follows—though obviously now not until Christmas. Does the Minister acknowledge that the failure to have an effective system up and running this summer will have a huge impact across vital services, including residential and nursing care homes? Do the Government expect care homes not to open for regular and routine visits from family, friends and others until the end of the year?

[Lord Bethell [V]]

I do not agree with that analysis. I am afraid that areas such as care homes are where the app is least effective, because the residents are static and therefore the app is not really the facility for identifying infections. This is where the manual “test and trace” process is the most effective. That is why we are super-focused on getting it right. We are working very closely with the social care community to ensure that the “test and trace” systems are working well. We are flooding social care with tests and ensuring that our tracing agents are well trained to handle local outbreaks in care homes and to deal with care home staff.

[The Lord Speaker (Lord Fowler)]

My Lords, I regret that the time allowed for this Question has elapsed, so we come to the second Oral Question. I call Lord Clark of Windermere.