As a GP, I‘ve seen the impact of Covid-19 on patients and colleagues, but many of my own family were infected too. My son and I both contracted the disease in March. I remember feeling exhausted and feverish for days and losing my appetite. We both recovered well, but this was sadly not the case for three of my family members. My father died in hospital in April. My sister and I were allowed to be with him at the end, which was a comfort as I know he died peacefully and had very good care. My elderly mother was also hospitalised but she, amazingly, recovered. At one point we faced the unbearable possibility of losing both of our parents.

In April, my husband was admitted to hospital, while on the brink of needing to be ventilated. For several hours, we waited anxiously for news – I knew if this happened I would not be able to communicate with him and that there was a 40-50% chance of death in those being ventilated. But staff nursed him lying prone, which means with his body lying face down – something they’d recently discovered helped with oxygenation – and that turned the situation around so he recovered quickly after that. I can’t describe the relief I felt. Nearly losing a loved one gives a whole new perspective on what really matters. I recount these personal experiences to remind people of the human impact of this pandemic. There have been over 43,000 coronavirus deaths in the UK: these are not just numbers, but real people. I know firsthand how much people suffered during the first wave, and how our NHS staff and resources became utterly exhausted and depleted. I now watch in horror as we hurtle headlong into a second wave. Since last week, there has been a huge increase in cases – a near doubling of deaths and more people in hospital than before the first lockdown. Covid-19 is spreading across the country.  I hoped the Government would have learned from its failings the first time round but they still exhibit a frightening lack of cohesion, clarity and strategy. Opportunities to get on top of the virus in the summer have been squandered with a failure to institute an effective test and trace system. Restrictions and lockdowns are only useful if, by getting viral levels down, you have an effective test, trace, isolate and support system to quickly identify outbreaks and stop them spreading. Otherwise the situation just oscillates between lockdown and release, prolonging the epidemic, and devastating people’s lives and the economy.  The Government’s current test and trace system is failing. According to the Government’s own scientific advisory team known as SAGE, Boris Johnson’s supposed ‘world-beating’ track and trace app is only having a ‘marginal impact’ on reducing transmission numbers. They added: ‘Unless the system grows at the same rate as the epidemic, and support is given to people to enable them to adhere to self-isolation, it is likely that the impact of Test, Trace and Isolate will further decline in the future.’ Other countries such as Germany have got effective track and trace systems. So what’s gone wrong with the UK system?

Our system is run by private companies with a lack of sufficient experience of this work. It is a centralised system with little connection with localities so is not as effective as one that uses local public health expertise and contact tracers. Consultancy firm Deloitte was tasked with setting up the new Lighthouse labs – bypassing the network of NHS, university and public health labs – which remain underutilised. Communication of data between the Deloitte labs and local Public Health was initially non-existent, and is still full of errors. For example, Keir Starmer claimed there was a ‘lost week’ of testing figures in Leicester, which lost vital time in getting on top of the outbreak. Boris Johnson denied claim. Then, in answer to a parliamentary question, Nadine Dorries admitted that ‘the contract with Deloitte does not require the company to report positive cases to Public Health England and local authorities.’ In addition, Serco – who employ ‘contact tracers’ to inform people who have newly tested positive for Covid-19 and ask them about their recent movements, before identifying others they may have come into contact with – is one of the biggest outsourcing companies in the world. They don’t have a very trustworthy record, having been fined and lost contracts for fraud. For example the electronic tagging scandal and falsifying data when they ran GP out-of-hours services in Cornwall. But that didn’t stop them getting the contract to organise test and trace. As a result, testing is a shambolic mess and contact tracing is a farce, with over a third of contacts not being reached – therefore having minimal impact on reducing transmission. As a GP, I’m deeply frustrated that our tried and tested network of health provision – whereby GPs, Public Health, NHS hospitals and labs are interconnected – hasn’t been used to establish an effective local test, trace, isolate and support system. I am currently not able to take a Covid-19 swab from a patient and send it to my local NHS lab for testing – it would be rejected because it has to go to Lighthouse labs. A local system would use NHS laboratories with local facilities for testing, results transmitted quickly both to GPs and to local Public Health services. This would deploy locally employed contact tracers who know the community, speak community languages, and would be able to help people understand the importance of self-isolation. Of course there also needs to be adequate financial support for people needing to self isolate. This would give us another chance to get on top of this epidemic: public health teams could quickly locate and isolate outbreaks; patients could get the advice, care and support they need quickly; and workers in front line services could return to work sooner knowing they weren’t infected. That’s what happened in Germany and is one of the reasons a country with a similar population to ours has suffered far fewer deaths and less disruption to their economy. I want the Government to learn from its failures and implement changes now to establish an effective test and trace system, under the control of local Public Health, with the funding it needs, instead of wasting more money on an ineffective system where consultants are paid the equivalent of a £1.5million salary.

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