UKH

The head of test and trace has such a firm grip on her brief that she can’t see that the country might see a huge increase in demand and uses the excuse that SAGE modeling is to blame.

Let’s assume that the government does the right thing - yes, I know, fat chance of that - and sacks her, how do we then reach a point where testing is coming close to meeting demand?

Is it a question of money?
More labs?
Quicker if less accurate tests as seen in Italy?
Does the government actually want to solve the problem?

Does any of this matter given the seemingly suicidal like behaviour of many of the population?

Too many health officials never seem to understand how vast swathes of society operate. They are naive. 
 

Anyway, my money is in that ten minute saliva test I’ve just seen in the news, 90% accurate, but seems cheap enough to repeat test in regular basis. Trialling it in Spain. Problem is, if the owner isn’t related to Winston Churchill then they won’t get a look in. 

Didn't New Zealand eradicate it? Then they eased travel restrictions and it started popping up all over? Even if we stopped being suicidal we kind of need a large part of the world to join in. If we manage to find a way to stop covid-19 before we reach herd immunity I'll be very impressed. I think it could prove to be an incredibly difficult thing to do.

Harding, uni mate of Cameron, PPE Magdalene, daughter of a baron (hmmm!), is a super example of our 'betters' failing up it seems - so I think you're scepticism over her imminent departure is pretty well founded.

A typo there. Did you meant to write 'Dominic Cummings'...?

I think what we need is a Ministry of the Bleeding Obvious. To advise other departments on how to plan for the bleeding obvious.

Funny, though, I thought Dom, in his new underground super data lair, would have predicted all this, with his shiny-bonced genius. Oh, wait...

There’s a few names you could insert instead.

On a slight tangent: whole school year groups are isolating for two weeks coz one pupil has covid. I’ve just done some  high end maths and reckon there will almost always be a pupil in a year group with Covid, especially when u consider they have been sent home to isolate which is where we are told most of the infection takes place. And chances are none of these pupils will end up that ill. This needs sorted - my answer* is: go to school unless you have symptoms. 

* reserving the right to change my mind coz my views change all the time!!

Meanwhile, here in NSW (pop. 8m) the premier is begging more people to get tested even though our daily caseload is 5-10 ish.

Contact tracing seems effective, although Victoria has recently had some backlog due to high daily case numbers. They have just moved from pen and paper to using Salesforce which the other states have been using for a while. There was a well publicised app which millions downloaded but I don't hear very much about this (apart from the odd notification on my phone) so don't know if it is playing a role.

If I look for local test locations on the NSW Health website then I get about 20 locations within a 10km radius some drive through & some that need an appointment. On the NHS site you have to book via gov.uk and there is no local info. The NHS is also advising only symptomatic people to get tested while NSWH is advising certain asymptomatic people to take the test.

Anyway i hope you guys can get on top of it!

Came across this on twitter. Pillar 2 test capacity vs  tests processed.  Seemingly from Dido's presentation. As far as I can tell it shows a clear dereliction of duty. why was no capacity added (and some removed) from June to August?

If you don't know why no capacity was added (and some removed) from June to August then how can you know it was a dereliction of duty? I'm not saying it wasn't but without knowing the reason how can you be sure it was?

If authentic that graph is absolutely damning.

I can not be sure of course, and i'm happy to hear the reasons, but that graph shows also that it's been clear for some time that demand was going to outstrip supply if capacity wasn't increased, yet the lockdown has continued to be opened up further increasing demand, and at no time was the public warned of this issue, instead all we've heard are speeches about millions of tests a day in some kind of "moonshot"

Fair enough, I see what you're saying. I'd be interested to know why, I have no idea.

If any explanation is forthcoming (doubtful), I would expect a statement along the lines of "That only shows the private lab testing. We determined that during that period the increase in demand would be satisfied by the public/NHS/bullshit lab testing".

And does good works in the Racing World - I'm sure that this has something to do with the spreading at the Cheltenham Gold Cup - no one could have predicted that being so well attended at a Critical time by just modelling!

Vested self interests, corrupted and used by Putin, breaking us down.

https://www.thejockeyclub.co.uk/about-us/our-structure/our-board/

We have passed from being the country I grew up in to being run like Russia by Oligarchs and patrons

I'm certain that I had the wool pulled over my eyes about all this when I was growing up.  Or perhaps we did have some decent politicians like Heath etc. who'd seen the horrors of war.

I don't think you wrong. My suspicion is that nearly every aspect of this pandemic is being handed to the private sector, who are charging 'market rates' for their services but with absolutely no sanctions if/when they fail to deliver. At a further guess these private sector firms are pitching for the business and only starting to think about delivery when they have the contract.

This pandemic is accelerating the privatisation of the NHS in front of our eyes.

Head of Covid testing Dido Harding - married to Tory MP.

Private company collecting the samples - Serco - CEO is brother of Tory MP.

Worst performing UK lab in program - associations to a Tory MP.

Large US laboratory running tests for the program - not being paid on time

Best performing labs in the program - in Germany and Italy.

TLDR;

They gave too many contracts to their mates instead of to people who knew what the f*ck they were doing.  

How do we resolve the present testing problem?

Let’s presume that the government would like to solve it and there is, as it appears, plenty of money available.

The only thing that is going to solve it quickly is to get the number of infections low enough for it to handle.  They need to do something major and do it quickly because, like we saw last time, when there's a lot of delay in the system and exponential growth you can't afford to wait and see.

I think England is probably stuck with what it has, changing the organisation again isn't going to make things go faster.   The Scottish Government overestimated the competence of the Tories when it signed up for the UK wide program and gave it some of the test machines that were in Scotland.  I think they are now trying to get the Scottish NHS to get some more of its own equipment so we are less dependent on the UK resources.

I'm sure they would like to solve it and they do have plenty of money but they are also egotistical, incompetent and corrupt.   If they would give up on 'moonshots' and 'world beating', admit they are history/PPE graduates who are totally out of their depth and stop giving contracts to their mates it would help. 

Little details like paying suppliers on time when it is a seller's market.

Apart from key workers etc, don't test people below a certain age (say 30?) because: 1) most symptoms are simply people with colds, 2) a large % of this age have it and show no symptoms so it is of limited value anyway.

Also:

1. If children show symptoms, including if it is a normal cold, stay off school 2 weeks

2.Put more resource info protecting vulnerable people

3. Pray that we had good leaders who could get the message across that:  'if you stick to Space Face Hands, and be sensible, then most things could stay open and its partly your fault if they shut.'  But sadly our leadership was crap to start with and is shot to bits at the moment.

Increased lockdown where appropriate to lower the number of cases below the current "meltdown" point for testing.  This is happening in various parts of the UK already.

Produce a clear priority list for access to testing, with clear guidance on when to just isolate vs when to get tested for each priority.   Consider having more people just isolate rather than get "cleared" by a test for the lower priorities until testing is scaled up more or cases are down more.

Put someone who (a) is not a political appointment (b) is not endowed with a history of cocking things up (c) is a logistics specialist in charge of the system, and give them a close advisor who understands the challenging scientific/technical aspects of the problem and is a competent, clear communicator.  Make sure both these people are not married/related/in the pocket of anyone involved in government, 55 Tufton Street or the Russian oligarchy.  

Yes; they're likely to be asymptomatic spreaders and to false negative, so I don't really understand the pandemic control aspect of using tests to "clear" people out of self isolation.

Most of this makes sense to me, but i doubt the current type of lockdown will have the desired impact.  Bolton and most Grter Manc has been in similar extra measures and look at what's happened.  I'm increasingly in favour of better enforcement of Space Face Hands but keep stuff open.  Oh, I'd have bouncers on the doors of pubs and increase beer price to cover.

Edit:  and I'd ditch SAGE and have a cross section of people from this forum, including you, 'advising' the government.

I've been wondering if smart watches could be programmed to detect when someone is (subconsciously) going to touch their face and make a racket to snap them out of it.

Wouldn't work for me though as I've not worn a ring or watch since February to make it easier to do a thorough job of hand washing...

I'm not convinced our new lockdown-lite in the North East is going to have the desired effect either.  Fingers crossed.

It would be fairly easy to use the accelerometers in a watch to detect a hand towards the face gesture but it would probably have a lot of false positives and be really annoying if multiple people in a room had it enabled.

I notice Apple have changed the sensors in the new iWatch so it can measure O2 saturation with the idea of monitoring Covid symptoms.

I would expect there will be a second generation of face masks designed specifically for this epidemic.  There's a Crowdfunder one I saw with transparent plastic so you can see the wearer's mouth with replaceable filters.  I guess if the air is going in and out through a filter then there's not so much risk in touching other parts of the mask.

Lockdown fatigue will be a bigger factor in all this soon. The idea mooted above about keeping children off school for two weeks for cold like symptoms is likely to be highly disruptive to education and working parents for instance (how many colds over the winter for the average junior school kid - 3 or 4?)

I'm still waiting for this up-tick in death rates - where is it?

What about hospitalisation rates (seems like data up to 2nd September is only available from the NHS website)? We should be seeing an up-tick now with the schools starting back in September.

I think the reality of the situation will start to be apparent in the next 3/4 weeks looking at these two factors. The case numbers are irrelevant surely as they correlate to testing levels (randomised sampling excluded).

Surely we need the traps to deliver the increase - no point in having the kit, cast etc without minions to do the donkey work

Re SERCO - I rather think they combined their prison business with a contract to repair radio equipment for the MOD - a lot came back with loose screws and not properly put back together causing serious damage.  I can easily picture offenders given a screwdriver and paid little to fix?  I had some of these clansman sets through my hands and it is true as folk say, beware the SERCO label (even if it does say "Another radio fixed by SERCO for Zth Armoured Division).

Aditya Chakrabortty put it well in his Guardian article yesterday: 

"These chancers bring to the state no imagination, nor any idea of how to mobilise its resources. Their main skill is looting it for money to give their mates in the private sector, while blaming it for their own fatal mess."

https://www.theguardian.com/commentisfree/2020/sep/17/england-test-and-trac...

It's coming - you can start to see it in the daily data on the government dashboard if you zoom in on the tail and add some 7-day window filtering.  I'd suggest waiting for another week before judging this one.

• It's clearly visible in the first figure here - https://coronavirus.data.gov.uk/healthcare
• The number of patients in mechanical ventilator beds has almost doubled since Sep 1st and is rising daily  - see the third figure in the link above.  Many of these sadly are likely to translate to deaths down the line.

> I think the reality of the situation will start to be apparent in the next 3/4 weeks looking at these two factors.

I think 2 weeks is going to be more than sufficient.

Agree somewhat - they're not "irrelevant" as they're a hard minimum floor which is useful if incomplete information.   They are to be treated with caution though as various leaks and the evident chaos around testing suggest we no longer have enough capacity for the rising case level.

Agreed.  The latest update to the ONS pile survey just came out with its random sampling.  The sampling period for it ended 8 days ago.  - https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/con... - selected plot attached below which explains why deaths are currently not rising very much - cases are rising most in younger people who are both much more numerous and much less at risk of death.  Cases can't keep rising indefinitely in younger people before the consequences of this break the defences around older people - for example by breaking the test and trace system...

This guy has a map of the chances of getting a Covid test in different parts of the country.  It would be interesting to see the Tories explain what is going on.

https://twitter.com/Rog_Anderson/status/1307336732359221250/photo/1

Looks like those pooled testing resources are working very well for Scotland - seems the U.K. has served that area and NI well!

Looks like Scotland is doing OK.

Not sure that was the Conservative plan!  

London and the South East are doing OK too.

There's definitely something going on.  Whether it is just fewer cases in Scotland so not maxing out assigned capacity or better organisation of testing stations or additional resources to supplement the UK labs I have no idea.   Whatever they are doing, it seems to be working so far.

It's interesting that the area around Glasgow with the current problem has 100% test availability and more availability than other regions, which seems like the way the system should react.   In England it is going the other way with the problem areas having poorer availability.

Could just be the system being overwhelmed in those areas - it took us about 12hrs and about 15-20 attempts to book a test on Tuesday night/Wednesday morning (south of Bristol), for a test on Wednesday in the Rhondda. A colleague booked a test today within a couple of goes - not sure where she’s getting tested. 
 

So tests are available, you just need to keep trying. Speed of results more problematic about 60hrs. The process took out two key-ish workers for 3 days, and put significant pressure on our respective teams.

only a few weeks ago it was very easy to get tests in this area at the drop of a hat, usually same day, and usually results the next morning - certainly a system under significantly more strain now.

I think it does depend on your area. 

I tried booking from last Sunday evening with an essential worker code and had to keep trying until Tuesday morning where I finally booked a test.

Sadly the website didn't send me the QR code so we were turned away from the test centre.

Tried to book again as of Tuesday pm and couldn't get anything anywhere until my boss took pity on Thursday afternoon and gave me one of the emergency postal test kits. 

Still waiting for the results of that.

I can't help but feel that if I cocked up my job like Harding has, the outcome would be different.

It seems a fundamental flaw that there is no queueing system - why not be able to register that you need a test and get allocated one once available? The repeated attempts to book are very frustrating and just make people worried.