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expert reaction to BMJ analysis on tracking, testing, and contact tracing for COVID-19

An analysis, published in the BMJ, looked at tracking, testing, and contact tracing for COVID-19.


Prof Paul Hunter, Professor in Medicine, UEA, said:

“This paper is a coherent analysis of the current situation and the authors conclusions and recommendations are in line with what I and probably many of my colleagues believe.

“An important point in the article is the apparent disregard of The Health Protection (Notification) Regulations 2010.  In these regulations it is a legal requirement that a medical practitioner must notify the proper officer of the local authority if they suspect that the person has a notifiable disease, which from March includes COVID-19 and SARS-CoV 2.  This notification must include amongst other information “insofar as it is known” the patients name, date of birth and sex; home address including postcode; telephone number; and NHS number.  Directors of diagnostic laboratories must notify Public Health England. For medical laboratories this is generally taken to mean that the Medical Director of the laboratory should notify both Public Health England and the local authority.  This dual system has served the UK well over many decades in protecting us from infectious diseases.  That this well-established system does not appear to apply to COVID-19 is a great concern.

The Health Protection (Notification) Regulations 2010:

“The lack of an integrated system of management of infectious disease notification and contact tracing for COVID-19 will hinder our ability to cope with the second wave.  If we do have a second wave, which seems likely, we will sadly have more deaths and yet more impact on our economy and society.”


Dr Bharat Pankhania, Senior Clinical Lecturer, University of Exeter Medical School, said:

“The summary by Allyson Pollock et al is a fair and robust analysis of the very disjointed approach to tackling a national emergency, it is very disappointing to see the parallel emergence of private testing and contact tracing emerge where as we have well established, expert organisations in the form of local Public Health England offices, the local NHS labs, the Public Health departments in Local Authorities, our excellent network of GPs and Genito Urinary Medicine teams, all of them are experts in testing, contact tracing and most importantly working together, every day, for outbreak control and management.

“To abandon well established structures and in the middle of a national emergency and to set up untried and tested parallel systems without engagement of established local experts is a very worrying development.

“Time is of the essence and it is important to take heed and immediately change course, engage with local experts, and have a much more robust approach to testing, contact tracing an outbreak management.

“The current test, track and trace system is not making full use of local expertise by not actively engaging with the local experts and therefore it lacks precision and furthermore there is a deficiency in the flow of results and data flows to the local experts, it is not enabling smarter, timely localised data to be made available and for local interventions to be put into operation, something that will be required in the months and years going forward, it is concerning to disinvest in local systems which will be much needed and will be the cornerstone for managing local outbreaks.

“Local Directors of Public Health play a vital role in taking their local population with them, thus for testing and tracing systems to work well and have adherence to instructions, it is vital for this advice and information to come local sources and be reinforced, at present there is a lot of anxiety and mistrust with messages coming from the one central Gov sources.  We need to make sure mistrust does not result in reduced compliance with, for example, testing, contact tracing and quarantine instructions.

“It is extremely worrying when we have a situation whereby, firstly, the four new “lighthouse labs”, which involve AstraZeneca and GlaxoSmithKline, even though both state that diagnostic testing is not part of either company’s core business.  Why have local NHS Labs been frozen out of contributing during a national emergency, with their high standards of governance and established, tried and trusted links with PHE, NHS and Primary Care?

“And secondly, Randox analyses the samples from its home test kits, with a contract for £133m (€150m; $165m).  This compares with the £86.9m provided to PHE for infectious disease, surveillance, and outbreak management in 2018-19.  In all, 67,000 Randox tests are reported to have been sent to the US for analysis.  How can it be that the agency charged with protecting the nation receives the much lower funding to do a lot more?  Furthermore, it would be much better and a true investment if PHE was commissioned and funded to deliver on in house testing and tracing, an opportunity to establish an asset for the nation is being bypassed.”



‘Getting back on track: control of covid-19 outbreaks in the community’ by Peter Roderick et al. was published in the BMJ at 00:01 UK time on Friday 26 June 2020.

DOI: 10.1136/bmj.m2484


Declared interests

None received.

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