Transform Test and Trace into an isolation service!

Despite a budget of £37 billion over two years “NHS” Test and Trace is having a negligible effect on reducing infections. The huge testing and contact tracing infrastructure alone is having very little effect because only about one in five are fully isolating when they have symptoms.

The current Serco-G4S-Deloitte mess is performing very poorly. But even a first class testing and contact tracing service operating at a time of relatively low infection rates would only reduce infections by about 7-10% according to government research. Graham Medley, a member of the government Scientific Advisory Group for Emergencies argues for a new approach: “To have the greatest impact [resources should be focussed on] an isolation strategy rather than a test and trace strategy. Enabling people to isolate if they are infected, or have a high risk of being infected, is essential to gaining the most out of the investment.”

The data shows that people are really struggling to maintain seven to ten days of isolation without mixing with others outside their household. For millions of low paid workers isolation is almost impossible. The Coronavirus pandemic has been a crisis of presenteeism: people turning up to work when they should be isolating. In the UK this has been driven by the fact around 12 million workers have no occupational sick pay and have to rely on the manifestly inadequate Statutory Sick Pay of just £95.85 a week.

Instead of frittering away £37 billion on a system that makes a neglible impact on transmission rates, we need an isolation service that supports people when they are isolating. What would such an isolation service look like?

First and at a minimum the service should ensure that workers are not losing any income due to isolation. The service must ensure the worker receives full pay whilst isolating, whether as part of their occupational sick pay entitlement or through an improved statutory sick pay scheme that compensates workers for loss of earnings. Germany has a scheme that allows all workers to isolate on full pay for up to six weeks. The service could also look at debt relief and could impose rent and debt holidays. Vermont in the US has imposed rent holidays and a moratorium on utilities cut offs for those isolating.

Second, a whole range of practical support could be offered. In New York residents who need to isolate get a whole menu of support services they can access from medication and grocery collection to dog walking.

Third, alternative hotel quarantining should be an option for people in overcrowded accommodation. Schemes like this in the US and South Korea have been shown to reduce infection rates.

Fourth, people who isolate should be celebrated for their contribution to the collective effort. There might be all sorts of ways in which this contribution is recognised and rewarded from symbolic gestures of appreciation to material rewards. Isolation should be recognised as a difficult sacrifice for people and programs should be established to help people through the 7-10 days, such as linking isolators together in mutual online support groups. Or people who complete isolation could receive a package of gift vouchers to be spent in local shops, cinemas and restaurants when restrictions ease. There are many simple ways those who isolate could be championed and isolation could be framed as an important act of community service.

Fifth, leave to remain should be granted to all current residents of the UK regardless of immigration status. The complex system of immigration controls means that over a million workers have no recourse to public funds. All migrants should be granted leave to remain to reduce the fear of accessing isolation support and other health services and as a recognition of the important contribution of migrant workers throughout the pandemic.

An isolation system on these lines would cost a lot of money but £37 billion is currently being wasted on a system that does not reduce infection rates and has failed to prevent two lockdowns. Moreover, the cost of an isolation service would decrease as it helps to reduce infections. A successful isolation service is needed to effectively combat Coronavirus, reduce the need for further lockdowns and restrictions that are so costly and unpopular.

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