PHMCC (public health medicine consultative committee) on the easing of lockdown and on test and trace during COVID-19
There has been a significant reliance on testing for the presence of COVID-19, and the implications of negative test results in particular, in the UK Government’s policy response to COVID-19. However, this has been without a clear idea of the purpose of testing and of the level of confidence one can have in a negative result, and the policy implications of that level of confidence.
We need scientifically consistent guidance and clear advice that COVID-19 symptoms are also an indication to self-isolate for seven days, regardless of test results. We, therefore, welcome the recent changes to the national guidance in response to this concern.
We support the statements by the Association of Directors of Public Health, the Faculty of Public Health, the British Dental Association and the BMA on the risks of easing lockdown too soon. We share the concerns raised by the ADPH that the UK Government is “lifting too many restrictions, too quickly” ahead of all the Government’s own five tests being met.
We echo the important message about the role of directors of public health in developing and implementing local outbreak plans in partnership with other stakeholders, including national and local government, health services and public health agencies and others.
We also highlight the need for support and engagement by the UK Government with several pressing issues such as:
- workforce capacity
- timely access to relevant data
- the unequal impact of COVID-19 on Britain’s communities.
Furthermore, we urge the UK Government to commit to a renewed drive to promote the importance of handwashing, social distancing and self-isolation of individuals and their households if symptomatic.
We recognise that the app has a role to play as a possible means of helping with the concerns around workforce and system capacity. We note that it requires high take-up and a national public information campaign to be fully effective. There are also potential health inequalities issues arising from its use that should be considered.
With all that in mind, it is not yet appropriate to implement all phase 2 measures. The number of new cases and of deaths is still too high meaning that the NHS test and trace service as it stands is not capable of following up the contacts of all new cases either because of workforce capacity limitations or because the app is not yet fully functional.