As we go to press, once again the coronavirus pandemic is running out of control across Britain. In early July, the daily average of around 500 reported Covid-19 cases had shot up tenfold; the daily number of hospital deaths from Covid-19 more than tripled in September. New measures to contain the pandemic are announced almost every day; local lockdowns have become the norm, and now the government is countenancing the use of the military to back up the police in an effort to enforce its new regulations on social contact. Back at the end of July, FRFI said that the government had ‘ignored the World Health Organisation’s (WHO) advice on 16 March to “test, test, test” and even now the programme it has set up is completely inadequate, reliant as it is on private companies which have no experience of public health campaigns.’ Nothing has changed: the privatised NHS Test and Trace system remains in chaos, not fit for purpose, and unable to function as a tool to control a second spread of the coronavirus. CHARLES CHINWEIZU and ROBERT CLOUGH report.
The government’s ideological determination to use private companies to deliver public services lies behind the fiasco. To call the privatised national test and trace system NHS Test and Trace is a fraud: of 35 organisations that are involved in its delivery, only eight are NHS organisations or public health bodies. The majority are either private companies (22 of them) or corporate-university partnerships in-volv-ing Big Pharma corporations such as AstraZeneca and GSK which run the Light-house lab-or-atories that process the tests. The private firms include Serco, Sodexo, Amazon, Randox, Boots, DHL, Levy, G4S and Deloitte which were handed contracts without any competition or public scrutiny. What such contracts stipulate in terms of activity volumes, performance or information sharing is shrouded in secrecy: commercial confidentiality is the omerta of capitalist enterprise.
Testing failures
Crucial to managing any outbreak of this character is to get a handle on asymptomatic cases, those who have the virus but never show any symptoms. It now seems that up to half of all people who get infected remain asymptomatic themselves, but can still pass the infection on to others. Yet the government, far from having plans to find such people, has made it absolutely clear that only those who have Covid-19 symptoms can apply for a test. It then had the audacity to blame the public for the shortage of tests that occurred in mid-September and which required ill people to travel hundreds of miles to a testing centre with spare capacity, with Health Secretary Matt Hancock claiming that a quarter of those going for tests were, in his view, ‘ineligible’. The absurdity of this was evident back in June when Morecambe Bay Hospital had to close a complete ward because one member of the ward staff had tested positive and the rest had to be sent home to self-isolate – the rules prevented them from obtaining the tests which could prove they were able to work. As we go to press, there is still insufficient capacity to adequately test NHS and care home staff to enable them to provide safe services. A parliamentary motion to test all health and care workers weekly was voted down by MPs on 24 June by 335 to 197 votes. Not only have people been unable to get tests, but there have been mounting delays in getting results. Only 28% of tests carried out in community-based centres came back in 24 hours in the week up to 16 September, compared to one in three the previous week, and two in three the week before that, with swabs being sent abroad for processing.
Tracing failures
Of those testing positive and being referred to NHS Test and Trace for follow-up, only 65% are providing a contact, with only 60% of those being reached. Only 52% of those living at the same address as the infected patient were reached. Testing and contact tracing is pointless if the infected person cannot or does not isolate to prevent infecting others. According to the government’s Scientific Advisory Group for Emergencies, fewer than 20% of people in England fully self-isolate when told to do so. Many refuse to answer contact tracer calls as they come from unrecognised 0300 numbers. Others were not aware that they should stay home full-time and not mix with family or friends or go out for essential tasks, such as buying food. People on poverty pay, zero-hour contracts are less able to self-isolate as they may lose their jobs. As it is, those seeking the new £500 grant available from 12 October to support self-isolation are dependent on a letter from their employer confirming they cannot work from home. To qualify, workers need also to be in receipt of Universal Credit, Housing Benefit or Working Tax Credits. Seven out of eight households do not receive these benefits and along with people not in local lockdown areas, would be unable to claim. Fines for breaching the rules will begin at £1,000 and rise to £10,000 for repeat offenders: punishment is the natural response of the ruling class when faced with possible working class non-compliance.
As ever in this debacle there is no idea as to what has been written into the various contracts, and while Labour in parliament talks of the collapse of the test and trace system, it has avoided any criticism of the privatised arrangements that underpin it. And these contracts are substantial: Serco, run by Rupert Soames, Winston Churchill’s grandson, has been paid £108m for the first 14 weeks of test-and-trace, and may receive up to £410m after its contract was renewed on 23 August. Sitel were paid £84.2m for an initial 14-week period, and up to £310m when its contract was extended for eight weeks around 10 August. In March 2020, Serco was also awarded a £45.8m-£90m ‘Emergency Capacity Contact Centre Services’ contract to support vulnerable Covid-19 patients self-isolating.
Coronavirus resurgence – a government failure
The starting point for the renewed spread of coronavirus lies in the premature relaxation of lockdown regulations over the summer. Eager to protect the economic interests of the private sector, on 17 July, Prime Minister Johnson announced the easing of restrictions when the first wave had barely been brought under control. From mid-May, the government was encouraging workers to head back to work. Pubs and restaurants were re-opened before schools. Without making workplaces ‘Covid-19 safe’, this exposed workers to infection either on public transport or at work or in pubs. Leaving it to the capitalist class, Transport Minister Grant Shapps said on 28 August ‘What we’re saying to people is it is now safe to go back to work and your employer should have made arrangements which are appropriate to make sure that it is coronavirus-safe to work’, adding that complaints should be made to the Health and Safety Executive (HSE) or local councils if there were concerns. Cases were on the rise within days of his declaration. Complaining to HSE is for the birds: the government has consistently cut funding to the HSE over the last decade. The number of full-time local authority health and safety inspectors has more than halved, from 1,020 in 2010 to 543 in 2017. By July 2020, there were only 390 full-time HSE inspectors in the UK. The infrastructure to inspect workplaces and ensure it is safe to return to work is completely absent.
The government has completely failed to heed the warning from the Academy of Medical Science to reduce the risk of the NHS being overwhelmed in winter by ‘increasing capacity of the test, trace and isolate programme to cope with the overlapping symptoms of Covid-19, flu and other winter infections, and establishing a comprehensive, near-real-time, population-wide surveillance system’. Instead, to shift the blame for the disaster for which it was completely responsible, the government announced on 18 August that it would abolish Public Health England (PHE) and merge its health protection functions with NHS Test and Trace and the Biosecurity Centre. Baroness Dido Harding, currently chief executive of NHS Test and Trace will chair the new body: a reward for failure. She revealed her lack of grasp of the real world when she had to admit to a parliamentary committee that she had not anticipated the surge in demand that followed the return of children to school at the beginning of September, despite every warning from teachers and academics. That would also be true of universities with the report that 124 students in Glasgow University have already tested positive within days of starting the new academic year, and 87 at Liverpool John Moores University before term started. Despite what has been claimed, PHE was not responsible for mass testing and tracing of the sort necessary to manage the pandemic, nor was it authorised to commission or approve laboratories to analyse tests. That was always down to the Department of Health and Social Care, headed by Hancock. PHE’s operating budget for 2019/2020 was £287m; a cut of £120m since it was first established in 2013. One consequence of this blatantly political reorganisation will be the loss of perhaps 20% of highly skilled and desperately needed staff.
The opportunity in July and August to establish an adequate public health testing, contact tracing, isolation and support system, using existing public health infrastructure, NHS systems and resources, was rejected by the government. On 9 September, in an effort to distract attention from his failures, Johnson announced ‘Operation Moonshot’, a crackpot £100bn scheme to test up to 10 million people a day by March 2021. Operation Moonshot has been described as devoid of any contribution from scientists, clinicians, and public health and testing and screening experts, and is heavily reliant on the private sector: GSK will supply tests, AstraZeneca laboratory capacity, and Serco and G4S logistics and warehousing, with a major role for Deloitte. When that fell flat, Johnson found another card up his sleeve: a commitment to test 500,000 people a day by the end of October. If the earlier commitment to test 100,000 people by the end of April is anything to go by, this figure too will be fudged in order to prove success. Then the government claimed it had achieved its goal, but only because it had in the final moment included 40,000 testing kits in the count which had been sent out to people’s homes but yet to be returned. A further gimmick is to offer saliva-based screening tests. These will be unable to detect the difference between infectious and non-infectious cases, and will result in huge numbers of false positives, and extra demand for proper testing.
Blame everyone else
The government has blamed everyone but itself for the resurgence of the pandemic: asymptomatic people seeking tests, holidaymakers, partying young people, people previously urged to ‘eat-out-to-help-out’ in pubs and fast-food restaurants. Muslims are also in the frame: Labour Mayor of Greater Manchester Andy Burnham claimed that the local rise in viral transmission was in part due to gatherings ‘in multi-generational households’. Asked whether he meant predominantly the Asian population of Greater Manchester, Burnham replied: ‘Yes, I do mean that.’ Eid celebrations were banned the night before on 31 July. We need a coordinated public health response, support for all workers having to self-isolate, an end to punitive measures, fines and the blame-game, and a clear strategy for active case-finding, symptomatic and asymptomatic testing.
