Richard North, 29/05/2020  

Obviously fed up with merely moving on, an increasingly irritable prime minister has resorted to drawing lines. He has yet to specify the crayons or the colour but, since the primary schools are still closed, there is plenty to choose from.

However, while Johnson wants to stand behind an uncrossable line, it doesn't look as if the rest of the world is too keen on playing. The Cummings crisis is just as active as ever it was, making it not so much uncrossable as dotted.

And yet, if we are to pay careful heed to the words of the prime minister, when he was asked at yesterday's presser why anyone should take the rules seriously if Cummings didn't, he actually said: "I've said quite a lot on this matter already. Durham Police said they were going to take no action, and that the matter was closed". Only then did he add: "… and I intend to draw a line under the matter".

So, actually, Johnson hasn't got round to borrowing a crayon set from the local primary. He only intends to draw a line. And knowing this prime minister, that could be any time, or not at all. If this man shakes your hand, you count your fingers. As for lines, you cross them when you come to them.

Nevertheless, all this talk of lines rather took the journos' eyes off the ball – or perhaps they were never really on it. Not one has ever asked why, in order to lift the lockdown, Johnson has devised five tests while the WHO has suggested six.

Furthermore, Johnson's five tests are in important respects significantly different from the WHO criteria. These require that public health and health system capacities are in place to identify, isolate, test, trace contacts and quarantine them, and that outbreak risks are minimised in high-vulnerability settings, particularly in homes for older people, mental health facilities and crowded places of residence.

Since neither of those criteria are in place, one can only assume that the WHO would not be too happy with Johnson's lockdown relaxation programme. But since they are not on the list, the prime minister can fudge the figures and make out that we are on the way to a brighter, more relaxed future – which is exactly what he did yesterday.

As he intends to draw only one line, though, we have a little bit of difficulty. In order to read between the lines of what the prime minister was saying, we really need two to be going on with. And with only an intention to work with, we can't even dart round the edges of the forthcoming line and pretend it's two.

But intentions are really what Johnson is all about these days – all he's ever really been about. For instance, he doubtless intended to be a good prime minister, but that somehow got lost on the way.

In his attempts to beat the virus, he intended to have a world class test and trace system up and running by 1 June. But yesterday we learnt that it would not be fully operational until the end of June.

This came out in a conference call between the disaster-prone Dido Harding and a group of MPs. Not all the 25,000 people who had been recruited, she admitted, had been fully trained – and that was even accepting that the process undergone by the gig-economy telephone operators actually constituted training – and the all-important process of integrating with local government and its teams of experienced contact tracers "was yet to be completed" .

That, however, is only the half of it. As the system opened for business yesterday, the website crashed, with staff unable to log in and commence work. Others found their phones not working and other technical faults, leading one new recruit to observe that the system was "a sticking plaster", made to look as if it is being delivered.

As to the local government operation, Devon county council is one of the so-called 11 "beacon areas" identified by the government for extra funding to enable it to put a test and trace system in operation.

Yet, although it has been told it has until the end of June to put its plans in place, it hasn't been given any detail about how it’s supposed to link up, or how to enforce against people who don’t comply with requests to self-isolate. All they've been told is to have a plan in place.

To add to their woes, a potentially fatal flaw in the system has been reported: up to 350,000 test samples – those carried out at drive-through centres between 2 April and 6 May – have been taken without recording individual NHS numbers or full addresses.

This was picked up by the Manchester Evening News last week and reported on this blog, flaws which make the data effectively unusable to local investigators.

This, to an extent, was foreseeable. In my very first major outbreak investigation – back in 1976 - we had something like 600 cases dumped on us in a matter of days.

As it transpired, one of the forms which accompanied the samples we took was badly designed . Inspectors kept missing vital information, because it was not clear what was wanted. Many of the samples collected were unusable and, midway through the outbreak, a substantial resource had to be devoted to re-sampling.

The point here is that sampling is the easy bit. The crucial part is to make sure that the administrative system is effective – so that the samples go to the right lab, with the right data, and the results are then processed and returned to investigators in a timely fashion.

Getting a working system up and running is never simple. There are so many working parts, and so many things that can go wrong, that systems have to be devised, trialled and refined, until all the bugs have been sorted. Put an untried system into the crucible of a major outbreak and it will most likely collapse – which is exactly what is happening here.

Then there is the system on the ground – with this report pointing to some of the practical difficulties, not least the struggle to extract information from healthcare workers, particularly in the NHS.

Notwithstanding the technical flaws, this points to another fundamental flaw in the system. Covid-19 is nothing if not a hospital acquired disease, with hospitals becoming reservoirs of infection, seeding the communities they serve.

Those who have had practical experience of dealing with the NHS – the monolithic nature of the bureaucracy and the natural inclination towards secrecy - already know something of the problems faced. In food hygiene days, it wasn't until we had got rid of Crown Immunity and started prosecuting NHS managers that the service woke up to the need to stop poisoning patients and did something about their kitchens.

The only way the system is going to work is if it is wholly independent of the NHS, staffed by experienced law enforcement officers (such as EHOs) who can prise information out of this organisation.

Fundamentally, contact tracing is a law enforcement function. Under public health powers, we were armed with detention powers, which we were able to use in the event of non-cooperation. This is not a job for amateur call-centre operators, or even Public Health England muppets.

And this, interestingly, is what this report states, noting that tracing "would be backed up by the law, by the environmental health officers who have absolute authority". Our powers, in this respect, were greater than those held by the police, where we could apply for a magistrate's order to detain those suspected of carrying disease.

Unsurprisingly, of that system, we see a report that only one-third of people asked to self-isolate actually complied with the request.

The trouble is that the likes of Johnson and Hancock have no idea of what an effective system looks like, and neither do Whitty or Vallance. They simply lack the practical experience and background, while institutional knowledge has been lost. In short, they haven't a clue, and they're not prepared to listen to those who have.

It comes as no surprise, therefore, to find the Guardian suggest that, after PPE and testing, contact tracing looks like the next UK shambles. Pete has the same idea.

But, for Johnson, nothing of this matters. He intends to provide a "world class" contact tracing system and, locked in his own fantasy world, the great intention becomes the reality. He reminds me of that 1965 Animals song, which went: "I'm just a soul whose intentions are good. Oh Lord, please don't let me be misunderstood".

Interestingly, the follow-up was: "We gotta get out of this place".

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