Coronavirus testing outside hospitals stopped over shortage of capacity rather than scientific advice

Testing for coronavirus outside hospitals was halted in early March because of shortage of capacity rather than scientific advice, a senior government adviser has confirmed.

The comments by Ministry of Defence chief scientific adviser Angela McLean came amid a spiralling row over why the UK broke with the World Health Organisation’s advice to “test, test, test” on 12 March to restrict testing only to patients and health staff in NHS hospitals.

Cabinet minister Therese Coffey pointed the finger of blame at scientists for shortcomings in the government’s handling of the crisis, saying: “If the science was wrong, advice at the time was wrong, I’m not surprised if people will then think we then made a wrong decision.”

But her cabinet colleague George Eustice insisted it was “right” to prioritise NHS patients and staff at a stage when there was “an issue of capacity”.

Speaking at the daily Downing Street coronavirus conference, Mr Eustice also acknowledged that some Covid-19 patients were discharged from hospital into care homes with symptoms before ministers acted to tighten up procedures.

The admission came as the chief executive of Care England, Martin Green, launched a stinging attack on the government’s handling of the Covid crisis, calling for a “forensic examination” of the way care homes have been treated.

Prof Green told the House of Commons Health and Social Care Committee the government had pursued a policy of “emptying hospitals and filling care homes” while NHS medical support was withdrawn and homes had their supply of personal protective equipment disrupted.

“We should have been focusing on care homes from the start of this pandemic,” he said. “What we saw at the start was a focus on the NHS… Given that care homes are full of people with underlying health conditions, I think we should’ve looked at focusing on where the people at most risk were, rather than thinking about a particular organisation.”

Meanwhile, care home operators complained that the failure of Public Health England to provide information about rates of infection within the sector until late April left them preparing their pandemic response “with their hands tied”.

In a special report, BBC Radio 4’s File on Four revealed that data was not released to homes until 29 April, by which time there had been more than 4,500 outbreaks in the sector.

National Care Forum executive director Vic Rayner said: “The consequences of not having that data are huge.

“It has affected our ability to plan, prioritise, identify early outbreaks and bring in the right level of medical and health expertise.

“Having that overall picture of knowing what’s going on is absolutely critical. I think it’s impossible to operate effectively without that. We’re now in a terrible game of catch-up.”

The Office for National Statistics said there had been around 15,000 deat Covid-19 in care homes across the UK since the start of the pandemic.

Care staff were not on the list of those entitled to tests in the early stages of the pandemic, while only the first five residents showing symptoms in any home were tested. It was not until later than mobile units began visiting homes to allow blanket testing of all those who wanted it.

At the time that testing in the community was halted on 12 March, ministers and advisers insisted that the decision was driven by the fact that blanket testing was of little value once the disease was established in the country.

But Prof McLean, a member of the government’s Scientific Advisory Group on Epidemics (Sage) told today’s briefing: “With the testing we had, the right thing to do was to focus it on people who were really sick in hospital, so we knew who in hospital had Covid.”

She added: “The advice we gave certainly took account of what testing was available. It was the best thing to do with the tests we had. We couldn’t have people in hospital with Covid symptoms and not knowing whether or not they had Covid.”

Mr Eustice confirmed: “At the beginning of this, when there was an issue of capacity of tests, of course we needed to prioritise where those were most needed, and that’s of course in the NHS. We couldn’t have a situation where people working in the NHS didn’t know whether they had coronavirus or not, so it was right to initially prioritise the tests for that particular outcome.”

The government has faced accusations that low levels of testing in the early weeks of the pandemic allowed the virus to run out of control in a way not seen in Germany, which tested at a far higher rate and has suffered just 8,000 deaths compared to the UK’s official tally of 34,351.

But environment secretary Mr Eustice said that Germany “naturally had more capacity” for tests and that the government had “very rapidly” escalated to an ability to test over 100,000 a day by the end of April.

Challenged over how the coronavirus got into the UK’s care homes, he acknowledged that some infectious patients had been transferred from hospitals.

“In those early weeks, there will have been some instances where people may have been discharged who were asymptomatic and some where they may have been showing symptoms but were isolated,” he said. “That was the guidance at the time that was in place.”

But he told the Downing Street press conference: “We don’t accept the caricature that we took an approach that was wrong.

“Very early on in this epidemic we had protocols in place for care homes, there was guidance as to how they should approach things.

“As the situation developed, then more stringent policies were introduced by way of policy around discharge, and we got to the point where everybody was tested before discharge.”

An official review of death certificates showed Covid deaths in care homes declining for the second week running in the week to 8 May, with 1,940 fatalities compared to 2,800 the week before. Overall, care homes account for over a quarter of UK deaths in the outbreak.

Speaking in the House of Commons, health secretary Matt Hancock stood by the principle of releasing patients into care homes, insisting it was “appropriate in many cases” and often safer for those being moved out of hospital.

“What’s important is that infection control procedures are in place in that care home,” he said.

The incoming president of the Royal Society, Sir Adrian Smith, cautioned against a blame game on scientists for failings in the UK’s response.

“The danger is if the politicians keep saying, ‘We’re simply doing what the scientists tell us’. That could be awkward. Politicians ultimately must make the decisions,” he told The Times.

But Ms Coffey insisted the science had been followed “every step of the way”, adding: “I think that is what the British public would accept.”

She told Sky News: “You can only make judgments and decisions based on the information and advice that you have at the time.”

Boris Johnson’s spokesman later distanced the prime minister from Ms Coffey’s comments, saying: “Scientists provide advice to the government, ministers ultimately decide. That’s how government works”

File on Four reported that PHE had been collecting data on the number of suspected and confirmed outbreaks in English care homes since 9 March, but published it only in late April, after introducing detail about the number of outbreaks at local authority level.

The Local Government Association (LGA) confirmed it had not received the data and told the BBC that directors of public health found it “difficult” to get postcode-level figures.

James Bullion, director of the Association of Directors of Social Care (ADASS), told the programme: “We were all, as directors, wanting greater distribution, greater understanding and transparency of the data around outbreaks and indeed, around incidents.”

A Department of Health and Social Care spokesperson said: “The care sector has always been at the forefront of our response to this unprecedented global outbreak. Since the start of the outbreak, PHE has been monitoring the impact on care homes which provided vital information which helped shape our response and provide further protection to the sector.

“We have ensured delivery of PPE to the social care frontline, ramped up testing for care workers and residents, and announced over £3 billion to help local authorities deal with the impacts of the pandemic on public services, including adult social care.”

Source: UK Politics - www.independent.co.uk