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    Making the Right Decisions to Combat the Coronavirus

    If the current pandemic is a test of the global emergency response system, the international community is flunking big time. It has done just about everything wrong, from the failure to contain the coronavirus early on to the lack of effective coordination thereafter. As the predicted second wave begins to build — the world is now adding over 400,000 new cases per day — it is truly disheartening to think that the international community hasn’t really learned any lessons from its snafu.

    Sure, some countries have successfully managed the crisis. South Korea, despite several super-spreading outbreaks, has kept its death toll to below 450, which is fewer than Washington, DC, alone has suffered. Thailand, Vietnam, Uruguay and New Zealand have all done even better to address the public health emergency. After its initial missteps, China has managed not only to reopen its economy but is on track for modest growth in 2020, even as virtually all other countries confront serious economic contractions.

    Scientists’ Social Engagement Is Needed to Stem the COVID-19 Pandemic

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    It’s not too late for the rest of the world. Robust testing, tracing and quarantining systems can be set up in all countries. Richer nations can help finance such systems in poorer countries. Governments can penalize non-compliance. Even before a vaccine is universally available, this virus can be contained.

    But perhaps the most important takeaway from the COVID-19 experience so far has little to do with the coronavirus per se. The pandemic has already killed more than a million people, but it is not about to doom humanity to extinction. COVID-19’s mortality rate, at under 3%, is relatively low compared to previous pandemics (around 10% for SARS and nearly 35% for MERS). Like its deadlier cousins, this pandemic will eventually recede, sooner or later depending on government response.

    Other threats to the planet, meanwhile, pose greater existential dangers. At a mere 100 seconds to midnight, the doomsday clock of the Bulletin of Atomic Scientists now stands closer to the dreaded hour than at any point since its launch in 1947. As the quickening pace of this countdown suggests, the risk of nuclear war has not gone away while the threat of climate change has become ever more acute. If fire and water don’t get us, there’s always the possibility of another, more deadly pandemic incubating in a bat or a pangolin somewhere in the vanishing wild.

    Despite these threats, the world has gone about its business as if a sword were not dangling perilously overhead. Then COVID-19 hit, and business ground to a halt.

    Embed from Getty Images

    The environmental economist Herman Daly once said that the world needed an optimal crisis “that’s big enough to get our attention but not big enough to disable our ability to respond,” notes climate activist Tom Athanasiou. That’s what COVID-19 has been: a wake-up call on a global scale, a reminder that humanity has to change its ways or go the way of the dinosaur.

    Athanasiou is one of the 68 leading thinkers and activists featured in a new report from the Institute for Policy Studies, the Transnational Institute, and Focus on the Global South. Now available in electronic form from Seven Stories Press, “The Pandemic Pivot” lays out a bold program for how the international community can learn from the experience of the current pandemic to avoid the even more destructive cataclysms that loom on the horizon.

    The Path Not Taken

    Let’s imagine for a moment how a reasonable world would have responded to the COVID-19 pandemic when it broke out late last year. As the virus spread from Wuhan in January, there would have been an immediate meeting of international leaders to discuss the necessary containment measures. The Chinese government closed down Wuhan on January 23 when there were fewer than 1,000 cases. At the same time, the first cases were appearing in multiple countries, including the United States, Japan and Germany. On January 30, the World Health Organization (WHO) declared the pandemic a global health emergency.

    Instead of working together on a plan, however, countries pursued their own approaches that ranged from the sensible to the cockamamie, the only common element being the restriction of travel and the closure of borders.

    The US and China, embroiled in a full-spectrum conflict over trade, technology and turf, were barely talking to each other, much less working together to contain this new threat. The United Nations didn’t get around to discussing the pandemic until April. There was precious little sharing of resources. In fact, many countries took to hoarding medical supplies like drugs and personal protective equipment.

    To be sure, scientists were sharing knowledge. The WHO brought together 300 experts and funders from 48 countries for a research and innovation forum in mid-February.

    Political leaders, however, were not really talking to each other or coordinating a cross-border response. Indeed, a number of leaders were running screaming in the opposite direction. US President Donald Trump stepped forward to head up this denialist camp, followed by Jair Bolsonaro of Brazil and Andres Manuel Lopez Obrador of Mexico. Authoritarian leaders like Rodrigo Duterte of the Philippines and Daniel Ortega of Nicaragua focused on consolidating their own power rather than fighting the COVID-19 disease.

    As the global economy went into a tailspin, there was no international effort to implement measures to contain the damage. Countries like the US refused to lift economic sanctions on countries hard hit by the coronavirus. International financial institutions issued debt moratoria for the poorest countries but have yet to consider more substantial restructuring (much less loan forgiveness). Trade wars continued, particularly between Beijing and Washington.

    Conflict has not been confined to the level of trade. A sane world would have not only rallied around the UN secretary-general’s call for a global ceasefire in conflicts around the world, it would have actually enforced a cessation of hostilities on the ground. Instead, wars have continued — in Yemen, Libya, Afghanistan. New violence has erupted in places like the disputed Nagorno-Karabakh region between Armenia and Azerbaijan.

    Military spending and the arms trade have continued unchecked. At this time of unprecedented economic need, countries continue to pour funds into defending against hypothetical threats rather than to defeat the enemy that is currently killing people on their territory. Both the US and China are increasing their military spending for next year, and they’re not the only ones. Hungary announced in July an astonishing 26% increase in military spending for 2021, while Pakistan is increasing its military expenditures by nearly 12% for 2020-21.

    Meanwhile, on this economically polarized planet, the ones who have borne the brunt of this pandemic are the poor, the essential workers, and all the refugees and migrants currently on the move. The stock market has recovered its value. Everyone else has taken a hit.

    Looking Ahead

    The international community took a giant step backward in its fight against COVID-19. Rather than build on the cooperation established in the wake of the 2003 SARS epidemic, countries suddenly acted as if it were the 19th century all over again and they could only fall back on their own devices. The hottest heads prevailed during this crisis: right-wing nationalists like Trump, Bolsonaro, Vladimir Putin and Narendra Modi, who not coincidentally head up the four most-afflicted countries.

    It’s not too late for a pandemic pivot, a major shift in strategy, perspective and budget priorities. “The Pandemic Pivot” looks at how COVID-19 is changing the world by showing us (briefly) what a radical cut in carbon emissions looks like, dramatically revealing the shortcomings of economic globalization, distinguishing real leadership from incompetent showboating, and proving that governments can indeed find massive resources for economic restructuring if there’s political will.

    Our new book lays out a progressive agenda for the post-COVID era, which relies on a global Green New Deal, a serious shift of resources from the military to human needs, a major upgrade in international cooperation and a significant commitment to economic equity. Check out our new video to hear from the experts quoted in the book.

    The coronavirus forced leaders around the world to hit the pause button. Even before the pandemic recedes, many of these leaders want to press rewind to return to the previous status quo, the same state of affairs that got us into this mess in the first place.

    We can’t pause and we can’t rewind. We need to shift to fast forward to make our societies greener, more resilient and more just — or else we will sleep through the wake-up call of COVID-19. We won’t likely get another such chance.

    *[This article was originally published by FPIF.]

    The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policy. More

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    If the poorest Americans are selling their blood, the US is in serious trouble | Arwa Mahdawi

    Looking to make extra cash? Don’t want to retrain in “cyber” but need a new gig? Good news! All you need to do is contract Covid-19, try not to die, then sell your antibody-rich blood plasma. Blood centres in the US are currently paying Covid-19 survivors a premium for their plasma, the yellowish liquid that makes up about 55% of blood. Apparently, you can get $100-$200 (£75-£155) a pop.It would seem some enterprising students have cottoned on to this money-making scheme. Administrators at Brigham Young University’s campus in Idaho recently announced that they are “deeply troubled” by accounts of students who have “intentionally” exposed themselves to coronavirus in order to get that sweet, sweet blood money. “There is never a need to resort to behaviour that endangers health or safety in order to make ends meet,” the school said.A noble sentiment. However, the US would not have a booming blood plasma industry in the first place if it weren’t for the fact that so many people have to resort to potentially endangering their own health in order to make ends meet. Even before the coronavirus hit, low-income Americans were selling blood plasma to get by.“Selling plasma is so common among America’s extremely poor that it can be thought of as their lifeblood,” a 2015 Atlantic article noted. The US is an outlier in this regard: you’re not allowed to sell your blood plasma in the UK or in many other developed countries. In the US, however, you can donate up to twice a week; the procedure typically takes about 90 minutes, and you will get somewhere between $30 (£23) and $50 (£38) a time. Which is more than the $7.25 (£5.50) per hour federal minimum wage. The companies bleeding you dry, of course, will be earning a whole lot more: blood plasma is a multibillion dollar business in the US. Indeed, blood products are the US’s 12th most valuable export; in 2016, they made up a greater percentage of all American exports than soya beans or computers. Industry people joke that the US, which produces 70% of all plasma worldwide, is “the Opec of plasma collections.”Giving blood plasma now and again won’t hurt you. Indeed, it is something we should all do if we can: plasma is desperately needed for life-saving therapies. In Britain, the NHS is urging Covid-19 survivors to donate plasma to treat those who fall ill during a second wave. But selling your blood plasma 104 times a year, as some desperate Americans do, may be another matter. Someexperts and research have queried whether it is healthy, and even in the US if you donate plasma rather than sell, there are limits on how many times you can do it. Some people who sell their plasma frequently have also complained about things like migraines, numbness, and fainting.I am not necessarily against the idea of allowing people to sell blood plasma: as long it is strictly regulated, the number of donations safely capped, and the pay fair. However, I am definitely against people having to resort to selling plasma because the lack of a meaningful welfare state, along with a stagnant minimum wage, means it’s the only way they can scrape by. Even if there were zero health consequences involved there is something fundamentally sickening about the blood plasma industry. According to one study, plasma donation centres are disproportionately located in low-income areas and the most frequent use of money earned from donating was paying for food and basic necessities. And this is happening in the richest country in the world. It should make your blood boil.• Arwa Mahdawi is a Guardian columnist More

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    Coronavirus: 'Very high' level restrictions not enough to reduce R rate below one, Sage adviser warns

    Even the toughest coronavirus restrictions in the new three-tier system will not be enough to reduce the coronavirus R rate below one, a government scientific adviser has warned. Professor Andrew Hayward from University College London said he thought it was “clear” these measures would not be sufficient to get the R rate – which represents the number of people one positive case goes on to infect – below that point. His comments came after Boris Johnson announced a three-tier system of alert levels for England, which will see areas categorised as medium, high, or very high risk.In the top tier – where currently only the Liverpool City Region is placed – social mixing will be banned both indoors and in private gardens, while pubs and bars will be told to close unless they can operate as a restaurant.Local leaders will help to determine whether other venues should close, and residents will also be advised against travel in and out of the areas.Watch more“Obviously the recent announcement is an attempt to simplify the advice through these tiers of systems,” Prof Hayward, a member of the government’s Scientific Advisory Group for Emergencies (Sage),  told the Today programme on Tuesday.”But I think it is clear even at the very high levels of restriction, so-called, that those will not be sufficient to reduce R below one.”On Monday, the government’s chief medical officer said he was “not confident” the top tier restrictions would not be enough to get on top of Covid-19 on their own. Professor Chris Whitty said: “That is why there is a lot of flexibility in the tier three levels for local authorities guided by the directors of public health … to actually go up that range so that they can do significantly more than the base, because the base will not be sufficient.”“I think it is very disappointing we had clear advice that we needed to take decisive action several weeks ago,”  Professor Hayward said on Tuesday. “Since that time all we have really done is sent students back, introduced the rule of six, advised people to work from home if possible … and closed the pubs an hour early.”Read moreThe UCL professor of infectious disease epidemiology added: “So I think it is not really surprising that we are continuing to see large increases in cases, and that those increases are being seen around the country.”The documents show Sage suggested immediately introducing a “circuit-break” lockdown lasting between two and three weeks to halt the rapid spread of the virus.Downing Street insisted that “robust but targeted and proportionate” action had been taken in September, including the rule of six and the 10pm hospitality curfew.MPs will debate and vote on the three-tier system on Tuesday and – if approved – it will come into effect on Wednesday.One step down from very high risk, an area in the high level would mean household mixing is banned indoors, although support bubbles will still be permitted.Medium areas will be subject to national measures, including the 10pm curfew for pubs and restaurants, and the rule of six. More

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    UK at ‘critical’ moment as coronavirus infections double in a week in England

    MPs have been warned that the coronavirus crisis is at a “critical” moment, as figures suggested the number of infections had doubled in a week.Jonathan Van-Tam, the deputy chief medical officer, is understood to have warned that the situation in the UK was now similar to that in early March, before the national lockdown was introduced.      Sadiq Khan, the mayor of London, also predicted further restrictions in the city were inevitable as pubs and restaurants in coronavirus hotspots braced themselves for new restrictions. Boris Johnson is expected to make a statement to MPs on Monday during which he will outline a three-tier local lockdown system designed to slow the spread of the coronavirus. And more details on the possibility of further restrictions emerged last night in a letter written to MPs by Mr Johnson’s chief strategic adviser, Sir Edward Lister. In the letter, written following a meeting with northern leaders, Sir Edward stated that the “rising incidence” of coronavirus in parts of the country meant it was “very likely” that certain areas will face “further restrictions”. The letter also said that the prime minister believed local leaders should “help shape the package of measures in the most concerning areas” and that the government will discuss “difficult choices” with them. In preparation, the chancellor Rishi Sunak unveiled a rescue package for businesses expected to be ordered to shut their doors.  Ministers will cover two-thirds of the wages of all staff in workplaces legally required to close, Mr Sunak announced, in what will be seen as an effective extension of his furlough scheme for some.  
    During a briefing with Matt Hancock and Mr Van-Tam, MPs are understood to have been warned the situation was “critical” and could be compared to early March, just weeks before Boris Johnson ordered an unprecedented nationwide lockdown.The latest infection numbers from the Office for National Statistics revealed cases may be doubling with 224,400 people in England thought to have caught coronavirus between 25 September and 1 October, equating to about one in 240 people. A week earlier, the numbers infected were nearer 116,000.According to the daily data from Public Health England and the NHS 13,864 lab-confirmed cases of coronavirus in the UK were reported on Friday with 87 more people dying within 28 days of a positive test.
    Almost 600 people were admitted to hospital in the last day, with a total of 3,660 now on wards and 436 on ventilators to help them breathe.The latest analysis from the government’s Scientific Advisory Group for Emergencies warned the growth in infections was between 4 and 9 per cent a day with the R rate of transmission at between 1.2 and 1.5.
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    A Year On, the Clean India Mission Falls Short

    Research amidst the COVID-19 pandemic has shown that the virus is transmitted through wastewater. This makes it crucial to revisit the goals of India’s ambitious Swachh Bharat Mission (Clean India Mission, or SBM) that came to a close almost exactly a year ago. While there were substantial improvements made in toilet coverage, a lack of data clarity muddies an understanding of exactly how large these improvements were across the country. According to government estimates, national sanitation coverage was 51% in 2014 when SBM began and reached 78% in 2018, less than a year prior to the end of the program. While this certainly shows progress — the national average was just under 26% in 1999 — no one would think to take these numbers and simply round up to 100%.  

    But at the close of the SBM last fall, this is exactly what Prime Minister Narendra Modi did. Speaking to a crowd, Modi proclaimed that India was now completely open defecation free (ODF), with sanitation coverage reported by the SBM portal as 100% in rural areas and, inexplicably, 105% in urban areas. From the start of the 2014 campaign, the central government maintained that in just five short years, India would be ODF. Despite the gains made, a singular focus on meeting steep targets in a very short amount of time seems to have put Modi in a tight spot by the time October 2019 rolled around. 

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    The gaps have been, at times, glaring. News reports from established outlets all over the country reported open defecation in areas that were already recorded as ODF. A 2018 study by the Rice Institute estimated an open defecation rate of 44%, meaning nearly half of the sampled population was still engaging in the practice hardly a year before SBM ended. In urban areas the picture looks a bit better: 95% of urban households access an improved toilet. But this includes community toilets, which may be used by hundreds of other families and are often plagued with maintenance, hygiene and safety issues. Furthermore, one survey from 18 states identified over 48,000 manual scavengers still cleaning “dry” toilets which do not discharge into sewer lines.

    Social Pressure-Cooker

    What explains these inconsistencies? The use of shame-based tactics to stop open defecation, alongside a rush to meet ODF goals, have built up a pressure-cooker environment. The SBM has continued prior national efforts that deemphasized technical solutions and focused heavily on strategies to encourage behavior change at the local level. One such strategy is Community-Led Total Sanitation (CLTS), which hinges on “triggering” disgust and extreme emotions among community members to spur the abandonment of open defecation. Despite some concerns about shame-based approaches, the SBM continued with the CLTS Foundation and others as implementation partners.

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    But open defecation is an issue that needs more than short-term emotional reactions. The longstanding practice is mired in cultural tradition, casteist taboos and environmental factors, among others. Some reasons people give for it is that they do not wish to empty a pit themselves, that it is considered more hygienic to defecate further away from the home — certainly reasonable considering how few poor Indian homes have running water — or that community toilets are dirty and unsafe, so squatting in a quiet area nearby is actually preferable.

    In the SBM environment, people who have not built a toilet, for whatever reason, are highly likely to experience retaliation for continuing to defecate in the open. Because Indian culture is quite collective — the actions of one person are seen to have radiating effects on the family and community — sometimes social pressure can play a role in nudging behavior change. However, this is a slippery slope. In India’s highly unequal society, characterized by stark gender and caste-based hierarchies amidst a wide array of languages and ethnicities, such strategies have the potential to be misused, with large social costs.

    There is ample evidence to show this. In June 2017, Zafar Hussein, a local community leader agitating against the eviction of his settlement in Rajasthan, was allegedly beaten to death by local officials for trying to stop officials from taking photographs of women defecating in the open. His death was reported by multiple outlets. In other areas of Maharashtra, people have been followed by a loud band, jailed or fined for defecating in the open.

    Walls of shame have been instituted by local village councils onto which the names and photographs of people defecating openly are be pasted. These individuals were often removed from eligibility for local government programs. The previously mentioned Rice Institute study also recorded coercion and threats of the loss of government rations as a way to bring down open defecation rates. Notably, the study found that Dalits and Adivasis were the most likely to face such behaviors. India’s Health Ministry has publicly denounced the results of the Rice survey. But in September last year, weeks before Modi’s ODF declaration, two young Dalit children were beaten to death in their village in Madhya Pradesh for defecating in the open.

    Numbers, Strategies and Health Equity

    These debates over sanitation data are not merely academic exercises. They have real, material impacts on people. In some ways, the above tragedies are not surprising. If a hasty approach is taken toward declaring areas ODF, it follows that any activity hinting that this claim is not matched by reality will be quashed. Despite this, the Bill and Melinda Gates Foundation bestowed the Global Goalkeeper Award upon Modi last year. It is surprising that one of the largest, most influential health organizations in the world, committed to facts and data, accepted without question the Indian prime minister’s claims, failing to consider all the evidence to the contrary.

    So what is the solution? Certainly, the answer is not to give up on sanitation programming as the need remains great. There are several organizations on the ground that have successfully integrated mobilization with communities, technical expertise and a sustained presence through which people are not merely pressured to stop a practice but meaningfully guided toward an alternative and given the facts and tools to integrate that alternative into their lives.

    However, this takes a more long-term presence, a less single-minded focus on quick targets, a commitment toward waste management infrastructure besides just toilets, and a willingness to meet people where they are. Further, the same people who have fallen through the gaps in the SBM are those with a lot to lose during the current pandemic: the rural poor, slum-dwellers, sanitation workers, manual laborers and migrants. Brutal crackdowns against those who kept working amidst India’s COVID-19 lockdown illustrate that retaliation cannot continue to be a solution when reality does not match the official word. Amidst the pandemic, sanitation infrastructure and the transparency of data surrounding it are necessities that cannot afford to wait.

    The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policy. More

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    Coronavirus: 'Worrying' questions remain after technical error blamed by PHE for 15,000 missing cases, expert says

    Following the revelation that some 15,000 overlooked coronavirus test results had been added to the weekend’s totals, experts have warned the seemingly “fundamental” IT error raises “worrying” questions over the government’s past and future handling of data.The explanation prompted concern that additional cases may remain overlooked, with one expert comparing the system apparently used to collate testing data to “a similar architecture you used to see in banks 30 years ago”.And as officials grappled with drastically altered local infection rates, a data scientist warned the blunder’s possible “knock-on effects” on the already strained contact-tracing system could have a “substantial influence on the generation of new cases”.After the government’s Covid-19 Dashboard showed record daily caseloads of 12,872 and 22,961 on Saturday and Sunday respectively, officials said the stark rise was due to an IT glitch discovered on Friday evening.As a result, 15,841 cases were included that had previously been left out of the totals announced between 25 September and 2 October.Watch moreWhile the revelation prompted furious and still unanswered questions over how many possibly infected people had been missed by contact tracers as a result of the glitch, Public Health England (PHE) sought to clarify the cause of the error.The “technical issue” was that some digital “files containing positive test results exceeded the maximum file size” accepted by the government’s central computer systems, officials said.A “rapid mitigation” had been put in place to split large files, while “a full end-to-end review of all systems” had been ordered “to mitigate the risk of this happening again”, PHE said, adding that there are already a number of automated and manual checks within the system.But a computer science expert said the explanation raised a “whole series of unanswered questions, some of which are quite worrying”.The statement suggests that the mistake was only picked up as officials audited or reconciled previous counts of results, and that computer systems did not issue basic alerts that some results had been rejected by the central server.“It’s quite an oddity because it only seems to have been found out by happenstance. It’s not that the system was warning them,” Alan Woodward, visiting professor at the University of Surrey’s Department of Computer Science, told The Independent. This appeared to raise the possibility that test results had been slipping through the gaps for weeks, and thus omitted from official counts in the past.“It is a possibility, and that’s one of the really worrying things about this, are they going back to look?” Prof Woodward said. “I mean, how big are these files?”He added: “If this [explanation] is plausible, what’s also plausible is the fact that it may have been happening before, so were the numbers higher all along?“But then presumably somebody would have caught it earlier and, if they didn’t catch it, does that mean they weren’t reconciling things to make sure all the tests were actually counted?”Asked whether smaller quantities of test results could have been slipping under the radar for weeks, a PHE spokesperson told The Independent: “Smaller numbers wouldn’t have triggered this problem. It’s not that the individual files are too big, it’s that when they’re all grouped together and large numbers are reported simultaneously, that can become too big. “I’m not sure how big the individual files are, but I’m reassured that the problem is with bundling them together rather than the actual file size. “It’s also important to note that this isn’t the only place where there’s a record of [the results] — the individual trusts who perform the tests keep a record which can be … cross-referenced.”Despite the multiple records available for cross-referencing, the spokesperson was unable to explain the week-long delay in officials realising thousands of results had not been counted.Meanwhile, the admission that the government’s computer systems send test results over in batches rather than in real-time raised eyebrows.“That’s a very old fashioned way of doing it,” Prof Woodward said. “In this day and age, especially with continuous connectivity, there should be no reason why … once [a test result] gets confirmed and validated inside the lab, it goes up, so as real-time as possible could be done.”He added that the structure by which results appear to be collated from individual laboratories is “a similar architecture you used to see in banks 30 years ago”.Coronavirus test chief Baroness Harding denies system is failing as pressure mounts“Being naive, I thought it would have been just literally the test centres would have had a … piece of software they would be putting their results into and that would then get stored on the central database,” Prof Woodward said. “But it looks like what’s happening is that all the testing centres have got their own systems and then at some point a batch of those get sent to the centre, which is a bit odd for this day and age.”He continued: “It’s not a huge surprise on a big system that you get teething problems, but at the same time — and I should show some of my frustration here — building a completely new system as we have done rather than continue with the existing NHS track and trace and just utilising that all seems odd to me. The very time you do not need to be ironing out the bugs in a new system is in the middle of a pandemic.”Meanwhile, Test and Trace chiefs insisted that all those who tested positive received their results “in the normal way” and were told to self-isolate.And despite daily positive tests caseloads in the week from 25 September being between 744 and 4,786 infections higher than shown in government figures, the government insisted decisions on localised restrictions affecting millions of people had not been affected.But in Liverpool, where new restrictions were imposed on Thursday, the revised total meant the city’s infection rate soared from 287 to 456 cases per 100,000 residents, while Manchester emerged as the worst-hit part of the UK, with some 496 infections per 100,000 people.“The big problem with this latest data issue from PHE is that we were misled as to the underlying trend during that period,” said independent statistician Nigel Marriott. “Up to Friday it looked like the recent surge in cases had paused and there was hope of a turnaround in some places.  But with the revisions, it is clear that there is still a strong upward trend and more measures may be needed to reverse the trend.  “At present, the ‘50,000 cases by mid-October scenario’ postulated by [England’s chief medical officer Chris Whitty] last month can’t be ruled out, although I suspect the number will be closer to 25,000. “What hasn’t changed is the sensitivity of the national trend to what is happening in the North.  The sooner the North slows down and reverses, the less likely we are to fulfil the CMO’s scenario”.And as cabinet minister Therese Coffey was unable to give an estimate for how many people had been missed by contact-tracers as a result of the blunder, one expert warned there would be a knock-on effect upon future contact-tracing efforts.“While it appears [contacts] are now being contacted as a matter of priority, this additional strain on a system already stretched to its limit implies that further delays are likely to occur for other cases where contact tracing is needed,” said Rowland Kao, a professor of veterinary epidemiology and data science at the University of Edinburgh.“These knock-on effects may have a substantial influence on the generation of new cases, over a period even longer than that.” More