Health Policy
Independent SAGE calls for immediate circuit breaker

By - Integrated Care Journal

Independent SAGE has called for an “immediate national circuit breaker” to halt the spread of Covid-19 as the Government’s three-tier system of restrictions is “not enough to reverse growth”.

The panel of expert scientists, chaired by former chief scientific adviser Sir David King, set out a ‘six-week emergency plan’ to bring infection rates below 5,000 a day. At a live-streamed briefing, Independent SAGE outlined its blueprint for an “urgent reform” of the failing test and trace system, which Sir David King described as “a national scandal. ”

Independent SAGE’s proposal for a two to three-week lockdown, includes the immediate closure of schools, non-essential retail and businesses, the leisure and hospitality sectors (takeaways permitted) and places of worship. It also urges a return to 2-meter physical distancing, a ban on household mixing outside of support bubbles and a switch to online teaching in universities.

The proposed measures are in line with those recommended by the Government’s SAGE committee on 21st September which the Government has failed to implement. It is recommended that the implementation of a circuit breaker be followed by a period of continued restrictions sufficient to keep the ‘R number’ below one while allowing schools to stay open.

Independent SAGE says the circuit breaker must be used to buy time for an “urgent reform” of the Find, Test, Trace, Isolate and Support (FTTIS) system which is failing to keep up with rising infection levels.

New figures show that only 25 per cent of test results are being received promptly in England and the number of contacts being reached has remained flat.

Proposals outlined in the blueprint include: 

  • The FTTIS system to be overseen by a national body such as NHS England with regional Directors of Public Health placed in charge of managing their local programme.
  • Establishing a national Covid testing consortium, including all current providers, under the oversight and management of the NHS
  • Freeing resources by terminating contracts for Lighthouse Laboratories
  • The urgent creation of a Covid-19 office in each region, led by an experienced senior public health professional or NHS Chief Executive, with support from public health professionals.
  • Staff from local authorities or NHS bodies within the region seconded to oversee and manage the performance of the FTTIS programme
  • Active involvement of local health professionals, including GPs, pharmacists, health visitors, environmental health officers and school nurses, is crucial.
  • The strategy for FTTIS should be developed by Public Health England (or its successor NIPH) in conjunction with regional directors.

The Independent SAGE blueprint states that the £10 billion allocated by the Treasury for the existing track and trace system has not been used effectively. “With this budget, the Government  could have provided £1 million to every UK general practice and £10 million to every top tier-local health authority. ”

Professor Christina Pagel of University College London said: “Cases, hospitalisations and deaths are rising across England. The tiered system will not be enough to reverse growth. Despite four weeks of living under “tier 2” type restrictions in many areas and three weeks of “tier 1” restrictions elsewhere, cases continued to increase rapidly everywhere. ” 

Professor Pagel added: “Agreeing with SAGE, we believe a sharp national circuit breaker for two to three weeks followed by three to four weeks of continuing restrictions is needed to stop the current wave in its tracks, preventing tens of thousands of new cases and thousands of hospital stays. This will buy us precious time to build a public health and social scaffolding to support easing restrictions and restarting our lives. We must not waste this time. ”

The Independent SAGE FTTIS blueprint states: “National and regional lockdowns and other large scale restrictions are blunt tools; testing and tracing should be a targeted, precise system. Done well, it allows us to identify sources of outbreaks and isolate individuals and those they have been in close contact with, rather than entire populations. Without an effective FTTIS system, the Government has little choice but to rely on imprecise and damaging local and national lockdowns to prevent surges in infection. The urgent reform of FTTIS is the most important economic and health priority for the Government and the country right now. ”

SAGE stated that they recognise this is a difficult decision but explains that there is no reason why the United Kingdom shouldn’t emulate the successes of countries like Norway, Finland, Germany, South Korea, Taiwan, Vietnam, China and Singapore and enjoy the near normality that they have secured.

The report also notes that laboratory activities in Wales, Scotland and Northern Ireland are already more coordinated but suggests that structures in the devolved nations follow the trajectory laid out in the blueprint.

Sage clarify that any new restrictions must be accompanied by a package of financial support for individuals and businesses affected. It has also called for a “comprehensive reset of the government communication strategy” to ensure that it is clear and consistent and avoids blaming the public for increasing infection rates.

Finally, the committee urges the implementation of a robust regulatory and inspection framework to ensure that all workplaces, hospitality and other public spaces are Covid-19 compliant.

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