COVID 19: known unknowns. Facing up to scientific uncertainty during a pandemic. 08:45-19:45, 20 November 2020. Zoom link (full programme to follow)
Liverpool mass testing, 06 November 2020
Raffle AE. Screening the healthy population for covid-19 is of unknown value, but is being introduced nationwide. BMJ Opinion 09 Nov 2020
The UK has over 20 years experience of delivering evidence-based, systematic, high quality screening programmes, which deliver more good than harm at affordable cost.
This experience tells us that if you embark on a screening programme without having carefully evaluated it first, without a proper quality assured pathway, without certainty of test performance in field settings, without full information for participants, and without the means to ensure that the intervention needed for those with positive results does indeed take place, then you will end up with an expensive mess that does more harm than good.
From what we can tell, the current proposals for screening the City of Liverpool using SARS-CoV-2 rapid tests are not fit for purpose.
- It is called a ‘pilot’ yet there appears to be no research design.
- There is no concrete evidence that screening of this nature is helpful in outbreak control.
- It appears to have no system design for who is eligible, how they will be contacted, how they get results, what advice they will be given, how this will be followed up, and how this will be integrated with test and trace and with local health and social care services.
- The tests being proposed are new and there is little data about their performance in field settings, so therefore many people will be given false results.
- The harm from false results includes unnecessary isolation (for false positives), and false reassurance with potentially riskier behaviour (for false negatives).
Our concerns are that the Liverpool screening will fail to realise any benefit, and will cause harm through diversion of resources – including by distracting from solving the problems with the test and trace programme.
Publications and reports
Briefing on Operation Moonshot screening for SARS-CoV-2. 15 November 2020. Deeks J, Pollock AM, Taylor-Phillips S, Raffle AE.
Independent SAGE. 13 November 2020. Bambra C, Hayre J, Pollock AM, Brown H. COVID-19 and health inequality. download
Journal of the Royal Society of Medicine. 28 October 2020. Harding-Edgar L, McCartney M, Pollock AM. Test and trace strategy has overlooked importance of clinical input, clinical oversight and integration. download
BMJ. 22 September 2020. Deeks JJ, Brookes AJ, Pollock AM. Operation Moonshot proposals are scientifically unsound. download
Tribune. 21 August 2020. Pollock AM. Track, trace and the myth of private sector efficiency.
The Guardian. 31 July 2020. Pollock AM. Thanks to outsourcing, England’s test and trace system is in chaos.
All Party Parliamentary Group on Coronavirus. 24 July 2020. Roderick P. Submission to APPG on Coronavirus
BMJ Opinion. 21 July 2020. Khunti K, Pollock AM, Pareek M. Find, test, trace, isolate and support programmes need to be localised and culturally tailored to reach ethnic minority populations.
House of Lords Science & Technology Committee. 17 July 2020. Pollock AM. Response: The science of COVID-19, 12th evidence session (29 Jun 20). download
New Statesman. 01 July 2020. Pollock AM. Spending cuts and privatisation have left us without a functioning social care system.
BMJ. 25 June 2020. Roderick P, Pollock AM, Macfarlane A. Getting back on track: control of covid-19 outbreaks in the community. download
Wales Centre for Public Policy. June 2020. Recovery from COVID-19: note of the expert roundtable on public services.
Daily Mail. 11 June 2020. Pollock AM. They died alone and frightened, victims of a broken system that shames us all.
Advice note for Independent SAGE. 05 June 2020. Raffle AE, Taylor-Phillips S. Test, test, test: lessons learned from experience with mass screening programmes. download
Scottish Left Review. 18 May 2020. Pollock AM, Harding-Edgar L. Coronavirus crisis: underfunding, restructuring, privatisation and fragmentation at the heart of the crisis in Holyrood and Westminster.
The Independent SAGE report. 12 May 2020. COVID-19: what are the options for the UK? Recommendations for government based on an open and transparent examination of the scientific evidence. download
BMJ Opinion. 07 May 2020. Coleman MP, Di Carlo V, Ashton JR, Pollock AM, Matz M, Allemani C. Reliable, real-world data on excess mortality are required to assess the impact of covid-19.
The Observer. 26 April 2020. Pollock AM, Roderick P. To tackle this virus, local public health teams need to take back control.
Scottish Centre on European Relations 23 April 2020. Pollock AM, Harding-Edgar L. Coronavirus crisis: underfunding, restructuring, privatisation and fragmentation at the heart of the crisis in Holyrood and Westminster. download
BMJ editorial. 14 April 2020. Covid-19: why we need a national health and social care service. download
BMJ editorial. 30 March 2020. Covid-19: why is the UK government ignoring WHO’s advice? Testing and tracing must resume urgently. download
Letter to BMJ: Covid-19: local implementation of tracing and testing programmes could enable some schools to reopen: I am increasingly concerned about the apparent failure to implement fundamental public health measures to tackle the covid-19 outbreak—specifically, community contact tracing, clinical observation, and testing … read at the BMJ (may require login) or on this site
We need hands-on public health expertise to tackle COVID-19: The government has released its scientific evidence, which sheds light on the fiasco and the catastrophe that is unfolding economically, socially, and health wise. It also highlights the lack of public health input and the decimation of the speciality and expertise in communicable disease control prior to and after the Health & Social Care Act 2012. There appears to be no public health evidence from experienced physicians in communicable disease control and their teams. … read more
Contacting public bodies and politicians
14 April 2020, Orkney MP Liam McArthur seeks clarification about localised approach to tackling coronavirus
Letter to the Scottish Government, 07 April 2020. “… I have still not had a reply to my letter of 21 March 2020. It is a generally shared view of me and my colleagues in public health that re-establishing intense contact tracing is essential at local level if we are to enable children to return to education and control measures to be lifted in different parts of the country. …Of course it goes without saying that I would be happy to offer help and support. I will be writing to you separately about residents in long term care settings where the situation is extremely troubling.”
Response from Public Health Wales, 02 April 2020, on contact tracing and testing … view
Sample email to local authority or other responsible organisation on contact tracing and testing: Peter Roderick to Public Health Wales, 30 March 2020
Write to your local MPs, councillors and mayors about following WHO advice … read more
Letter to the North of Tyne Combined Authority, 23 March 2020: The purpose of this letter is to urge you as soon as possible to do everything you can to make the case with your local authority colleagues and Public Health England to institute an immediate and meticulous contact tracing and testing programme in each local authority within the NoTCA area, and more widely in the North East. … read more
Letter to the Scottish Government, 21 March 2020: I urge the Scottish government immediately to institute a massive centrally-coordinated, locally-based contact tracing and testing programme … read more
Draft parliamentary questions on contact tracing and testing, 20 March 2020