Testing and contact tracing in the community is the “most promising approach” in the short term to helping lift the Covid-19 lockdown, a major report has said.
The Organisation for Economic Co-operation and Development (OECD) study said isolating people with coronavirus and tracing their contacts so they also isolate – an approach abandoned by the UK Government early on – is the key to controlling further outbreaks of coronavirus.
It comes as former health secretary Jeremy Hunt took to social media on Monday to say contact tracing “needs to be our next national mission”.
Mr Hunt, who is chairman of the Health Select Committee, said a national figure outside of politics was needed to spearhead contact tracing, adding: “I hope we will get a move on so the Cabinet has a choice to the current national lockdown when they come to review this decision in three weeks’ time.”
Why contact tracing must be our next national mission: my video today pic.twitter.com/0HNQECY1CM— Jeremy Hunt (@Jeremy_Hunt) April 20, 2020
The OECD report said Covid-19 infections would “rebound rapidly” if countries just moved to lift their lockdowns completely, and urged them to ramp up contact tracing.
It said: “Once the number of infected people has successfully been brought sufficiently down, quick suppression of new waves of viral infections will be key.
“Testing strategies are central to achieve this.”
The study argued that “strong and effective testing, tracking and tracing (TTT) is needed” and “is the most promising approach in the short run to bringing – and keeping – the epidemic under control without resorting to widespread lockdowns of social and economic life”.
It added: “The TTT approach may be used to block the initial or recurrent spreads of a pathogen, aiming for a rapid extinction of local, well-defined outbreaks that collectively can control an epidemic.”
The Government has come under intense scrutiny over its testing and contact tracing policy after Public Health England (PHE) advised ministers in early March that contact tracing should be stopped.
PHE told the PA news agency in mid-March that “because the virus is more widespread and we will not necessarily be able to determine where someone has contracted the virus”, contact tracing was being stopped in favour of a more “targeted approach”.
It said anyone who had been in contact with someone who had the virus “no longer needed to take action” unless they developed symptoms.
The UK approach has contrasted with other countries such as Singapore and South Korea, which have successfully kept up contact tracing to contain their outbreaks.
Germany, which has a far lower case and death rate than the UK, has also worked on contact tracing.
Health Secretary Matt Hancock told MPs on Friday that contact tracing was part of the strategy going forward and would be introduced again, admitting that “it wasn’t possible when we had a small number of tests”.
The Government is hoping that a contact tracing app being developed by NHSX will enable larger-scale contact tracing and will “assist individuals to do contact tracing themselves”, Mr Hancock said.
However, Mr Hunt questioned this reliance on Monday, saying not everybody could download an app.
On Sunday, England’s deputy chief medical officer Dr Jenny Harries also defended the UK’s approach and questioned the link between high levels of contact tracing and low death rates seen in other countries.
She told the No 10 press conference: “We had a containment phase and it was very successful.
“We had strict quarantine regimes from high-risk areas, we followed up individual cases and families.
“But once you end up with seeding and cases across the community, our focus has to be on managing the clinical conditions of those individuals.”
However, she admitted that in an “ideal world perhaps, if you have endless resources” then continued contact tracing was an approach to consider.
I cannot believe what I am hearing at the press conference. Deputy CMO Jenny Harries still believes that testing policy in the UK has been correct. And she doesn't understand links between tests and #COVID death rates. Is this #CMO policy? If so, they should resign.— Anthony Costello (@globalhlthtwit) April 19, 2020
Professor Anthony Costello, a former World Health Organisation director, immediately attacked her comments, saying: “I cannot believe what I am hearing. Deputy CMO Jenny Harries still believes testing policy has been correct. And she doesn’t understand links between tests and Covid death rates. Is this CMO policy? If so, they should resign.”
The OECD report said contact tracing was successfully used in recent disease outbreaks such as severe acute respiratory syndrome (Sars) in 2003, Middle East respiratory syndrome (Mers) in 2012, and Ebola in 2014.
But it said for TTT to be effective against Covid-19, those contacts who were with a person in the days leading up to them being diagnosed would need to be found due to the fact the virus can be passed on before symptoms develop.
The report praised South Korea and Singapore, who have “managed to control the initial Covid-19 outbreak in a relatively short period of time by implementing a package of initiatives that had TTT as a key component”.
It said that the effectiveness of TTT depends on “both high speed and the accuracy through which this approach is deployed”, with 70% to 90% of contacts traced and asked to self-isolate.
The report praised South Korea’s “innovative solutions” early on such as drive-through Covid-19 testing centres and thermal image cameras to identify people with fevers.
It said the country also forces anyone in isolation to download a mobile phone app which alerts officials if a patient breaks isolation, while CCTV and the automatic recording of mobile phone locations helps locate contacts.