Coronavirus in England: half of those with symptoms not isolating | World news


Only half of people who develop coronavirus symptoms self-isolate for at least a week, according to government science advisers, raising urgent questions about the success of the test, trace and isolate strategy needed to contain future outbreaks.

In an April report to the government’s Scientific Advisory Group on Emergencies (Sage), behavioural science experts said “rapid” research was needed on how best to get people to comply with self-isolation advice given that “only around 50%” took the precaution when they developed a cough or fever, according to Department of Health tracking in England.

Under the new test-and-trace system, people will be required to self-isolate for 14 days if they are informed that a recent contact has tested positive for the virus.

The same document from the Sage subgroup states that scientists “anticipate major behavioural barriers” to people using the NHS contact-tracing app that will prevent it from being the primary method of containing outbreaks.

They go on to warn that foreign powers will seek to capitalise on any weaknesses they spot in the UK’s response to the outbreak and in particular “will examine planning and capabilities in response to a civil contingency/peacetime threat”.

The revelations appear in the latest tranche of documents and the first minutes of meetings published by Sage. The minutes from 34 meetings held from January to May were released with other documents submitted to Sage by its modelling and behavioural science subgroups.

Many of the documents include redactions, mostly of names of people on the Sage secretariat and others who participated directly in the meetings.

Weeks before lockdown in March, a Sage meeting on 25 February discussed the importance of perceived fairness in reducing the chance of disorder, saying public compliance was “likely to be enhanced [by] a sense of collectivism”, and that “flash points tend to happen where there is a perceived lack of equity”.

One Sage meeting on 16 March, a week before full lockdown, said there was “clear evidence to support additional social distancing measures be introduced as soon as possible”. A “significant increase in testing and the availability of near real-time data flows” was needed to understand the spread of the virus, the scientists said. It was possible that there were already up to 10,000 new cases a day in the UK.

Just two days later the next Sage meeting said evidence “now supports implementing school closures on a national level as soon as practicable to prevent NHS intensive care capacity being exceeded”, warning that the UK appeared to be a few weeks behind Italy in the pandemic curve. The advice added: “If the interventions are required, it would be better to act early.”

The chronology of the minutes shows how rapidly events overtook planning. On 3 March a Sage meeting said there was “currently no evidence that cancelling large events would be effective”, and that closing restaurants and bars “would have an effect, but would be very difficult to implement”. But only a week later, the next Sage meeting said the UK could have up to 10,000 cases, spread nationally.

Other points raised by the documents include:

  • The main No 10 representative was Ben Warner, a data scientist recruited to Downing Street after running the Conservatives’ election campaign model. He previously worked with Dominic Cummings on the Vote Leave campaign.

  • A warning that creating “bubbles” for people to mix in would have mental wellbeing benefits but carry unforeseen risks and the potential for the virus to spread.

  • A request for pastoral support for advisers and more effective means of screening requests to Sage members, given that they would continue to work “under intense pressure” for many more months.

Government scientific advisers have also expressed caution about the efficacy of the planned track-and-trace system, saying that for it to work, around 80% of non-household contacts would have to be traced and isolated within 48 hours of the first person experiencing symptoms.

This would need about 30 contacts to be tested per case, the Scientific Pandemic Influenza Group on Modelling, which reports to the health department, said in meetings in April, adding: “Beyond that, benefits would be marginal.”

The group also said that an app to help trace contacts, which has since been delayed, would most likely only track half the necessary number of people even if it worked perfectly.

The documents are the latest to be released after No 10 came under pressure to publish the membership of Sage and the advice it provided to ministers. In April, the Guardian revealed that Cummings, the prime minister’s senior aide, had participated in Sage meetings. His presence at meetings “shocked” the government’s former chief scientific adviser Sir David King, who said: “If you are giving science advice, your advice should be free of any political bias.”

A previous release of Sage documents provoked dismay among some advisers after parts of a report that criticised potential government policies on social distancing were redacted, with one declaring the act was reminiscent of “Stalinist Russia”.

Earlier this month, Anthony Costello, professor of global health at UCL, and a former director at the World Health Organization, called on the government to publish the scientific advice it received from Sage as the UK faced “the greatest public health disaster in a century”, adding that the public deserved to “understand how we got here”.



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