The pincer movement on the Government from Keir Starmer, calling for a “circuit-breaker”, and Conservative MPs, urging a Sweden-type policy, has been enabled by a political development amidst the Covid-19 crisis.
It’s the same one that has spurred Andy Burnham’s public resistance to Ministers in Manchester, and complaints from Tory backbenchers that their lower-Coronavirus suburban seats are being lumped in with higher-virus urban ones under the new three-tiers plan.
Namely, a loss of confidence in the central element of Boris Johnson’s strategy, and the strategic alternative to lockdowns and loosening: test and trace.
The scheme depends on finding within 48 hours 80 per cent of those who have been in contact with someone who a test has confirmed has Covid-19. And on those who are so traced then self-isolating for the required period.
ConservativeHome hasn’t yet found anyone with knowledge of the system who believes that this target will be hit, despite the localisation of tracing that the Government has recently agreed to.
However, Downing Street and senior Ministers believe that there is now a way out of the predicament that it currently finds itself in – one that will put Starmer back in his box, quell the calls for a national lockdown, relax the three-tiered restrictions plan and quieten those restive Tory backbenchers: a new testing programme entirely.
It is centred around two kinds of tests – in the jargon, LAMP tests and lateral-flow tests. The key to the latter is that they cut out the need for tracing, because of the scale at which they can be delivered.
If there are enough tests, after all, and they deliver results fast enough, then an elaborate tracing programme simply isn’t necessary. Crucially, the lateral-flow tests can deliver a result within 15 minutes or so. This programme is the Prime Minister’s “moonshot”.
Trials will be rolled out in some of the worst affected regions to universities, with students tested weekly; to care homes, with staff tested fortnightly, and schools, where pupils and staff will be tested in the event of an outbreak.
Meanwhile, the LAMP tests will be concentrated on testing asymptomatic NHS staff in seven urban areas. These require contact tracing. So the results will be collected by NHS Test and Trace, and then published as part of the daily case numbers.
Millions of these new tests – the lateral-flow ones are all done by means of swabs and don’t need to be sent off to laboratories – have already been bought. Similar ones are being used in America.
Government sources claim that present trials with students show that a higher proportion of the latter are prepared to self-isolate if tested directly, and told that they have the virus, than if contacted by a tracer, and told that they might do (which makes sense).
Unusually, the Prime Minister underplayed the chances of an immediate breakthrough last week, saying that “no country in the world is regularly testing millions of people”.
The Government will now need “to take the time to establish how to do this effectively and safely, and to build the logistics and distribution operation necessary for a large scale operation across the country”. That will involve a shake-up.
It will involve streamlining and if necessary changing the administrative and legal framework that obstructs parts of the NHS from sharing data with government, and the private sector from delivering tests.
The present test and trace scheme will continue (Ministers insist that it is on track to hit a 500,000 daily testing capacity target by the end of this month) and the Department of Health will be responsible for the delivery of the new programme.
Nonetheless, it is Downing Street itself that has been driving the moonshot, working with scientists, laboratories, companies and deliverers: a new operational system, in short.
One Government insider says that, if the new scheme is to work, private sector involvement is crucial. “We need to get to the point where, say, pubs and football clubs can deliver the lateral-flow tests themselves”. There is frustration with the gold-plating of laws and regulations that make data sharing more difficult.
How soon could the new tests really start to deliver results? One MP insider told this site that it might be as soon as “a couple of months”, but all concerned are being cautious.
Ministers with a range of approaches to tackling the virus were supportive of the new plans when quizzed about them. The question is whether Tory MPs, and in particular the 50 or so who have voted against the Government on scrutiny and the strategy, will be as easily reassured.
They will ask some searching questions. The moonshot is, after all, trials to date. What if they don’t work? Or can’t be rolled out smoothly, because of the legal and bureaucratic obstacles to which insiders refer?
Given the operational and cultural failures of the state to date – the NHS app fiasco during the summer; the recent under-reporting of tests; the use of outdated software; the chaos over airports; the carnage in care homes; the grim death numbers – they are also bound to say: why should it all be different this time?
Johnson will hope that early successes will win them round, and that political life will be breathed back into testing (and tracing, as local authorities and health trusts begin to deliver it on the ground).
As the number of tests scaled up, Starmer’s push would then falter, the three-tier system could be eased, pressure from local councils, not least Conservative ones, would wind down – and the UK really might emerged as the “world-beater” that the Prime Minister has promised so often.
All this would happen, please note, whether a vaccine is delivered successfully or not. Our sense is that Number 10 is less optimistic than some Government scientific advisers on this point – a subject big enough for another day.
The moonshot may work and it may not. But even if it does, there is a question about political timing. If those quick wins don’t come, neither Tory MPs nor local authorities will be reassured, and Johnson will find himself pulled betweeen loosening and lockdowns, with more defeats in Parliament and even less authority.
Either way, Ministers need to change the public conversation, or try to, about the balance of risk – through reports on the healthcare and economic impact on lives and livelihoods of lockdowns, restrictions and Covid-19 itself.