Covid-19: Mass testing a distraction from vaccine rollout – health leaders

Mass testing plans in England threaten to be a “distraction” from other priorities such as the rollout of a vaccine, health leaders have warned.

The PM has said mass community testing, as seen in Liverpool, will be offered to all areas in tier three after lockdown ends.

But experts have questioned whether this is possible due to the “enormous” resources it requires.

The government said it will work with local authorities to support plans.

In a joint statement, the Faculty of Public Health and the Association of Directors of Public Health said improving NHS Test and Trace must remain the top focus for testing.

Mass testing of people without symptoms using new rapid “lateral flow” tests – which give a result in about 20 minutes, without the need for a lab – has been piloted in Liverpool.

So far more than 100,000 people without symptoms have been tested using the new rapid tests, with just over 700 positive results.

Now thousands of rapid tests have been sent to more than 90 local authorities in England as part of an expansion of the Liverpool scheme, which was supported by 2,000 members of the military.

One of those is Liverpool’s neighbour, the borough of Sefton, which has half as many residents.

But the area says it only has a team of 12 people to carry out mass testing and has been offered no other support.

The Faculty of Public Health and the Association of Directors of Public Health said: “The additional capacity provided to Liverpool to set up and manage testing sites alone has been enormous and it is difficult to envisage how or even whether this could be replicated at the pace being proposed across the country.

“This threatens to be a distraction from other activities, like planning and rolling out vaccines.”

Their statement added: “The key priority needs to be targeted community testing… in settings or locations of higher risk of transmission or where the consequence of infection is higher.”

The government is asking local leaders and directors of public health in tier three to put forward proposals and said it will work with them to make sure they’re resourced.

It said it is not expecting to see Liverpool replicated up and down the country.

Liverpool’s mass testing pilot began earlier this month. Prof Louise Kenny, pro vice chancellor at Liverpool University, which is running the pilot scheme with the city council, said they were delighted with the results.

“It was a pilot, we had very few expectations about how it would turn out. But I’m really pleased by how the city has embraced it from all corners,” she said.

“Yes, it’s been lower in some areas but we’re addressing that by making the testing more available, we assess what the barriers are, that’s a work in progress.

“And I think the fact that we have identified over 700 of our residents who were positive, didn’t know it, were at risk to their fellow citizens is a hugely encouraging thing.”

Covid: Has Englands lockdown worked?

When England went into a national lockdown on 5 November, it left behind a three-tiered system of restrictions designed to keep the virus under control.

Now the system is returning – although with stricter rules and more areas in the toughest, third tier. So has the lockdown worked – and why was it necessary in the first place?

Between 14 October, when the tiers were introduced, and 5 November when they were replaced, cases continued to rise across the country. The weekly number rose in every region – by half in London, more than three-quarters in the East of England and, in the South East and the West Midlands, it more than doubled.

In the North West and North East, though, cases began to level off, rising by only 6% and 10% respectively.

It suggests the highest tier may have had some impact – the North West, where cases rose the least, was largely in tier three. But tier two had little effect in most of the country, while in many tier-one areas – particularly in the South East – cases rose quickly.

The government’s independent advisers, the Scientific Advisory Group for Emergencies (Sage) concluded: “Tier-one measures alone are not enough to prevent the epidemic from growing rapidly.”

It estimated cases could shrink by a “modest” 10% when moving from tier one to tier two.

And even for tier three – as it stood before 5 November (less stringent than it will be from 2 December) – it was “unclear” whether those restrictions alone would be enough to cause the epidemic to shrink “at a regional or national level”.

Case numbers did fall in some areas under the tier system, at a more local level. For example, in Manchester and Liverpool they fell by about a third and a half respectively. Labour and Conservative MPs have criticised the government for not factoring in the differences in rates within regions when assigning tiers – putting the whole of the North East into tier three, for example.

This picture of generally rising cases sets the scene for why the government might have felt a second lockdown was necessary. Beyond the over-arching aim of ensuring that numbers falling ill are as low as possible, case numbers need to be reasonably low for the test-and-trace system to have a shot at controlling the epidemic.

According to Sage: “Test and trace, including mass testing, is most effective when prevalence is low. Even the most effective test-and-trace system will have little impact when caseloads are high.”

And the lockdown does appear to have turned the tide in most of the country. Cases fell by about a third in the North East and South West, and about a half in the North West and in Yorkshire and the Humber.

But case numbers take much longer to fall than they do to rise. One estimate suggested for every day of cases increasing, it could take five days for them to come back down again.

You can see this in the figures. Whereas some areas’ cases more than doubled while the tier system was in place, the most dramatic falls under lockdown were only half that rate over the same period.

In London, the South East and in the East of England, cases remained virtually static – rising at first immediately after lockdown, perhaps because of pre-lockdown socialising, before starting to decline slightly.

But the government has judged that there are now enough cases to return the country to restrictions that, while slightly looser than in the lockdown, are tougher within each tier than they were before it.

Fears of what a lockdown in the run-up to Christmas might do to already-struggling shops and restaurants are likely to have been in the prime minister’s mind.

Health Secretary Matt Hancock has said the new tiers have been based on factors that include numbers of positive tests and the pressures on the NHS.

The government is also looking at the numbers involving people aged over 60 and the rate at which cases are rising or falling.

But if you plot every local area on a graph, it’s clear the the overall number of cases per 100,000 people is the main deciding factor.

The regions with the highest number of cases are generally in tier three, those in the middle in tier two and those with the lowest number of cases are in tier one.

That’s why, for example, the North East is in tier three and London in tier two, even though the region has had a much bigger fall in cases, comparatively, than the capital. The North East still has almost twice the number of cases that London has.

It is thought that there won’t be much movement between tiers before Christmas.

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Bolton park stab death: Child-killer missed taking medication

A mentally-ill woman who slit the throat of a seven-year-old girl at a park on Mother’s Day had not been taking her medication, a court heard.

Elation Skana, 30, who has paranoid schizophrenia, missed several days of taking anti-psychotic medication, Manchester Crown Court was told.

Emily Jones was killed in front of her parents in Bolton on 22 March.

Ms Skana admits manslaughter on the grounds of diminished responsibility but denies murder.

Michael Brady QC, prosecuting, told jurors the main issue was whether Ms Skana’s paranoid schizophrenia was the reason behind the killing or “a convenient excuse behind which to hide?”.

Dr Victoria Sullivan treated Skana at a medium secure mental health unit in Manchester after her arrest and detention under the Mental Health Act.

She told the court Ms Skana’s sister, Olestra, turned up at the unit, “distressed”.

“She told us Ms Skana had been missing days in her medication,” Dr Sullivan said.

While on the unit Ms Skana was observed “muttering” to herself and turning her head abruptly as if to respond to visual stimuli.

She also claimed sometimes to see “angels” which communicated to her through gesticulations.

Dr Sullivan said: “I suspected she had either not been taking medication in the community or it had for some reason stopped working.”

The court has heard Ms Skana, originally from Albania, came to the UK in 2014 and was injected with anti-psychotic drugs each month since 2017.

She lived in a flat in Bolton, while her mother, two sisters and brother lived in Manchester.

Dr Suhanthini Farrell, an on-call psychiatrist who assessed Ms Skana after her arrest, described her as “clean, well kempt,” who maintained fixed, staring eye contact and was “guarded and suspicious” with a “tone of hostility and increasing irritability”.

“It did feel she was thinking carefully about the answers she was giving, rather than responding intuitively, naturally,” Dr Farrell told the court.

“My impression was there was active psychotic symptoms. The symptoms were subtle.

“Objectively she did appear to be paranoid.”

The trial continues.

Covid in Wales: mass testing to be extended to lower Cynon valley

Mass coronavirus testing will be rolled out in a second location in the south Wales valleys.

People living or working in the lower Cynon valley, which includes Abercynon, Penrhiwceiber and parts of Mountain Ash and Aberaman will be offered tests.

The testing will begin on 5 December and continue until 20 December, the Welsh Government said.

It follows a pilot in Merthyr Tydfil which saw almost 1,000 people tested on its opening day.

Those living in Mountain Ash East and West and Aberaman South will also be eligible for testing.

The mass testing sites in Merthyr opened last weekend and will run until 11 December – about 8,000 people were tested in the first six days there, Health Minister Vaughan Gething said.

The Cynon valley is part of Rhondda Cynon Taf, where the number of coronavirus cases per 100,000 people measured at 252.4 over the most recent seven day period.

The two main test centres will be the Cynon Valley Indoor Bowls Centre in Mountain Ash and the Abercynon Sports Centre, although more sites will be announced in the coming days.

People without symptoms will be tested at the sites, with results being issued within 20 to 30 minutes.

Anyone who tests positive will be told to go home and self-isolate immediately.

Mr Gething said: “As the Merthyr Tydfil pilot has shown, mass testing is providing us with a greater understanding of prevalence within the community and how many people have coronavirus.

“It’s also identifying how many people within the community are asymptomatic. Coronavirus has not gone away and we all need to work together to tackle this deadly virus.

“I want to thank everyone in Merthyr Tydfil who have made the pilot project a success and I would encourage the people of lower Cynon valley to get tested.”

Andrew Morgan, the leader of Rhondda Cynon Taf council, said: “This is an integral part of our fight against the virus, as it gives us a greater understanding of the prevalence and level of transmission within our communities.

“Following the positive progress seen in the downward trajectory of daily cases and the positivity rate after both the local measures and the national firebreak lockdown, it is now important that we identify and isolate those who are asymptomatic within our communities to break those chains of transmission as cases are now starting to rise again.”

Speaking to Gareth Lewis on BBC Radio Wales, Labour member of the Senedd for Cynon Valley, Vikki Howells, said: “Those are the areas where we have seen the highest rates of coronavirus in the last few months so it’s very important to focus on those.

“Just yesterday I was in Abercynon and the vicar told me there that he’s averaging three coronavirus-related funerals a week. Facts like that really bring it home.

“I would say do the right thing for the sake of the community, we look at Merthyr, the tests seem to be going very well there.”

PC had sex with woman in Launceston police station toilet

A police constable is facing a prison sentence after having sex with a crime victim in a disabled toilet at his station.

PC Christopher Wilson, 43, invited the woman to the toilet via text on 2 December, Exeter Crown Court was told.

He told her sex inside the police station in Launceston, Cornwall, was “the naughty bit which makes it more exciting”.

Wilson, of Saltash, East Cornwall, admitted misconduct in a public office.

The woman was reporting a crime when Wilson approached her, asking if she wanted to “get with a man in uniform”.

She followed him into the unisex disabled toilet where they engaged in sexual activity, the court heard.

Judge Timothy Rose told Wilson he was likely to be sent straight to jail when he returned for sentencing in January.

“Obviously, the court will consider other options but I don’t want to mislead you. You must come back realising that prison is very high on the agenda,” he said.

Mr James le Grys, prosecuting, said messages were found in which Wilson discussed sex with another woman.

He also sent sexual messages to the woman after she left the police station, the court heard.

Susannah Stevens, defending, said Wilson had not expected the woman to follow him into the toilet but accepted acting improperly when she did.

Wilson remains suspended from duty with Devon and Cornwall Police.

Covid Christmas: Avoid board games and sleepovers

Quizzes rather than board games are one of the recommendations from scientists for a Covid-safe Christmas.

Earlier this week, the government announced up to three households will be allowed to form a “Christmas bubble” from 23 to 27 December.

But the government’s scientific advisory committee, Sage, warns coronavirus could easily spread during the festive relaxation of the rules.

They say people should still weigh up if an event could be postponed.

If not, meeting online or outdoors where the risks of transmission are lower, could be a better option.

But if you do go ahead, they say, it’s important to include everyone taking part in drawing up a plan for how to manage the event.

They highlight the particular importance of involving women in the decision-making.

The document says: “Women carry the burden of creating and maintaining family traditions and activities at Christmas.

“Messaging should be supportive of women adapting traditions and encouraging those around them to share the burden and to be supportive of any alterations to adapt for Covid-19 restrictions.”

The advisers recognise that negotiating these arrangements may “create tensions”.

But they suggest a series of measures, ranging from minimising the numbers getting together to keeping events brief to avoiding physical contact.

Maintaining social distancing, keeping surfaces clean and opening windows to allow in fresh air are all highlighted.

There are also practical suggestions:

But there’s a warning that no single measure will guarantee that Christmas is risk-free.

Scientists warn that, within households, one infected person can pass the virus to as many as 50% of the rest.

And they say that the spread of the disease could multiply as the newly-infected people return to their usual lives after the break.

In one paper, the advisers spell out that “this is not a theoretical risk”.

They point to earlier research into how other respiratory diseases such as pneumonia increase as older family members are exposed during the school holidays.

That’s why they conclude that cases are set to rise.

“The prevalence could easily double during a few days of the festive season, with further multiplicative increases as new infections go back to their “routine” networks.”

Another document published by Sage makes clear that most coronavirus infections happen during prolonged indoor gatherings of people who are familiar with each other.

That creates what’s called an “intimacy paradox” in which we let our guard down because we don’t see our loved ones as a potential dangers.

Algorithms: Public sector urged to be open about role in decision-making

Public sector bodies must be more open about their use of algorithms in making decisions, ministers have been told.

A government advisory body said greater transparency and accountability was needed in all walks of life over the use of computer-based models in policy.

Officials must understand algorithms’ limits and risks of bias, the Centre for Data Ethics and Innovation said.

Boris Johnson blamed a “mutant” algorithm for the chaos over school grades in England this summer.

Ofqual and other exam regulators across the UK were forced to back down following a public outcry over the use of a computer program to determine A-level and GCSE grades after the cancellation of exams.

The regulator’s chief executive resigned after the algorithm used to “moderate” marks submitted by schools and grading centres resulted in nearly 40% of them being downgraded, in some cases by more than one grade.

It was accused of breaching of anti-discrimination legislation and failing to uphold standards.

The government was forced into another U-turn last month over aspects of its planning reforms after Tory MPs accused ministers of relying on a faulty computer-based formula to decide house building targets across England.

In a new study, the Centre for Data Ethics and Innovation said there needed to be greater awareness of the risks of using algorithms in make potentially life-changing decisions and more done to mitigate them.

Those running organisations, it said, had to remember they were ultimately accountable for all their decisions, whether there were made by humans or artificial intelligence.

Its recommendations include requiring all bodies to record where algorithms fit into their overall decision-making process and what steps are taken to ensure those affected are treated fairly.

While organisations should be actively collecting and using data to identify bias in decision-making, it said there was a risk techniques used to mitigate bias, such as positive discrimination, could fall foul of equality legislation.

It urged the government to issue guidance on how decision by algorithm must comply with the Equality Act.

Adrian Weller said there was an opportunity for the UK to demonstrate global leadership in the responsible use of data and ensure appropriate regulatory standards were in place.

“It is vital that we work hard now to get this right as adoption of algorithmic decision-making increases,” he said.

“Government, regulators and industry need to work together with interdisciplinary experts, stakeholders and the public to ensure that algorithms are used to promote fairness, not undermine it.”

The Information Commissioner’s Office urged organisations to consult guidance on the use of artificial intelligence.

“Data protection law requires fair and transparent uses of data in algorithms, gives people rights in relation to automated decision-making, and demands that the outcome from the use of algorithms does not result in unfair or discriminatory impacts,” it said.

Michael Ball and Alfie Boes Christmas album beats BTS to UK number one

Michael Ball and Alfie Boe’s Christmas album has denied South Korean boy band BTS the UK number one spot.

Ball and Boe have gone to the top of the chart with Together At Christmas, on which they croon festive classics.

It has sold more than 31,000 copies on CD, which counts for much more than streaming in the chart calculations.

BTS have had two UK number one albums in the past two years, but their latest release, Be, had to settle for entering this week’s chart at number two.

Together At Christmas is Ball and Boe’s fourth album of duets following Together, Together Again and Back Together.

The new album includes covers of such seasonal songs as It’s Beginning to Look A Lot Like Christmas, Silent Night and Have Yourself A Merry Little Christmas, and a new track titled My Christmas Will Be Better Than Yours.

Ball said reaching number one was “the greatest early Christmas present we could’ve wished for”.

AC/DC, whose Power Up was last week’s number one, dropped to third place in this week’s chart, while Taylor Swift’s Folklore jumped from 37 to number four following its vinyl release.

Neil Diamond and Iron Maiden also had new entries in the top 10, but there was no place in the top 40 for US rapper Megan Thee Stallion with her debut album Good News.

Megan spent three weeks at number one in the singles chart with Cardi B earlier this year and received four Grammy nominations earlier this week. Good News is expected to land near the top of the US album chart.

In the UK singles rundown, Ariana Grande, Billie Eilish and Little Mix occupy the top three spots for the third week in a row.

This week sees a number of Christmas songs climb the charts, led by Mariah Carey’s All I Want For Christmas Is You at 14, the earliest the track has ever appeared in the top 20.

She is joined in the top 40 by festive favourites by Wham!, The Pogues featuring Kirsty MacColl, Shakin’ Stevens, Michael Buble and Band Aid.

Cardiff violence: Police to check city revellers for knives

People will be checked for knives when entering “certain premises” in Cardiff city centre after violent clashes, South Wales Police have said.

The force said “screening devices” would be in place to stop people carrying weapons.

On Saturday, six people were taken to hospital after a clash between two groups in Queen Street.

And on Wednesday, a 17-year-old was stabbed in the Canton area of the city.

Three teenagers and a man have since been arrested.

The force has said both incidents were “not random” and involved groups of local teenage boys “targeting each other”.

Det Sup Esyr Jones said: “There will be a very visible police presence across the city this weekend and screening devices will be present outside some city centre premises to help maintain a safe environment, reassure the public and deter anyone thinking of carrying a weapon.”

A 17-year-old boy was taken to the University Hospital of Wales with non life-threatening injuries after being stabbed in Broad Street, Canton, at about 10:00 GMT on Wednesday.

On Thursday a 16-year-old boy, from Canton, was arrested on suspicion of assault, while a man, 43, from Penarth, was arrested on suspicion of assisting an offender.

It brings the total number of people arrested for the Canton incident to four.

Earlier this week a 15-year-old boy, from Riverside, was arrested on suspicion of violent disorder and possession of an offensive weapon. He has been released on police bail.

While a boy, 17, from the Grangetown area, was arrested on suspicion of violent disorder and assault on Thursday, and remains in custody.

It was the second violent incident to take place in the city in a matter of days.

On Saturday, six people were taken to hospital with injuries including stab wounds, after a violent clash between two groups in Queen Street.

Detectives have said the incident involved two groups, from the Grangetown and Rumney areas of the city.

Seven boys aged 16 and 17 have been arrested on suspicion of violent disorder and have been released on bail pending further inquiries.

“I want to re-emphasise that Wednesday’s stabbing and Saturday’s violent disorder in the city centre are not random attacks, they involve groups of local teenage boys targeting each other and we appeal to the community for information,” Det Sup Jones said.

On Thursday police held a virtual meeting with community leaders in the Canton, Riverside and Grangetown areas of the city in a bid to deter knife crime.

Officers had been temporarily granted increased stop and search powers under Section 60 of the Criminal Justice and Public Order Act, allowing them to search anyone in the areas of the city.Four people were stop searched as a result of a Section 60 notice in the Canton and Grangetown areas on Wednesday and Thursday.

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