Hancock: it is public's 'civic duty' to follow test-and-trace instructions in England

Matt Hancock exhorted the public to do their “civic duty” and stay at home when instructed, as he launched a new test and trace system in the face of warnings from council leaders that they lack the data or powers to make local lockdowns work.

Employing Churchillian language, the health secretary called on every individual to do their bit, and warned that if they failed, the government would enforce compliance.

“It is your civic duty,” said Hancock. “This will be voluntary at first because we trust everyone to do the right thing, but we can quickly make it mandatory if that’s what it takes.

“Do it for the people you love. Do it for the community. Do it for the NHS and do it for all the frontline workers who have done so much and gone out every day to put themselves at risk to keep you and your family safe.”

He added: “And in return for following those instructions, you’ll have the knowledge that when the call came you did your bit, at a time when it really mattered.”

Starting at 9am on Thursday, the test and trace system for England is intended to allow the nationwide lockdown to be replaced with more limited, local measures, where the disease flares up again.

Testing is being extended to everyone with coronavirus symptoms, including under-5s, with primary schools and nurseries set to reopen to some children next week.

Those testing positive will be contacted by one of 25,000 call handlers and asked to share names and phone numbers of family, friends and colleagues whom they have been within 2 metres of for more than 15 minutes within the previous two days.

They will then call those people and instruct them to self-isolate for 14 days, and keep any children out of school. The instruction will stand even if they have previously self-isolated, or had a positive antibody test.

It is launching without a much-anticipated app to automate the process. It is still being trialled on the Isle of Wight.

Related: England's coronavirus tracing plan: 'beset by conflict and confusion'

Baroness Dido Harding, chair of the track and trace program, said: “A lot of this really is going to be about local coordinated action, from public health authorities, local government, the NHS, other civic leaders, to hunt out areas where the infection is spreading.”

But senior local government figures briefed by ministers about the scheme expressed concerns. The council leader of Newcastle, Nick Forbes, said local authorities do not have the power to close schools or workplaces where a cluster of cases develops.

“It’s all very well saying if there’s an outbreak in a school we’ll close it down – but councils don’t have the power to do that at the moment. And if there was an outbreak in a business, we could ask the business, we could ask the employees to be responsible – but we couldn’t tell them to,” he said.

The revelation that the prime minister’s chief adviser took a cross-country journey could dent the public’s willingness to comply, Forbes suggested.

“Whilst the vast majority of people would be sensible, clearly the issue with Dominic Cummings has fired an anger in people that is going to be hard to manage. Asking people to self-isolate for 14 days is a huge ask.”

Brenda Warrington, executive leader of Tameside council, said: “I think there are more questions than anywhere near the answers at the moment.”

The mayor of Hackney, Phil Glanville, welcomed the increased involvement of local government in the test and trace scheme, which was initially planned to be centrally-run. But he cited a lack of information on positive test results locally. “We still, as a local authority public health function, don’t get that data on who is and isn’t testing positive,” he said.

The shadow communities secretary, Steve Reed, said: “The success of the test, trace and isolate programme will be critical if we are to ease lockdown restrictions safely. That’s why it’s so worrying that government seems not to have learned the lessons of its mishandling of PPE distribution and the roll-out of testing; it has been too slow to engage councils with the knowledge and expertise to deliver the programme quickly enough.”

Some scientists are concerned about compliance, if people asked to stay at home will lose out financially.

Prof Simon Wessely, a psychiatrist with a role in epidemic preparedness, said: “Those most likely to get infected and their contacts are more likely to be the delivery drivers, transport workers, care home workers, shop assistants, the self-employed and so on. So at the point of notification there needs to be provision to support those in need – financially, medically and even accommodation if necessary.

“When this all started most people cooperated amazingly well out of a sense of altruism (“Save the NHS”) and then fear, which remains very high. But for [the] younger generation altruism may decline as they realise that they are going to be the generation most affected by the recession and restrictions, and fear will also decline as they realise they are the least vulnerable to the virus.”

Under the new system, those contacted and told to self-isolate will not be given a test unless they develop symptoms. That decision is partly a judgment on the tests that are available. Swab tests are known to get it wrong in up to 29% of cases, while a positive antibody test is no proof that somebody cannot get the virus again.


“NHS test and trace is a service designed to enable the vast majority of us to get on with our lives in a much more normal way,” said Harding. “Instead of 60 million in individual lockdown, a much smaller number of people will be told to stay at home if they are ill or in close contact with someone who is.”

Public Health England, overseeing the scheme, believes compliance will be good, pointing out that it was able to trace and isolate 95% of contacts of cases before testing and tracing was abandoned on 12 March.

Harding said people told by the NHS to self-isolate would be eligible for statutory sick pay and, if they were self-employed, they could get a government grant. An extra £300m had been allocated to higher-tier local authorities to help them assist people.

R, or the 'effective reproduction number', is a way of rating a disease’s ability to spread. It’s the average number of people on to whom one infected person will pass the virus. For an R of anything above 1, an epidemic will grow exponentially. Anything below 1 and an outbreak will fizzle out – eventually.

At the start of the coronavirus pandemic, the estimated R for coronavirus was between 2 and 3 – higher than the value for seasonal flu, but lower than for measles. That means each person would pass it on to between two and three people on average, before either recovering or dying, and each of those people would pass it on to a further two to three others, causing the total number of cases to snowball over time.

The reproduction number is not fixed, though. It depends on the biology of the virus; people's behaviour, such as social distancing; and a population’s immunity. A country may see regional variations in its R number, depending on local factors like population density and transport patterns.

Hannah Devlin Science correspondent

A group of expert scientists convened by the Royal Society to analyse what was needed from a test-and-trace system said transmissions could be reduced by 5 -15%, if it could work fast and efficiently enough.

“We make it very clear this isn’t a magic bullet,” said Anne Johnson, the professor of infectious disease epidemiology at UCL. About 45% of infections are prevented by self-isolation of those with symptoms, and the rest is mostly social distancing and hand hygiene, said their report.

The time from testing to getting results to speaking to the contacts must come down from five to three days, says the data evaluation and learning for viral epidemics (Delve) group.