{"id":48525,"date":"2020-09-10T15:21:55","date_gmt":"2020-09-10T14:21:55","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=48525"},"modified":"2020-09-22T16:27:04","modified_gmt":"2020-09-22T15:27:04","slug":"jennifer-richardson-test-and-trace-in-england-from-dysfunction-to-farce","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/09\/10\/jennifer-richardson-test-and-trace-in-england-from-dysfunction-to-farce\/","title":{"rendered":"Jennifer Richardson: Test and trace in England\u2014from dysfunction to farce"},"content":{"rendered":"<p><span style=\"font-weight: 400\">On current form, test and trace in England will shortly slide from dysfunction to farce as the winter season of coughs and colds\u2014especially in children\u2014arrives.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Working on <em>The BMJ<\/em>\u2019s News and Views journalism desk, I thought I had a pretty good idea of the flaws in the system. After\u00a0 last weekend, I have the clarity of personal (and parental) experience\u2014and it\u2019s even worse than I thought.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Firstly, why are we missing the opportunity to test those actively presenting with symptoms at a healthcare facility? Attending paediatric A&amp;E with a toddler with a temperature of 39.1C, I was asked on presentation if there were any symptoms of covid-19 (yes, the fever). It was never mentioned again, the toddler wasn\u2019t swabbed, and soon(ish) we were back out in the community\u2014where presumably I was expected to book a SARS-CoV-2 test.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I say presumably because, as I say, it wasn\u2019t mentioned after presentation. Would it be unreasonable for a patient to assume that, if no medic seemed concerned about covid-19, and didn\u2019t suggest or instruct them to book a test, they don\u2019t need to? Even if they realise they are still supposed to, it is inconvenient for the patient to have to book and attend a further appointment\u2014 especially after a long night in A&amp;E\u2014so perhaps some simply won\u2019t. Given that we are relying on people with symptoms getting tested in order to protect others, this seems a wasted opportunity to plug potential gaps.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The inconvenience to the patient is fairly small and therefore more likely to be borne, if it is easy, quick, and convenient to book, attend, and receive the results of the test. Over the past week, there have been growing numbers of reports that it is far from easy, quick, or convenient\u2014and that was certainly my experience. Twenty-four hours of repeatedly filling in the government\u2019s (non-user-friendly) form eventually yielded a testing site more than 1.5 hours drive away\u2014which after clicking through didn\u2019t have any appointments within the week\u2014and then, finally, a home test (which did at least arrive the next day). Even that then leaves five days (assuming the results take 48 hours from posting) between A&amp;E attendance and results when the whole household should self-isolate.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Not leaving the home for five days (unnecessarily, one may feel, if the result is negative) is a prospect few will relish\u2014and none more so than the parents of small children (the latter of whom should perhaps be in nursery or school while the former work from home). Anyone with experience of small children will also know that fevers come and go like the wind over winter, as coughs and colds circulate in nurseries and classrooms. After perhaps one or two experiences of SARS-CoV-2 testing akin to the above and household self-isolation, at the next brief fever with no other covid-19 symptoms in the household\u2014it is possible that some may decide not to bother.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Of course, schools and nurseries will as always send home children with a fever, and this winter particularly refuse to have them back until they have a negative SARS-CoV-2 test. But there will be children whose fever was only detected outside of school hours\u2014and, unless the testing system improves significantly, the risk of an increasing number of parents who will send them in without uttering a word of it.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The user experience of England\u2019s SARS-CoV-2 testing makes a mockery of the expectation that people book tests and self-isolate to protect others. It simply must be better or it will fail.<\/span><\/p>\n<p><em><strong>Jennifer Richardson<\/strong>, features editor, The BMJ.\u00a0<\/em><\/p>\n<p><em><strong>Competing interests<\/strong>: None declared.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>On current form, test and trace in England will shortly slide from dysfunction to farce as the winter season of coughs and colds\u2014especially in children\u2014arrives. Working on The BMJ\u2019s News [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/09\/10\/jennifer-richardson-test-and-trace-in-england-from-dysfunction-to-farce\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":48529,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[116],"tags":[],"class_list":["post-48525","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-editors-at-large"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Jennifer Richardson: Test and trace in England\u2014from dysfunction to farce - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/09\/10\/jennifer-richardson-test-and-trace-in-england-from-dysfunction-to-farce\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Jennifer Richardson: Test and trace in England\u2014from dysfunction to farce - The BMJ\" \/>\n<meta property=\"og:description\" content=\"On current form, test and trace in England will shortly slide from dysfunction to farce as the winter season of coughs and colds\u2014especially in children\u2014arrives. 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