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Hospital chiefs ‘increasingly frustrated’ with UK testing failures | World news

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Hospital leaders have launched a strident attack on the government’s coronavirus testing strategy, as it became clear that the target of 100,000 daily tests by 30 April would be comprehensively missed.

NHS Providers, which represents foundation trusts in England, rounded on ministers for “a series of frequent tactical announcements” to expand testing criteria, and dismissed the 100,000 target as a “red herring” that distracted from their failures.

Just 33,000 people were tested for Covid-19 in the latest 24-hour period – a record high for a single day – according to official figures. Dominic Raab, the first secretary of state, said that more than 52,000 tests were carried out, but this total is apparently bolstered by 19,000 retests.

Test capacity was now more than 73,000 a day, he said – still considerably below the target set by the health secretary, Matt Hancock, at the start of April.

Testing

Comprehensive testing – combined with tracing those who have come into contact with sufferers, and containing the spread through careful self-isolation – has been described as the route out of lockdown while avoiding a serious second peak. On Wednesday ministers confirmed that total UK coronavirus deaths had exceeded 26,000.

In recent days, testing has been expanded from hospital patients and NHS workers to key workers and, on Tuesday, to all symptomatic over-65s, those who need to go out to work, care home residents and staff. The swab tests can be booked online and carried out at drive-through test centres or using home kits.


NHS Providers said in a report released on Wednesday: “NHS trust leaders believe they have done all they can to support the national testing effort so far but are increasingly frustrated with the lack of clarity on how the testing regime will be developed for this next phase.

“At the moment they feel they are on the end of a series of frequent tactical announcements extending the testing criteria to new groups with no visibility on any longer term strategy, and are being expected at the drop of a hat to accommodate these changes with no advance notice or planning.”

Contact tracing is one of the most basic planks of public health responses to a pandemic like the coronavirus. It means literally tracking down anyone that somebody with an infection may have had contact with in the days before they became ill. It was – and always will be – central to the fight against Ebola, for instance. In west Africa in 2014/15, there were large teams of people who would trace relatives and knock on the doors of neighbours and friends to find anyone who might have become infected by touching the sick person.

Most people who get Covid-19 will be infected by their friends, neighbours, family or work colleagues, so they will be first on the list. It is not likely anyone will get infected by someone they do not know, passing on the street.

It is still assumed there has to be reasonable exposure – originally experts said people would need to be together for 15 minutes, less than 2 metres apart. So a contact tracer will want to know who the person testing positive met and talked to over the two or three days before they developed symptoms and went into isolation.

South Korea has large teams of contact tracers and notably chased down all the contacts of a religious group, many of whose members fell ill. That outbreak was efficiently stamped out by contact tracing and quarantine.

Singapore and Hong Kong have also espoused testing and contact tracing and so has Germany. All those countries have had relatively low death rates so far. The World Health Organization says it should be the “backbone of the response” in every country.

Sarah Boseley Health editor

Chris Hopson, its chief executive, added that the 100,000 target may have a “galvanising effect” but “what matters most is an updated strategy to take us through the exit from lockdown”.

He added: “Trusts stand ready to play their part in delivering that new testing regime, but they need to know a lot more, as quickly as possible, to play that part effectively.

“The NHS has achieved so much in confronting the challenges posed by coronavirus. However testing is one area where, despite all the work delivered by trusts and the NHS, the health and care system as a whole has struggled to develop an effective, coordinated approach.


Further criticism came from Andy Burnham, the mayor of Manchester, who said the goal had been set and driven forward without local consultation. Burnham, a health secretary in Gordon Brown’s government, said the drive to hit the target had been done in a “haphazard way” without local consultation.

At a meeting of the region’s Covid-19 emergency committee on Wednesday, he welcomed the increase in testing capacity but warned a more strategic and co-ordinated approach was needed.

“Lots of frustration [was] expressed at the meeting about arrangements for testing and what feels to people to be a confused picture across Greater Manchester with different capacity and overlapping schemes, and still capacity being put in without any reference to local authorities,” he told a press conference.

“It feels to us as though the government has been chasing the target on testing without fully thinking through the strategy at a local level and involving local leaders.”


Prof John Newton from Public Health England (PHE), who has been charged with increasing testing numbers, has said he is confident the 100,000 daily target will be met on time once numbers are finalised.

With just one day to go, there was evidence of a significant push to increase the numbers and hit the goal.

Hancock urged a wider range of people to apply for tests in an email sent out from Conservative central office. The over-65s or anyone who has to go out to work – or their families – could apply online for a test if they had symptoms. “This means construction workers to emergency plumbers, research scientists to those in manufacturing – can now be tested,” he said.

Matt Hancock



Matt Hancock, the health secretary, set the target at the beginning of April. Photograph: Kirsty O’Connor/PA

On Twitter, the department gave locations of the mobile testing units. “If you’re eligible for a test and near one of these sites you can book in now,” it said.

A Guardian analysis of the data suggests that around 20% more tests are carried out each day than there are people tested. On Tuesday, that rose to a high of 37%. The reasons are unclear, but it is known that retests because of results that doctors disbelieve are not uncommon. In hospitals, that can be because doctors are convinced a patient has Covid-19 and do not believe a negative result, so get the test repeated.

Although the lab processing is very accurate, getting enough swab sample of the virus from the back of the mouth or nose can be difficult. PHE said that originally people with symptoms would have a swab test of the back of the mouth and another one of the nose, but now there is a move to obtaining just one sample. That might mean a greater likelihood of retesting.


The government is not keeping a record of the number of inconclusive tests but, according to a departmental spokesperson, these are rare.

As of 9am on 29 April 818,539 tests had been carried out on 632,794 individuals, meaning 23% of all tests carried out to that date were retests.

A spokesperson for the Department of Health and Social Care said that some people are tested more than once for clinical reasons. “The number of people tested is the number of new people tested each day,” he said. “The number of overall tests could include the same person tested multiple times, hence the widening gap.”

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We thought Reagan was the devil – then came Trump. America, we’re rooting for you | Ronald Reagan

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Dear America,

HEY! How you guys doing? Longtime British Americanophile “reaching out” across the Atlantic. I’m here to heart you, USA. I’m like “hope the hurting stops soon” (strong-arm mid-tone emoji).

I guess you’re all making a list of The Worst Things Trump Did, then checking it twice because really, who’d believe it. And I know he’s primarily your monstrous problem. But even Brits are citizens of what we used to call “the free world”. Your president was once the leader of it. And one of the very worst things Trump’s done is to make Ronald Reagan look like an intellectual giant. Simply by comparison, Trump has humanised Reagan and elevated his memory to sainthood.

I’m currently researching the Gipper for a project and honestly, next to Trump he genuinely seems like … not the good guy, exactly? But definitely presidential. “Let’s make America great again” was Reagan’s slogan, of course. It was about “American values”, making America great in the world again. Trump’s slogan initially stood for rebuilding economic power. Now it’s shorthand for “let’s win the culture war I relentlessly inflame and sure, bring on an actual armed civil war if I lose the election”.

Of course, Trump’s humanity is at such undetectable levels he makes literally anyone else look like St Francis of Assisi. Infuriatingly, even deadweight predecessors like the Bush dynasty look competent. But Reagan? Along with millions of others in the 1980s, I was there at marches and demonstrations, noisily railing against hated neoliberal Raygun, his nuclear missiles, his utterly insane space force. Oh how we disdained him, this doddery warmonger, this huckleberry clown of a politician. It never occurred to us that 40 years on we’d be contemplating someone so much more clueless, so very much stupider, than Reagan.

None of my business, dear Americans, I know. You’re absolutely right. It’s not my country, it’s yours. You’re the ones pledging allegiance from sea to shining sea. I should butt out. And yet. All this used to be my business, back in the day when Potus was de facto leader of “the west” and led the forces of laissez-faire capitalism against the Evil Empire of Communism. “Ideology”, we used to call it. Man, we thought Reagan was the devil incarnate 40 years ago. Now the news is basically “Self-Satirising Human Cronut Yesterday On Twitter Said …”

As I write this letter of solidarity, I’m watching the televised presidential debate for election 1980, 40 years ago. Jimmy Carter the bruised defender, looking for a second term. Reagan the interloper, the disrupter, landing blow after blow on Carter – the failing economy, the Tehran hostages, the correct pronunciation of “nuclear”. Reagan was the older man but he sounded younger. What is frankly astonishing is the dignity of the debate itself. Here were political enemies – diametrically opposed on every issue – politely disagreeing, listening, yielding when time ran out. Basic human respect. And you stop and think – how is this normal, being nostalgic for normality itself?

Jimmy Carter and Ronald Reagan during a debate in 1980.
Jimmy Carter and Ronald Reagan during a debate in 1980. Photograph: The Ronald Reagan Presidential L/Reuters

Trump often invokes Ronald Reagan as an inspiration, and you can see how the analogy crosses his mind, like tumbleweed. Reagan too arrived at the White House from the world of entertainment. But Reagan had been governor of California for two terms. And president of a powerful union, the Screen Actors Guild. And served in the military. Reagan’s primary domestic objective of “getting government off the backs of the people” undoubtedly helped Trump the young shark-eyed entrepreneur – greedy to build, greedy for profit, greedy for tax credits.

Reagan consistently said that a free press was a prerequisite for a free country, and that it should hold presidents to account. Imagine that: a president inviting scrutiny. Trump dismisses any story he doesn’t like as “fake news” and deals only with Fox – his Pravda, his Tass. Unlike Trump, Reagan was self-aware enough to know his limitations. He surrounded himself with smart counsel and experts. Trump lives in a bubble of sycophancy.

Some of the stuff Trump’s pulling isn’t new, it’s just louder. You couldn’t imagine any of the other presidents not wanting America First. And like Trump, Reagan was an authoritarian who sent armed police in to break up civil protest. Reagan was indifferent to Aids; Trump is indifferent to Covid-19. More than 89,000 people died of Aids over seven years under Reagan administrations. Covid deaths in the US over seven months under Trump are 225,000 and rising …

In his foreign policy dealings, Reagan believed in statecraft, that ancient art of diplomacy now apparently lost in the murk of history. He saw his primary task as leading the world to peace and was prepared to sit down with cold war adversaries to thrash out a disarmament program. Does Trump even have a foreign policy, besides “screw you”? A resurrected Reagan would be aghast at Trump meeting Commie-In-Chief Kim Jong-un three times to discuss nuclear weapons with no tangible results.

Reagan’s statecraft did not hinge on whether the particular head of state “liked him”. Reagan’s preoccupation wasn’t self-aggrandisement. He sought world peace, and found gratification in good deeds. When his mind had gone, his memories lost, all knowledge of being President entirely faded, he remembered this: he had saved 77 people from drowning as a young lifeguard. That, in his shattered mind, was his legacy. In Trump’s bizarro world, drowners are losers.

Anyway, I’ll sign off. You have important stuff to do, like choosing a president. I wish you good luck; we’re all aware Kamala Harris is a result and a heartbeat from becoming America’s first female Potus. Things could be worse, no doubt. But they could also be better. The best to you and yours, my brothers and sisters.

I remain your most ardent admirer,

A Brit, Esq

Ian Martin is a comedy writer. His credits include Veep, The Death of Stalin, Avenue 5, The Thick of it and more

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Coronavirus live news: China reports highest infections in two months; US sees almost 500,000 cases in one week | World news

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UK’s second Covid wave likely to be deadlier than its first – report





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Questions whirl, justice stifled as immunity laws protect US nursing homes

By noon on 16 September, more than 100 people had gathered at the end of the long drive that leads to the Menlo Park Veterans’ Memorial Home in New Jersey. Eighteen-inch letters – red, white, and blue – spelling “THANK YOU HEROES” were pushed into the sod beneath a semi-permanent sign that reads “Now accepting job applications” and “SERVING THOSE WHO SERVED”.

Staff members – mostly Black, mostly female – stood to the right of a podium. To the left stood family members holding framed photos of their loved ones, former residents of Menlo Park who had died over the past several hellish months, either in the facility or in a nearby hospital.

Gary White, the no-nonsense, cigar-chewing commandant of the local Marine Corp League – an 80-year-old federal organization and advocacy group for Marine veterans – organized the event. White told the crowd that Menlo Park’s residents had, as service members, “given America a blank check payable up to and including their lives,” but that during the pandemic, “veterans died who never should have.” A week before the protest, White had received calls and emails from family members who were shocked by their loved one’s deaths, who had never even been told their father or grandfather was sick.

“They asked me to do something,” he said:









Mexico’s coronavirus cases pass 900,000





India nears 8m cases

















Macron to give televised address on Wednesday evening

Updated



























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Ontario: Doug Ford refuses to demote caucus member photographed maskless | Canada

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Ontario’s premier, Doug Ford, has come under fire for refusing to demote a scofflaw member of his caucus who was photographed without a mask at a large indoor gathering – even as the regional government pleads with residents to follow public health rules during the pandemic.

Sam Oosterhoff, a parliamentary assistant to the province’s education minister, posted pictures online this weekend of a large group gathered in a banquet hall. None of the nearly 40 attendees were seen wearing masks or practicing physical distancing.

The photographs – and the evidence of a flagrant breach of the provincial government’s public health messaging – prompted outrage. Oosterhoff subsequently deleted the post and apologized for not wearing a mask. He also told reporters the event was in a region of Ontario where gatherings of up to 50 people indoors are still permitted. But health officials require masks and physical distancing while inside.

“He came out and apologized. Hey, guys, everyone makes mistakes,” Ford told reporters. “I’m a strong believer, you make a mistake, you go out and apologize and say it’s not going to happen again. I accept that.”

But a post late on Monday evening from the restaurant where the event was hosted told a different story.

“There was a group in last week, that has caused some concern,” Betty’s Restaurant wrote in a post on Facebook. “This group was reminded several times that they were required to wear masks when not seated at their table. Unfortunately they chose not to follow posted rules about wearing masks and distancing. We can remind guests but we cannot strong-arm them into following rules.”

The premier’s office reiterated its support for Oosterhoff on Tuesday.

But the photographs – and his support for Oosterhoff – put Ford in a difficult position as his government tries to tackle the second wave of the virus.

Canada’s most populous province logged more than 1,000 new cases in a single day on Sunday, and outbreaks are surging in long-term care homes, prompting fresh appeals for the public to follow health protocols.

Ford has admitted he is battling divisions within his government over how quickly to roll out new restrictions.

“I always say I gotta listen to the docs, I always will, and the science, but in saying that, I have to listen to the small business owners,” Ford said on Monday, adding he was trying to find a “happy balance”.

Opposition leader Andrew Horwath of the New Democratic party told reports on Monday that the premier’s messaging on public health measures has been “so inconsistent and so unclear” that Oosterhoff “literally posed for a photo where he violated public health guidelines”.

“So why is the premier’s own team challenging, and outright ignoring, his directions?”



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