Ramping up COVID-19 testing to meet an abstract political target hindered effectiveness, according to the Association of Directors of Public Health (ADPH).
The “big push” to reach the “big number” at “all costs” meant that the purpose of the tests was not a key consideration, and consequentially did not deliver all the information needed by those trying to halt the spread of the virus.
Overall the importance of data as key intelligence in the pursuit of containing the virus was not properly understood, or handled with proper expertise. There was also a reluctance to share data with local government, which further hindered progress. While data sharing has improved, further work is needed to lift the burden of cleaning and reformatting data for local authorities.
Lack of detail in the data also inhibited the ability of local government to manage outbreaks, and meant the disproportionate impact of the virus on poorer communities and those with BAME backgrounds was missed earlier on.
ADPH highlighted the importance of Professor Kevin Fenton’s work on the impact of COVID-19 on BAME groups. The data, the association suggested, only captured part of the story and was directed by the questions being asked. Fenton took the quantitative data and captured the qualitative insight and experience needed to provide a richer understanding of what was happening.
ADPH president Jeanelle de Gruchy wrote: “There was a big push on a big number – 100,000 and then 200,000. Yes, tests are a critical element of containing the outbreak. Yes, we needed to hugely ramp up the number of tests. However, the consequence of this target, tied to a political imperative to reach it at all costs, was that the purpose of the tests was simply not a key consideration.
“In the rush, the testing infrastructure did not acknowledge or deliver the type of information that needed to be captured (such as unique identifier, ethnicity, postcode, occupation), realise the importance of the quality of this data and the need to build in an efficient, consistent and timely process of notification to public health authorities.”
On the refusal to share data, de Gruchy added: “The only explanation I can offer is that there has not been enough understanding – or trust of – the power of local leadership, and the knowledge and ability that exists locally to protect the health and wellbeing of our residents. Controlling data and knowledge and keeping parts of the system in the dark simply weakens the collective effort to stop the transmission of COVID-19.”
To tackle these problems in the future the ADPH has put forward the resource ‘Data: Explainer’, outlining the importance of data and the issues involved, and is now calling on national agencies to focus on five national ‘data principles’.
Sharing local data in full with directors of Public Health should be a default setting, including at postcode level, according to the first principle. Providing consistent access to the same data sets across every region and local authority is the second.
The third and fourth data principles advocate that quality “clean and complete” data sets should be provided, alongside timely access that is “real-time” where possible. Lastly, data must be useable in a format that is simple and allows for swift analysis at a local level.
