Nearly half of people with Covid symptoms failing to self-isolate, study shows

‘If we want to prioritise getting rates down low enough, we have to do everything we can to help people to self-isolate,’ says professor behind new research

Samuel Lovett
Science Correspondent
Thursday 01 April 2021 09:03
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Boris Johnson comments on possibility of Covid-19 vaccination passport in UK

Nearly half of people in the UK are still failing to self-isolate when displaying symptoms of Covid-19, new research suggests, further calling into question the effectiveness of Britain’s test and trace system.

As the country takes its latest step out of lockdown, with people now allowed to gather in groups of six outside, behavioural experts at Public Health England (PHE) and two major London universities have found that adherence to the rules remains worryingly low.

The research, published in The BMJ, also showed that only about one in five people request a test if they have the main symptoms of Covid-19.

Professor Susan Michie, a psychologist who co-authored the study, called on the government to provide more financial support for people required to self-isolate, explaining that a loss of income or the fear of being fired is discouraging many individuals from following guidance.

“If we want to prioritise getting rates down low enough, we have to do everything we can to help people to self-isolate in their own homes or alternative accommodation,” she told The Independent.

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The recent rise in temperature has also sparked concern among officials that adherence to the Covid guidelines could slip in the coming days and weeks. After health secretary Matt Hancock told the nation “don’t blow it now”, PHE warned that “we’re not out of the woods quite yet”.

Dr Yvonne Doyle, medical director of PHE, said there are still as many people in hospital now as there were at the start of the second wave. “As restrictions lift and the weather improves, we cannot drop our guard,” she added.

A drop in vaccine supplies is also expected to slow the UK’s rollout throughout this month. The administration of second doses will be prioritised, making it likely that few people under the age of 50 will be offered a first dose throughout April.

The latest findings from experts at PHE, University College London and King’s College London were based on 74,697 responses to online surveys from 53,880 people aged 16 or older living in the UK. 

In total, 37 survey waves were carried out from 2 March last year to 27 January 2021, with about 2,000 participants in each wave.

In the latest wave of data, recorded at the end of January, just 52 per cent of people adhered to self-isolation rules after experiencing Covid symptoms. Across the full study, the rate was 43 per cent.

Men, younger people and those with young children were less likely to self-isolate, as were those from more working-class backgrounds, people experiencing greater financial hardship, and those working in key sectors, the researchers said.

Common reasons for not fully self-isolating included to go to the shops or work, for a medical need other than Covid-19, to care for a vulnerable person, to exercise or meet others, or because symptoms were only mild or got better.

Just 18 per cent of people requested a Covid-19 test if they had experienced symptoms in the previous seven days, despite around three times as many saying they intended to do so if they developed signs of coronavirus.

The experts warned: “With such low rates for symptom recognition, testing, and full self-isolation, the effectiveness of the current form of the UK’s test, trace, and isolate system is limited.

“Practical support and financial reimbursement are likely to improve adherence. Targeting messaging and policies to men, younger age groups, and key workers might also be necessary.”

Prof Michie, who sits on the behavioural side of the government’s Scientific Advisory Group for Emergencies, said that it was “generally recognised that test and trace has been one of the weak links of Britain’s pandemic response”.

“If you look at other countries who have a more effective system and rates of self-isolation, they do much more in terms of financial support,” she added.

“They will pay a percentage of people’s salaries to stay at home, people get visited daily, they’re offered help to get provisions, or psychological support. In New York, people are offered local free accommodation in hotels. None of this has been done here.”

She said that the behavioural group’s calls for greater support had been overlooked by the government, which acted “counter-productively” in saying it would issue £10,000 fines for those people failing to self-isolate. This measure, Prof Michie said, made it less likely that people on low wages or in precarious jobs would get tested in the first place.

Last month, a Westminster spending watchdog found that NHS Test and Trace, overseen by Baroness Dido Harding, has swallowed up “unimaginable” amounts of taxpayers’ money and made little “measurable difference” in controlling the spread of Covid-19.

After being set up last May and handed a £23bn budget in its first year of operation, the system failed in its main objective of preventing further lockdowns, MPs said.

Despite the progress made by the UK in reducing hospitalisations and deaths, with just 43 Covid fatalities recorded across Britain on Wednesday, PHE said “tens of thousands of us are getting infected every week and could become seriously ill”.

Dr Doyle added: “Case numbers are still high in certain places and looking forward they are certainly not predictable.”

A Department for Health and Social Care spokesperson said: “Since last May, NHS Test and Trace has contacted 3.2 million people who tested positive, and another 6.4 million of their contacts. Behind these numbers are countless lives saved and the latest ONS statistics show that when people are asked to self-isolate, the overwhelming majority do so.

“It is vital that people continue to do their bit by isolating when they are asked to. As the prevalence of coronavirus falls, our testing and tracing system becomes more important in identifying and suppressing local outbreaks while also responding rapidly to the threat of new variants.”

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