How did the place I grew up in find itself with the highest Covid rate in England?
As lockdown lifted across the country this summer, people in the Merseyside borough of Knowsley exhaled a long sigh of relief. They’d made it through. Covid infection rates had fallen back into the double digits, and life in the borough began to resume its normal rhythms.
Workers returned to the warehouses dotted along the M57, shoppers piled into the megamarkets on the edges of towns, and pubs began to fill with people leaving the lonely months behind them. I took a trip from London to visit my family there. We sat in the garden enjoying the last of the good weather, and the biggest calamity we faced was the sight of my dad putting lighter fuel on an electric barbecue and the small – but nonetheless dramatic – explosion it caused.
Then cases began to creep up. Outbreaks occurred in pubs, schools and workplaces. At the start of September, the borough faced 18.9 cases per 100,000 of the population; by the end of last week, that number had risen to 707 per 100,000. A family friend died alone in hospital after becoming infected with the virus. My mum, a nurse, now has to balance working in a high-risk environment with being a primary carer for my partially sighted grandad.
Knowsley and the surrounding Liverpool city region have now been placed under severe tier 3 restrictions. Those unable to go to work or facing cuts to their income are relying on food banks to feed their children. The council is facing a shortfall of up to £32m in funding. This is a situation being repeated across the country, and to understand how we got here it’s instructive to examine how test, track and trace failed an entire community.
During the first few weeks of September, local officials noticed that an increasing number of women aged 20 to 39 were testing positive for the virus; they theorised that this could be because of the large number of people they encountered as a result of caring responsibilities. People, unknowingly carrying the virus, had continued to nip to the shops, chat to neighbours on the school run or go to work because of the breakdown in the system that was meant to contain it.
The problem started with the availability of testing. Despite rising infection rates in September, demand for swab tests outstripped capacity. Some people in Knowsley tried for up to five days to obtain tests. When they did get a slot, they were sent out of the area – an issue in a borough with one one of the lowest car-ownership rates.
Completed swabs then joined the national backlog of tests at the Lighthouse labs run by Deloitte. Dismayed by the increasing number of cases, the local MP, George Howarth, took up the issue and surveyed nearby hospitals and labs for extra capacity. He found that, if given the reagent and necessary equipment, they could carry out and analyse up to 25,000 tests per day. He wrote to the health secretary, Matt Hancock, with his findings, but the advice was ignored.
The sprawling outsourcing company Serco was then responsible for tracing any infected individual who had managed to have their swab processed, as well as anyone they had recently been in close contact with. By the end of September, the company was failing to contact 28% of positive cases within 24 hours. These trickier cases – 580 by mid-October – were handed to the local council to track down. While the private firm was given a £108m contract for its services, the council was given no extra funding for the task.
Knowsley’s council leader, Graham Morgan, was left to scrabble around for resources, “We don’t have contact tracing teams sitting waiting there. Where the private contact tracers are being paid, they’ve passed on the difficult cases to us … we’ve had to move staff out of jobs they do already.” The one area where the council could not step in was contacting any further close contacts of those who tested positive; these cases were left to Serco and their subcontractors, who contacted only 38% of them.
Morgan also wrote to Hancock, this time asking for a two-week circuit breaker to buy the government and the council time to fix the system. Hancock didn’t write back. Later, in mid-October, when minutes were published showing that in September Sage had advised the government to enact the very policy he had suggested, Morgan was livid. By that point, the number of cases had spiralled out of control and transmission of the virus was spreading across all age groups, but particularly affecting working-age adults.
When the council leader did hear about the government’s response to the situation, it was through the national news that the Liverpool city region was to be put under tier 3 of the new lockdown system. There was no negotiation over the measures – it was to be lockdown by diktat. Households were banned from mixing indoors or outdoors; gyms, casinos and betting shops closed their doors for a second time; and pubs could only stay open if they served a “substantial meal” – all with less financial support offered to business than during the first national lockdown.
It didn’t have to be this way. Despite advice from scientific experts, and problem-solving at the local level, the government’s stubborn commitment to an inadequate private test-and-trace system led to Knowsley becoming the worst affected area in England. One major concern is that infections are rapidly increasing in the over 60s population. As of last week, £14m has been given to the local authority to support efforts to trace infected individuals, but recruiting staff could take up to three months, while every day the virus continues to pass from person to person.
Arrangements are being made for a small funeral for the family friend who fell ill with the virus; my aunts and uncles won’t be able to care for my grandad after recent eye surgery left him temporarily blind; maybe I won’t be able to see them this Christmas. Until a functioning system is put in place by the people whose main aim is to suppress the virus, not turn a profit, life isn’t going back to normal for any of us.
• Kirsty Major is the Guardian’s deputy Opinion editor
