PDA Pandemic Series Update – 13 June 2020

With each edition, we aim to bring to your attention important issues either those that we are working on or general background information that helps you with your practice.

Sat 13th June 2020 The PDA

This issue specifically focuses on track and trace and its important role in containing COVID-19 as the restrictions of lockdown are eased.

In this issue:

  • The World Health Organisation / Europe on steps to ease lockdown
  • MHRA class apps as medical devices requiring a CE mark
  • Trace and Track – the NHS guidance
  • Track and Trace – exposing inequalities
  • Track and Trace – a community contact pilot exposes shocking attitudes

The World Health Organisation / Europe on steps to ease lockdown

The WHO/Europe noted: “The transition out of lockdown is set to be a complex and uncertain phase. Challenges and circumstances vary from country to country and there is no one-size-fits-all approach. It is vital that countries clearly communicate this to the public to build trust and ensure that people observe restrictions specific to their situation.”

A critical component of the measures that need to be in place is an ability to track/trace/quarantine those suspected of having acquired or having already acquired COVID-19.

The WHO/Europe lists 6 essential criteria to begin easing physical distancing measures, one of which is that countries must ensure: that public health and health system capacities are in place to identify, isolate, test, trace contacts and quarantine them;”

The advice from the WHO, as seen from the linked video below, since early March has emphasised the importance of test/track/quarantine.

The PDA note that countries that have been able to rigorously and successfully implement the track/trace/quarantine measures have been able to ease lockdown measures considerably faster than those that have not.

The WHO/Europe guide on measures for easing lockdown can be found here.

The WHO video on test-test-test and isolate can be found here.

The Guardian report on the successful countries adopting track/test/isolate can be found here.

MHRA class apps as medical devices requiring a CE mark

The MHRA recently published an update on the status of apps with a purported medical purpose:
“If the software or app you are using has a medical purpose it is important that it is CE marked. A CE mark is a logo that is placed on medical devices to show they conform to the regulatory requirements. It shows that the device is fit for its intended purpose and meets legislation relating to safety.”

However, for COVID-19 apps, the MHRA states that: “If you are developing new software or an app specifically in response to COVID-19 …. you may be able to apply for an exceptional use authorisation or derogation exemption prior to full CE marking of the product.”

The MHRA notes can be found here:

Trace and Track – the NHS guidance

There has been considerable confusion caused by the process that should be followed by those contacted by the track and trace centre. These charts are the latest ones on the NHS website and there is no mention of any exemptions or privileges for pharmacy teams or pharmacy contractors. The last link is a very short video from the Health Minister which illustrates how important it is to follow the instructions given by the NHS track and trace centre and this is irrespective of what your employer may state.

The NHS flowchart for those that are symptomatic can be found here.

The NHS flowchart for those that are asymptomatic can be found here.

The video by the minister stressing the importance of self-isolation can be found here.

Track and Trace – exposing inequalities

The results of a poll published by an independent charity “reveals a significant ‘digital divide’ along the lines of occupation, educational level and age.”

The poll also revealed that: “Almost three quarters (73%) of people in managerial, administrative or professional jobs say they are likely to download the app, but among the routine and manual workers, state pensioners and the unemployed, this figure falls to just half (50%)…… While 71% of those with a degree say they are likely to download the app, this falls to 63% for those with A-levels or equivalent only, 59% for those with GCSEs or equivalent, and 38% among those with no formal qualifications.”

The charity went on to note: “The potential negative impact of this digital divide must be considered against a backdrop of significant and growing socioeconomic and health inequality in the UK which has left those living in poorer areas at significantly increased risk from COVID-19. Recent data have shown that those in the most deprived areas are twice as likely to die from the virus.**”

Pharmacy teams need to be able to explain, in clear and straightforward language, to their patients the track and trace system so as to protect these at-risk groups from COVID-19.

The findings from the charity can be found here.

Track and Trace – a community contact pilot exposes shocking attitudes

The British Medical Journal (BMJ) recently commented on a pilot community track and trace scheme in Sheffield which exposed a surprising attitude to track and trace: “A COVID-19 contact tracing pilot scheme in Sheffield has found that two-thirds of people contacted did not fully cooperate, and many of those worked in health and care settings.”(1)

Equally shocking was the failure by employers to engage in the national effort to limit the spread of COVID-19: “Thus some employers were not willing to allow contact tracers access to their employees who had been identified as contacts, and in some cases when contacts were spoken with and advised to self isolate and therefore not go to work, they were unwilling to do so. Without formal authority, volunteers were unable to take these conversations further.” (2)

(1)  You can read the full BMJ article here.

(2)  You can read the full report of the Sheffield Community Contact pilot here.

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