The Möbius strip of government Covid-19 guidelines

3D representation created by BojanV03 on Creative Commons

The south west now has some of the highest Covid-19 prevalence rates in the country. We run a small manufacturing business in Cornwall, and I am updating our business Covid-19 protocols so have the unenviable job of trawling through the government guidelines. It’s been like circulating on a Möbius strip.

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First up, when to isolate. You are told to isolate and get a PCR test if you have symptoms.

The symptoms are the standard three: a high temperature, a new, continuous cough, a loss or change to your sense of smell or taste. Other countries such as New Zealand have a much more comprehensive list, based on what is now known about the Delta variant. But we don’t even have to go that far: Cornwall Council has updated its list of symptoms to include those of the Delta variant, which now makes up the vast bulk of new cases. These include a blocked/runny nose, sore throat, headache, lethargy/tiredness, diarrhoea and hay fever-like symptoms.

However, to book a PCR test based on symptoms, the government site expects you to have one of the standard three.

Next, when to isolate. The government website says you need to isolate if you test positive. This guidance has not changed for many months. However, it says you also need to isolate if you are a close contact “unless you are exempt”. Turns out most people are exempt.

You don’t need to isolate if you are under the age of 18  (those turning 18 have a six months grace period to allow them to get vaccinated, are double vaccinated, are not able to get vaccinated for medical reasons or if you have taken part in a Covid-19 vaccine trial. Most people in the UK now belong to one or more of these groups. So, most people without symptoms do not now need to isolate even if someone in their household has Covid-19. They need to book a PCR test, though. If it comes back positive, then they isolate.

Elsewhere on the government website, it says: “About one in three people with COVID-19 do not have symptoms”and“even if you’re vaccinated, there’s still a chance you can pass COVID-19 on.”

Let’s slow this down. Someone in your household gets Covid-19. You carry on working as you don’t have symptoms and are vaccinated. You book a PCR test as a close contact. The government guidelines say you are exempt from isolating but the same guidelines say you could still be contagious to others.

What are you supposed to do? You’re supposed to “follow the advice on how to avoid catching and spreading Covid-19”. Which takes you to another page.

Interestingly, the introduction to this page of advice talks about risks from droplets but not from aerosols, even though Covid-19 is now known to be an airborne disease readily spread by aerosol particles.

It then lists things you can do to avoid catching and spreading the virus:

  • Get vaccinated.
  • Meet people outside if possible.
  • Open doors and windows to let in fresh air if meeting people inside.
  • Limit the number of people you meet and avoid crowded places.
  • Wear a face covering when it’s hard to stay away from other people – particularly indoors or in crowded places.
  • Wash your hands with soap and water or use hand sanitiser regularly throughout the day.

Are you going to be able to do those things in your workplace, whilst waiting for your PCR test to come and waiting for the result? And should you perhaps at least inform your colleagues that you are very possibly infectious? The government leaves this very much up to you. Nowhere does it say that close contacts of cases are obligated to tell anyone else that they are in this position.

However, as an employer I am obligated to ensure the safety of my employees.

Let’s take another scenario. You get symptoms of Covid-19; what does the government say you should do? You must self-isolate and book a test. Do you have to tell anyone? Yes, you do, according to yet another page of government guidance: “Tell people you’ve been in close contact with in the past 48 hours that you might have COVID-19. You should tell them to follow advice on how to avoid catching and spreading COVID-19.”

Let’s take another deep breath. The government allocated £37bn to Test and Trace but now it is up to individuals to tell their close contacts what to do?

With my employer’s hat back on … Do I need to tell anyone if there is an outbreak at work? Well, this opens up another can of worms.

On the Cornwall Council website, I see that all councils have a local outbreak management plan. But nowhere does it say what constitutes an outbreak and who, as an employer, you are supposed to tell. I emailed the council for advice. Do I have to tell my local public health team if there is an outbreak in our business?

Waiting for an answer, and after quite a bit of digging, I found this on the central government guidelines site: “Employers should call the Self-Isolation Service Hub on 020 3743 6715 as soon as they are made aware that any of their workers have tested positive.”

Aha! So that’s how NHS Test and Trace is kept in the loop. They can then phone up the contacts and tell them that they do not need to isolate, but to get a PCR test and to take precautions that many will not be able to take.

I’m sorry if I sound cynical. But I used to teach science, and it was standard practice to build health and safety into our daily routines and those of the children and young people in our care. Staff were drilled in best practice in every school I worked in: tell the children the thinking behind the rules; all staff should follow the same rules; communicate these rules clearly and persistently.

As someone trying to get my head around the latest government guidelines as the infection rate in Cornwall goes through the roof, it seems to me the opposite is true of the government’s approach. Communications across pages of the same website are contradictory; the council website does not correlate to central government advice; knowing what you are supposed to do takes a lot of determined digging.

And once you have drilled into the messaging, you are left with a feeling of abandonment, confusion and worry.

One more example. If someone in your household contracts Covid-19, you do not need to isolate – unless you are one of the few who do not belong to an exempt group – but you do need to order a PCR test. Yet on the ‘work’ section of the government guidelines site, I could not see any instruction to order a PCR test if you are a close co-worker of someone who tests positive. But if you go to the government site on which you can order a PCR test, you find: “If you’ve been in close contact with someone who’s tested positive for COVID-19 you can get a PCR test, whether or not you have symptoms.” Why on earth is this not made clear on the employer section of the website?

I’ve just had a conversation with a local friend who works with elderly people in the NHS. Her boss looked at the guidelines and has told her team that if any of them is a close contact of a case to let her know and she will sign them off sick.

This is surely the responsible thing to do. But a worried head teacher, for instance, is not in a position to do this. She will have children in her school who have sick siblings at home. She will have teachers in school whose partners are off sick with Covid-19. There will be nothing she can do about it until a threshold of cases is reached.

Come October, when schools return and cases – already running at a very high rate are likely to rise further and MPs and media who have so far said nothing will no doubt feign shock.

Many of these cases will be people who suffer illness and possibly death as a result of perfunctory public health measures, covered in a veneer of administrative ‘guidelines’ that could hardly be more confusing if they had been deliberately designed that way.