Increase self-isolation support or risk undermining exit from lockdown, think tanks warn

Researchers from the Nuffield Trust and the Resolution Foundation put forward a costed policy to improve compliance with Covid-19 self-isolation.

Press release

Published: 14/05/2021

The government must spend more to fix its “blind spot” of supporting people to self-isolate or risk undermining the vaccine rollout and expensive test and trace system. The warning from two leading think tanks comes as much of the UK prepares to take the next steps to unlock further on Monday (17th May).

Researchers from the Nuffield Trust and the Resolution Foundation have put forward a costed policy to improve compliance with self-isolation, which is as low as 52% in some surveys. The policy would allow employers to apply for capped grants to cover the lost wages of any employee needing to self-isolate using a modified version of the Job Retention Scheme, while the self-employed could access similar levels of support through the Self-Employment Income Support Scheme.

The proposal would cost the government £39m a month if it were to cover 100% of wages capped at an equivalent of £2500 a month (or £822 for a typical 10-day isolation period), equal to the cap within the current furlough scheme. This would ensure that three quarters of all workers would be able to recoup lost earnings should they be required to self-isolate.

The cost would be equivalent to roughly 3% of the Government’s ongoing budget for the NHS test and trace system which is, on average, £1.25bn a month. These figures are based on the number of people who test positive for Covid-19 and numbers transferred to NHS test and trace remaining at levels seen in April 2021.  

Tackling Covid: A case for better financial support to self-isolate warns that boosting compliance with self-isolation is critical to resist the threats posed by rising cases as restrictions ease further, new variants and the need for the vaccine rollout to reach younger adults.

The briefing, which sets out why reforming self-isolation policy is needed, argues:

  • Self-isolation will remain a vital part of a multi-pronged approach to suppress the virus, protect lives and the NHS, and fully re-open the economy. The extra spending proposed is both an investment to keep the virus suppressed and ensure the investment on Test and Trace – a system that has been allocated £37bn over two years – is not largely wasted.
  • Compliance with self-isolation remains low. Compliance estimates vary but surveys conducted in January 2021 found that only 52% of people with Covid-19 symptoms fully adhere to self-isolation guidelines, and only 22% of people with symptoms get tested.
  • While the government has taken steps to expand self-isolation support to more people, the burdensome approach, low level of compensation and restrictive eligibility criteria have left too many people without adequate support or with financial barriers preventing them from self-isolating.
  • Inadequate support has reinforced existing inequalities. People from poorer areas were half as likely to take a test (17% in most deprived vs 33% in least deprived quintile), in part due to fears of inadequate self-isolation support.
  • Current policies do not go far enough. Self-isolation £500 support payments only cover about 1 in 8 workers, meanwhile statutory sick pay (£96.35 per week) only covers a quarter of the average worker’s earnings, and misses out 2 million of the lowest paid workers altogether.
  • The government recently increased funding for local councils to provide support to those self-isolating but many people have been unable to access and we do not yet know the extent to which extra funding has helped.

The government has recently announced a trial of regular rapid lateral flow testing which it hopes will reduce the need for a ten-day self-isolation period, but the data behind the effectiveness of these tests remains unclear.  Even with regular testing, any positive result will need to be self-recorded with the person infected then needing to isolate.

Nuffield Trust Senior Fellow Sarah Reed said:

“The support available for people to self-isolate has been a blind spot in our response to the pandemic. Compliance with test and trace requests to self-isolate are low with evidence pointing to loss of income as a key barrier for people.

“A fair solution would support people to do the right thing and help curb the spread of the virus. It would ensure that anyone being asked to stay at home and not work isn’t penalised for doing so. We believe the mechanisms to provide better support exist already, and the additional costs of doing so are comparatively small to the £15bn budgeted already on test and trace for this year alone.

“Next week the country will take further steps towards some resemblance of normality, but there are risks ahead. Case numbers are expected to rise coinciding with more social interaction, new variants are possible, and the vaccine rollout has not yet reached younger adults. With case numbers low, now is the time to fix the holes in our self-isolation policy.”

The Resolution Foundation Chief Economist Mike Brewer said:

“The UK’s failure to financially support workers who need to self-isolate has severely hampered efforts to curb the spread of the virus. Repurposing the successful Job Retention Scheme to compensate workers when they need to self-isolate could play a key role in continuing to suppress the virus as we continue to reopen the economy – and renew social interactions.”

Notes to editors

  • This briefing is a joint policy proposal from the Nuffield Trust and the Resolution Foundation to provide a mechanism to incentivise and support efforts financially to improve compliance with self-isolation requirements.
  • The briefing sets out a range of costings dependent on how payment caps are structured (ie, £2500-£1500 monthly). This has then been measured against three different scenarios based on Covid-19 case numbers and referral of close contacts. We have used the case numbers in April 2021 to illustrate this example.
  • Figures assume that two-thirds of cases are among the working age population, and that workers are as likely to be affected as non-workers in contracting Covid-19. All confirmed cases get paid for 10 days, in line with current self-isolation protocols. Close contacts are assumed to have to isolate for 6 days (the cut-off point after which they will be a confirmed positive or negative case with testing), and only receive payment if they are unable to work from home.

About the Nuffield Trust:

  • The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
  • For more information or to arrange an interview, please contact Simon Keen (07780 475 571 // or Meesha Patel (07920 043676 //

About the Resolution Foundation:

  • The Resolution Foundation is an independent think-tank focused on improving the living standards of those on low-to-middle incomes.