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It was one of humanity’s greatest and most inspiring achievements – the Apollo 11 mission to bring a team of men to the surface of the moon and bring them safely back to Earth.
Some 50 years later, as the world struggles with Covid-19, there are some who return to the moon for inspiration.
Operation Moonshot is the UK government’s ambitious plan to test large numbers of people at the same time, regardless of whether they have symptoms, at a cost of tens of billions of pounds.
Boris Johnson sees the scheme, which is already being tested in Liverpool, as a possible step into normal life, one that could allow people to go to concerts or attend football games in a number not seen since March this year.
As our closest neighbors experiment with mass testing, it is natural for us to wonder if it might work here in Ireland.
The concept is quite simple: the objective is to evaluate the entire population, or as close as possible to it, in a town, city or university.
Testing everyone allows even asymptomatic cases to be identified. Those who test positive must self-isolate for at least 10 days. In theory, it would provide a type of firewall, remove the virus from the community and stop transmission, while allowing those who did not test positive to move more freely with fewer restrictions.
It is not the first time that mass testing has been implemented: China has tested the populations of several cities en masse, while Slovakia has just completed its attempt to test the entire country in one go (in the end, it managed to test around two-thirds of the population, with just over 1% testing positive).
The key to the scheme is speed. In Ireland, we exclusively use PCR tests for Covid-19. They are the most accurate tests available, but they must be processed in a laboratory, which takes time. The Liverpool pilot still uses PCR, but in conjunction with less accurate lateral flow rapid tests (a test kit similar to a pregnancy test). In Slovenia, they are using rapid response antigen test kits, which do not need to be processed in a laboratory.
The accuracy tradeoff might be worth it. “The speed is making up for it, as it’s absolutely possible to reach more people,” Linda Bauld, a professor of public health at the University of Edinburgh, tells Prime Time.
“As we move through this pandemic, particularly for populations where we want to get test results quickly, for example, healthcare workers, students going home, I’m sure we will see many more countries from everyone adopts this kind of thing. ”
At the moment, test and trace is one of Ireland’s pillar strategies to control the spread of Covid-19. There are currently seven contact tracing centers across the country, with teams dedicated to contacting close contacts of confirmed cases, advising them to get tested or self-isolate to prevent further infections.
It’s a system that isn’t without its challenges, as contact trackers in Galway told Prime Time this week. While most people are happy to comply, there is still a minority that tells them they can’t, or don’t want to, isolate themselves.
Paul Gillen, who works on HSE’s national tracking team, says they often call people who are supposed to be isolated, but can be clearly heard driving on a highway or having dinner with family and friends.
There are others who just won’t show up for a test. Another problem for contact tracers is the considerable number of people who may have the virus but are asymptomatic. They may never be tested and are therefore unlikely to self-isolate.
Dr. Breda Smith, director of public health for HSE West, tells Prime Time that between 30% and 40% of positive cases do not have any symptoms.
Unless they have been identified as a close contact to an existing case, there is very little that can be done to restrict their movements or prevent them from spreading the virus.
Asymptomatic cases are usually less infectious than those with symptoms, but this does not mean that they cannot spread the virus. Mass testing could be a way to sweep away asymptomatic cases that would not otherwise be identified.
In that sense, the problems that contact tracers experience with people who are unwilling to comply with public health advice could also apply to mass testing. In the Liverpool driver, the test is completely voluntary. In Slovakia, it is also a volunteer, but those who do not volunteer must isolate themselves as if they have tested positive.
Pete Lunn, a behavioral economist at ESRI, says the key to mass testing success is in the message – that people need to be convinced that volunteering for testing will work and serve the greater good.
“You have to explain to people, in simple terms, why it is best for everyone to do this,” says Lunn.
“They are more likely to come together to do things if they can be persuaded that this is in the public interest.”
A consistent national identity could also help.
“The more people feel that they are a community that can come together towards a common goal, the better compliance you will get and the more commitment you will get. We have an advantage as a nation.” Lunn says.
But Ireland’s sense of national identity may not be enough to guarantee success alone. There’s a reason this plan has been labeled “a shot to the moon”: there’s no guarantee that it will work, and it comes at a high price. In the UK, Operation Moonshot is estimated to cost up to £ 40bn, more than the annual budget of several key government departments.
Dr. Smyth tells Prime Time that we should measure the success (or otherwise) of efforts in other countries before committing money that could be spent elsewhere.
“We have to do a harm-benefit analysis. We have to see how we allocate our resources,” he says.
“Is this a strategy that could actually be taking from the resources needed for our serial trials in nursing homes? As a strategy, it should definitely be explored, but we should definitely take a very evidence-based approach for ourselves and see what it is. the best option for us here in Ireland. ”
Watch reporter Conor Wilson and producer Aaron Heffernan’s report on Operation Moonshoot tonight on Prime Time on RTÉ One at 9.35pm.
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