[ad_1]
The government’s “moonshot” test plan contains several elements. Together, they form what appears to be an ideological commitment to the principle of mass testing.
Yesterday the prime minister said that his plan to “allow life to return closer to normal” was “based on massive tests“.
Today, the health secretary told the House of Commons that he wanted to go “as fast as we can” and “as big as we can.”
The question is: what is reasonable and what is simply an illusion?
The increase in the number of existing tests falls into the first category. The exact way the government defines the “capacity” of testing is becoming less clear, as recent testing shortages show: they occurred despite the system having a lot of reserve capacity on paper.
Still, the government’s promise to expand capacity to 500,000 tests per day by the end of October is a bold but achievable goal, because it means doing more than we currently do.
The same cannot be said for the plan to carry out up to 10 million COVID-19 tests up to date early next year, revealed this morning by the British Medical Journal. He got hold of leaked documents that featured a truly remarkable expansion of the national testing program, which is expected to cost around £ 100bn.
The problem with those documents, as I understand it, is that they are out of date.
Two sources close to the testing program told me they represent great ideas from a short time ago, not plans for today.
One source said the 10 million target was a “back part of the fag pack calculation” – a rough indication of what it would take to run weekly tests for the entire population. For 70 million people to be tested once a week, there would be 10 million tests a day.
“To be honest, everything is still being worked out,” the source said. But, they added, 10 million “is not what we are looking for.”
The actual target, as I understand it, is closer to two or four million. A big step below 10 million, but still a huge increase in current capacity.
Can be done? Today I met a testing company that thinks it can.
Founded by Craig Rochford, inventor of Epipen, and Dr. Nigel Kellow, NHS Nightingale Hospital Senior Faculty Member, HALO has a contract to deliver regular examinations to students and staff at the University of Exeter, as well as various large private clients.
However, just six months ago, it did not exist. It started in May in response to the crisis. Most of its staff were, until recently, Oxford students.
The HALO test uses the same PCR system as the government operation, but with one great advantage: instead of a swab that is stuck in the back of the throat, it works with saliva. Samples can be collected at home without loss of fidelity. The process is simple, easy, and they promise to be accurate.
Much higher testing capacity is needed for faster testing
HALO is not part of the government’s plans, but its sudden appearance shows how testing can be scaled up. Still, it is technology, not magic.
The test must be sent to a laboratory for processing; even with the most skilled operation in the world, that takes time. The results arrive in 24 hours, not in 20 minutes, the time to which the prime minister referred yesterday.
At the briefing, Boris Johnson said the government was working on a quick test that could allow the theaters and sports venues to reopen. The plan, he said, was “to test all members of the audience that day and let in those who tested negative, all who are not infectious.”
The problem is that this test does not exist.
There are rapid tests, but their samples must be collected by a medical professional, making it difficult for large numbers of people to perform them at once. Imagine the queues if the crowd at Young Vic, let alone Wembley, tried to make it “in the daytime”.
Also, the faster the test, the less accurate it becomes: for speed, you compromise the certainty of the result.
This is particularly the case with the 20-minute antigen tests, which analyze proteins rather than genetic material.
If you use these tests, you will not find everyone with COVID-19.
If you are testing a lot of people with no symptoms, you will also end up with a fair amount of false positives.
Faced with these difficulties, you begin to wonder why you are trying massive testing.
And this is really the point.
Tryouts are expected to help resume music and sporting events.
Despite all the compromises to massive testing, we still don’t know its exact purpose. Is it designed to identify where infections are or to keep people safe? And when lines have to be drawn, how shall we draw them?
If the tests beat the virus, we would have it better by now: population adjustment and the UK is testing much more than comparable countries. However, the cases are starting to increase anyway.
Sadly, it’s not just how many tests you do that counts, but how you use them and, more importantly, the system and society around them.
