Rising to the Challenge: Covid-19 Testing, testing, testing

Nobody should underestimate the extent of the challenge in dealing with a pandemic. That is why governments at national and local level carry out regular exercises to plan their response when the time comes, and can mobilise the resources they need quickly.

… Which this government manifestly chose to ignore. It is human nature to cling to the hope that this isn’t really happening until it is absolutely undeniable. That behaviour has occurred over and over again throughout history.

But there are well-developed strategies for dealing with pandemics, and the identification of infected persons and their contacts, and quarantine of those individuals until they are no longer infectious, is a long-established and vital foundation for the response.

Covid-19 is a disobliging agent. Many people can carry and pass on the infection, while displaying few symptoms. The only way to reliably identify these carriers is “Test, test, test.” And yet our national strategy is reminiscent of Tom Baker’s Elizabethan sea captain in Blackadder 2. “Opinion is divided on the subject: all the other captains say you do need a crew to sail a ship; I say you don’t.”

There is still a lack of clarity as to why Germany is able to test 70,000 people each day and the UK only 8,000. It is only this week that mainstream media are beginning to ask what the barriers are, but the answers have been threadbare, so far.

Is it lack of test kits, and if so, which components of the kits, have orders been placed and what is being done to step up production? Is it that certain testing machines are only compatible with specific test kits?

Is it lack of laboratory capacity? Two weeks ago, NHS England asked every pathology network in England to identify the local capacity for 500 tests a day. Has that been done and is that capacity coming on-stream imminently? If not, why not?

Is it lack of manpower to run the machines? Are the machines running 24/7? Many Medical Laboratory Scientific Officers were offered early retirement in the reorganisation of pathology laboratories, in line with the Carter Review. If more staff are needed, has a call gone out to ask if some of them will return, to boost capacity?

Is it lack of manpower to do the contact tracing that would be needed to identify, test and quarantine the contacts of infected people? In Wuhan, China mobilised 1800 teams of at least five people to trace tens of thousands of contacts each day. When the social distancing measures start to be relaxed in this country, testing for antigen and effective contact tracing will be essential to close down the inevitable localised outbreaks that will occur. Are the necessary teams being assembled in preparation?

Or is it a lack of political will and belief that this can be achieved?

We call on our Government to identify and understand the specific obstructions that are standing in the way of mass testing for active infection, to be open with the public and the profession about the problems and to provide all the resources needed to bring this disease under control. It is not easy, but it is achievable.

 

Dr Colin Hutchinson

Chair, DFNHS

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