By UK National Testing Strategy Coordinator Professor John Newton
As the Evening Standard commented yesterday “when the Health Secretary promised that 100,000 people a day would be tested for coronavirus by the end of this month, it looked an impossible goal.” I know too well how, at times, it has felt impossible.
By tomorrow night we will know if we have achieved that goal. To the surprise of many outside the programme we are already very close to that level of testing. This is an extraordinary achievement and a tribute to the sheer hard work of some amazing people.
Our aim as we tackle this virus has been to make it easy, fast and simple for NHS workers, care staff and an expanding range of essential workers who need a test to get a test, in addition to patients. We have also prioritised the most vulnerable expanding testing to the over 65s and their families.
As we move to the next phase the requirement for testing will change and we can now respond quickly with the testing capability needed.
Our ultimate goal is that anyone who needs a test should have one.
The UK entered this crisis with a world-leading pharmaceutical industry, but our diagnostic capabilities did not match.
In the space of weeks, we have created a test for this virus, more than doubled the capacity of NHS and Public Health England labs, built a network of 50 regional testing centres, we are building 70 mobile testing units by this weekend, and have created home testing kits. This is all backed-up by the creation of three ‘mega-labs’ that can analyse all the tests taken. This is the biggest expansion of diagnostic capacity in modern times.
There have been a few bumps along the road – who would have thought lockdown would have seen so many post boxes closed - so in order to be able to offer a home test to everyone on a uniform basis we need to use couriers to get the used kits back to the labs so the samples stay live?
But what is the point? Why do we need all this testing? First a few myths to bust.
Back in March, the country moved into “lockdown” because the virus was circulating widely, not because we did not have enough tests.
Cases were popping up with no obvious connection to other cases. The infection was entering the exponential growth phase. At this point access to limitless testing would have made no difference. The decision to enter lockdown would have been the same and would have been taken at the same time.
In the same way the route out of lockdown has not been blocked by lack of testing. We can relax social distancing only when the Government’s five tests are met and that means getting the infection rate right down. Testing will help to keep it under control once we are out, but lack of testing has not kept us in lockdown a day longer.
What about Germany? Yes, Germany had a lot of tests available from the get-go, but there was also a lot less virus around and it was in younger people.
Back to the here and now, where does all this leave us in the UK at the end of April?
The 100,000 a day target was set for two purposes. It was intended to motivate the programme and set the scale of our ambition. It has certainly done that. More importantly we knew from our calculations that we would need something like this level of testing to be ready for the next phase.
Looking to the future then, we now have a very substantial and flexible testing capability in the UK.
It will be used to drive extensive contact tracing to control any new infections, help us keep patients and staff safe in hospitals and care services, and to tell us with some precision how the virus has spread across the country. This means that we can identify who may have been in contact with someone infected, and prevent them from passing it on further, driving down transmission of the virus.
The introduction of the new NHS app for contact tracing is also in development. As we do this, we are working closely with some of the best digital and technological brains, and renowned experts in clinical safety and digital ethics, so that we can get all this right. The more people who sign up for the new app when it goes live, the better informed our response will be and the better we can therefore protect the NHS.
All this frees Ministers and their scientific advisers to choose whatever future strategies are best suited to keep the country safe.
Whatever the outcome tomorrow, I can assure you that the testing capacity we have built in the last few weeks is world-leading in its scale and sophistication, and gives us the flexibility we need to deal with rises and falls in demand. As the pandemic evolves, we will have the testing capacity to meet changing demand across the country. It is there to serve us all.