An ambitious “moonshot” plan to carry out Covid-19 tests on millions of people a day by early next year is being examined by the UK government, as it seeks to curb the spread of the virus and return the country to a semblance of normality.
Under the plan, huge swaths of the population could be regularly checked, either using new swab tests that deliver results in 20 minutes, and do not have to be sent to a laboratory, or self-administered saliva tests.
Those who receive a positive result would then be expected to seek a more accurate laboratory-analysed test and to self-isolate until they knew the result.
Matt Hancock, health secretary, told the House of Commons on Thursday that Operation Moonshot would deploy mass testing to “allow people to lead more normal lives and will reduce the need for social distancing”.
The government was piloting the approach and “verifying” the technology so it could be rolled out nationwide, he added.
However the technology has not yet been proved to work. Grant Shapps, transport secretary, told LBC radio on Thursday: “These exist in prototype, there are none worldwide that have been signed off yet”.
Experts have also warned about the consequences of what are expected to be a high proportion of inaccurate results. And it was not clear whether Downing Street would authorise a testing programme for everyone in the country.
Documents about the Moonshot programme, obtained by the medical journal The BMJ and prepared by consultants Boston Consulting Group for the government, suggested it could carry out 2-4m daily tests by December, followed by a more ambitious rollout of “up to 10m” tests per day from January.
Separate briefing notes for senior Scottish ministers and officials suggested that the UK programme could cost £100bn a year, close to the entire NHS budget of around £130bn.
However UK government figures suggested the cost would be closer to £20bn if the scheme went ahead and played down the idea of 10m daily tests.
Experts are sceptical about the benefit of testing everyone, at huge cost, even in remote communities that have not seen any Covid-19 infections. They also fear that even with a small proportion of “false positives” hundreds of thousands of people would be forced to self-isolate unnecessarily.
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Sage, the government’s scientific advisory group, said in a document last Friday that saliva tests were less reliable than the current swab tests. It warned that twice-weekly tests in a population with low incidence of Covid-19 would lead to 41 per cent of people receiving a false positive in six months.
“In such circumstances, rapid follow-up confirmatory testing will be needed to determine whether individuals should continue to self-isolate — it is important to rapidly isolate infectious individuals, but efforts will be needed to quickly release false positives,” it said.
The government has come under heavy fire following myriad reports pointing to a chaotically-overstretched testing regime. People have reported being unable to secure testing slots, or being offered tests more than 100 miles away, despite a pledge by officials last week that a new algorithm should ensure no one had to travel more than 75 miles.
On Tuesday, the director of NHS Test and Trace, Sarah-Jane Marsh apologised for delays and said a lack of lab capacity was a “critical pinch point”.
Underlining the pressure on the system, data from the NHS Test and Trace programme released on Thursday showed a big rise in confirmed cases of Covid-19. A total of 9,864 new people tested positive in England between August 27 and September 2, a rise of 43 per cent on the previous week.
Contact tracers are still struggling to identify sufficient numbers of contacts of infected people to stop the spread of the disease. Where communication details were available, 79.4 per cent were reached and asked to self-isolate. But taking into account all contacts identified, only 69.2 per cent were reached.
Sage has said that at least 80 per cent of the close contacts of an infected person must be traced and isolated for the system to be effective.
The Moonshot plan prompted scepticism given the current flaws in the testing programme.
Anthony Costello, a former director of the World Health Organisation, described the new mass-testing plan as “waste/corruption on a cosmic scale”.
Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, told the BMJ that the plan transmitted “unbounded optimism, disregarding the enormous problems with the existing testing and tracing programmes”.
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