Matt Hancock’s promise to ramp up coronavirus testing over the next four weeks was broadly welcomed on Thursday night, but questions remain over whether it will turn out to be too little too late to cut short Britain’s economically disastrous shutdown.
Mr Hancock, health secretary, wants to increase testing to 100,000 a day in England by the end of April, including a mixture of swab tests to establish whether a person is infected and antibody blood tests to see if a person has already acquired immunity.
If Mr Hancock hits the target, it will come as a huge relief to NHS frontline workers who have been pleading for swab tests to establish whether they are infected or are safe to return to work; only 5,000 out of an estimated 500,000 frontline NHS doctors and nurses in England have been tested so far.
But it remains to be seen whether his ambitious “five-pillar” plan — engaging the private sector in testing and trying to develop a “huge diagnostic industry” almost from scratch involving big companies like AstraZeneca and Glaxo SmithKline — will in practice deliver enough capacity to offer Asian-style mass community testing.
Jeremy Hunt, a former health secretary and Boris Johnson’s principal rival for the Tory leadership last summer, welcomed Mr Hancock’s plan as “good news”, although he agreed that it would take time to build up scale.
Mass community testing, adopted in countries like South Korea and Singapore, allows a relaxation of a lockdown, with new cases identified and placed into quarantine, along with the people with whom they had been in contact.
Mr Hunt said he hoped that even if such testing had arrived too late to avoid the current lockdown in Britain, there was a prospect it could be used later in the year: “It means we can at least use community testing as a way to avoid lockdowns for future waves if they happen.”
Mr Hancock admitted mass public testing would only start to happen once demand from patients, critical NHS staff and their families and other key workers had been satisfied. “Over time we will expand testing in the community,” he said.
The plan includes a promise of 25,000 swab tests provided by the NHS and Public Health England — up from 10,000 daily tests now — for current infections by the end of April, and an unspecified number produced by new private sector partners: these are the tests deemed vital in isolating infected people immediately.
The remainder of Mr Hancock’s 100,000 target would be met by antibody tests produced by nine companies, although none have yet been shown to be reliable enough to be put on to the market.
They would help people who had previously been infected to return to work; the government is considering issuing “immunity certificates”. Boris Johnson has previously talked of raising overall testing to 250,000 a day.
The decision by Mr Hancock to move away from a highly centralised approach favoured by the NHS and PHE towards the wider involvement of labs operated by the private sector and other institutions has long been advocated by the science community.
Paul Nurse, director of the Francis Crick Institute, London’s biomedical sciences centre, proposed a vivid analogy for what will be needed to introduce mass coronavirus testing in the UK, invoking the evacuation of Dunkirk in 1940 when hundreds of small boats helped the big ships of the Royal Navy ferry troops home.
In his analogy non-specialist labs in the public and private sector, which are temporarily converting research facilities to test for the virus, are the small boats supporting specialist diagnostic centres operated by the NHS and Public Health England, including large new ones opening in Milton Keynes, Cheshire and Glasgow.
“Institutes like ours are coming together with a Dunkirk spirit — small boats that collectively can have a huge impact on the national endeavour,” said Sir Paul.
The Institute estimates that by early next week, its scientists will be able to conduct around 500 tests a day, using established polymerase chain reaction (PCR) technology to diagnose the presence or absence of the virus.
In the longer term they are aiming for 2,000 a day and to provide results within 24 hours so uninfected NHS staff who may suspect they have Covid-19 can return to work as quickly as possible.
In reality the £650m Francis Crick Institute is a big ship among biomedical research centres. Many small labs across the country are also planning to begin Covid-19 diagnosis. More than 600 biomedical labs are accredited by UKAS, the national accreditation body.
Greg Clark, the Conservative MP and chair of the Commons science committee, responded positively to Mr Hancock’s announcement.
“They are pulling out all the stops now but the question for future scrutiny is why didn't they do all this from the outset,” said Mr Clark.
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However, Richard Horton, editor-in-chief of The Lancet and one of the harshest critics of the government's coronavirus policy in the medical world, was less impressed.
“Matt Hancock has made the political promise of 100K tests by end-April while passing the entire responsibility to John Newton,” he said, referring to Public Health England’s director of health improvement, who has been appointed to help deliver the new plans.
“It’s a cowardly political dodge, one that John should never have accepted. Public health leaders and scientists are only deepening their complicity.
“Matt Hancock agrees the UK entered this pandemic unprepared. This is a huge admission of strategic failure.”
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