Covid-19 UK: Top Government adviser hints No10 could drop mass testing from January


Britain’s mass coronavirus testing programme could be abandoned in the new year, one of the Government’s experts hinted today. 

Professor Lucy Chappell, chief scientific adviser to the Department of Health, told MPs that officials were committed to the routine asymptomatic swabbing scheme until the end of 2021.  

But she admitted ministers were considering ditching the widespread use of lateral flow tests ‘beyond January’. 

Other experts said it is time to shift who is tested regularly, as the UK learns to live with the virus. 

No10 launched its ambitious mass-testing scheme to great fanfare in April. But the system — a key part of the £37billion Test and Trace programme — has repeatedly been derided since its inception.

All adults are currently entitled to pick up two free testing kits a week, which can be collected from pharmacies or ordered online.

They are intended to be used by people when they do not show symptoms of Covid to pick up the estimated one in five cases that are asymptomatic and ensure people isolate.

But the kits have been criticised over fears they are inaccurate, especially when self-administered.

Whitehall sources have already revealed the system will soon start to cost taxpayers billions of pounds.  

Professor Lucy Chappell, chief scientific adviser to the Department of Health and Social Care, said the Government was committed to mass testing ¿ including of schoolchildren ¿ until at least January but is considering dropping the programme after that

Sir Andrew Pollard, who was part of the team that created the Oxford/AstraZeneca vaccine, said the Government should move quicker and end mass testing in schools earlier this winter

Professor Lucy Chappell (left), chief scientific adviser to the Department of Health and Social Care, said the Government was committed to mass testing — including of schoolchildren — until at least January but is considering dropping the programme after that. But Sir Andrew Pollard (right), who was part of the team that created the Oxford/AstraZeneca vaccine, said the Government should move quicker and end mass testing in schools earlier this winter

ENGLAND TESTING: England’s lateral flow testing skyrocketed in March this year after No10 introduced a programme to swab all schoolchildren 

UK didn’t focus enough on airborne transmission of Covid at start of the pandemic, Government adviser admits 

Britain didn’t focus enough on airborne Covid transmission at the beginning of the pandemic, a Government adviser today admitted.

Professor Andrew Curran, chief scientific adviser for the Health and Safety Executive (HSE) — which issues the Government’s official workplace guidance, told MPs Covid advice may have overemphasised surface cleanliness, instead of the need for proper ventilation.

Speaking to the Science and Technology Committee, he said the recommendations have shifted as experts learn more about the virus.

Top scientists initially feared the coronavirus was spread mainly via surfaces such as door handles, post boxes and desks at the start of the crisis last year.

It led to Government-issued guidance to businesses which instructed them to spend thousands of pounds on cleaning products to wipe down PCs and door handles for when employees returned to the workplace.

But research has since shown the risk of transmission from touching contaminated surfaces is low, nailing aerosol droplets as the main way the virus transmits between people. 

Professor Curran today said Britain should have focused more on stopping airborne transmission at work. 

He added that thousands of offices which have been spot-checked by the HSE have not been following all of the agency’s guidance, which includes advice on cleaning, hygiene and ventilation.

Asked about whether the nation should move away from testing asymptomatic people at the Commons’ Science and Technology Committee, Professor Chappell said: ‘In the short term, I think we should be continuing with testing, particularly symptomatic individuals.

‘And I know that other groups are evaluating at what point we reconsider testing asymptomatic individuals beyond January, beyond spring.’

But she added: ‘I would like to think that in five years’ time we won’t all be lateral flow testing. There’s a stretchable point between those five years clearly.

‘Between now and January, it’s clear that we have committed to testing. We are then reconsidering where we go beyond January, beyond spring.’  

Sir Andrew Pollard, part of the team that created the AstraZeneca vaccine, said the Government should end mass asymptomatic testing in schools before January. 

Currently, secondary school and college pupils in England are told told to take two lateral flow tests a week as part of measure to curb the spread in classrooms.  

If they test positive they have to stay at home until a PCR test confirms they do not actually have the virus at least two days later — even if they are asymptomatic.

Addressing MPs in the same briefing, Sir Andrew said it was was ‘absolutely critical we keep children in school’.

He added the biggest impact of the pandemic in children was the psychological effect of being forced to stay home. 

Professor Pollard argued only symptomatic pupils — who would already be required to stay home because of their illness — should have to take a test. 

He told MPs: ‘Clearly, the large amount of testing in schools is very disruptive to the system, whether that is the individual child who is then isolating because they tested positive but they’re completely well, or because of the concerns that that raises more widely in the school. 

‘We’re aware of families taking their children out because someone’s tested positive in a school.

‘So I think there is a huge impact of widespread testing in schools.

‘I think probably we need to move in the pandemic, over this winter, maybe towards the end of the winter to a completely different system of clinically-driven testing.

‘In other words, testing people who are unwell rather than having regular testing of those people who are well.’

Sir Andrew added: ‘That does drive a lot of these actions that happen, particularly in schools, if you have lots of asymptomatic testing.’ 

He argued it was ‘an inevitable future’ not to be ‘testing at this rate for Covid forever’, adding: ‘We need to think about how that transition works.

‘There’s clearly a lot more transmission at the moment and that adds some additional pressures on the NHS because there are some individuals going into hospital and more than there were before, but I think we are in improving situation.’

Data from Test and Trace shows the proportion of children being told they are positive for Covid when they don't have the virus by lateral flow devices has doubled in the last month (red line). More than one in ten positive results from lateral flows are incorrect

Data from Test and Trace shows the proportion of children being told they are positive for Covid when they don’t have the virus by lateral flow devices has doubled in the last month (red line). More than one in ten positive results from lateral flows are incorrect

The mass testing scheme — a watered down version of No10’s ambitious ‘Operation Moonshot’ 10million-tests-a-day project — was launched on April 9.

Former Health Secretary Matt Hancock said at the time it would be ‘one of our most effective weapons in tackling this virus’.

Previously, the tests were only used routinely in schools, hospitals and care homes.

Ministers spent £2.8billion on hundreds of millions of the kits, which give a result in as little as 30 minutes. They have been shown to miss infectious people up to 40 per cent of the time.

Numerous studies have shown the kits are far less accurate when self-administered – which is how they’re used across the UK.

Leaked Department of Health emails in April revealed senior officials feared they only picked up 10 per cent of infections when done this way.

HOW LATERAL FLOW TESTS ARE ONLY TRUSTWORTHY WHEN ADMINISTERED BY TRAINED STAFF

Lateral flow tests are only accurate at diagnosing coronavirus when administered by trained professionals, studies have repeatedly shown. 

The tests, which give results in as little as 15 minutes, use swabs of the nose or throat. Samples are then mixed in a testing liquid and put into a plastic cassette which can detect the presence or absence of coronavirus and then produce an image of a line, the same way as a pregnancy test, to indicate whether it is positive or negative.

The Department of Health and NHS are instructing people to use the tests on themselves, despite manufacturers of some kits saying they shouldn’t be used as DIY swabs.

Both the swabbing procedure and the use of the test cassette can easily be done wrong and affect the accuracy of the test. 

If the swab isn’t done for long enough, or deep enough into the nose or throat, it may not pick up fragments of virus. Medical professionals are also able to use nasopharyngeal swabs, which go right to the back of the nostril, whereas this is not advised for people who test themselves.

And if the sample isn’t properly inserted into the cassette the result might be wrong, or people may misread the display when it produces a result. 

SELF-TESTING CUT ACCURACY FROM 79% TO 58%

A University of Oxford and Public Health England evaluation of the Innova lateral flow test, which is being widely used in the UK, found its sensitivity – the proportion of positive cases it detected – fell from 79 per cent to 58 per cent when it was used by untrained members of the public instead of lab experts. 

Based on this evaluation, officials pushed ahead and used it for a real-world self-testing trial.

PILOT IN LIVERPOOL FOUND FEWER THAN HALF OF POSITIVES

When the same Innova test was trialled on members of the public in Liverpool – with people taking their own swabs and trained military staff operating the tests – the swabs picked up just 41 per cent of positive cases.

In the study the rapid tests detected 891 positive results, compared to lab-based PCR swabs that found 2,829 positives in the same group. This means 1,938 people got a wrong negative result from the rapid test.

The study didn’t compare this to professionally done rapid tests, but the manufacturer Innova claims its test is 95 per cent sensitive in lab conditions. 

…BUT TESTING DONE BY MEDICS IN SLOVAKIA ‘REDUCED INFECTIONS’ 

Despite rapid lateral flow tests getting bad press, officials in Slovakia used them on 5.2million people – almost the entire population of 5.5m – in a trial that a study later estimated to have cut the country’s infection rate by 60 per cent.

The tests used were between 70 and 90 per cent accurate and all the swabs and evaluations were carried out by trained medical workers. They used deep nasopharyngeal swabs, that go to the back of the nose, whereas self-testing generally relies on a swab of only the nostril.

London School of Hygiene & Tropical Medicine researchers said that the scheme successfully weeded out coronavirus cases that wouldn’t have been found otherwise, slashing the number of cases by over half in a week during a lockdown. 

HOW RAPID TESTS ARE DIFFERENT TO LAB-BASED PCR SWABS 

Lateral flow tests are an alternative to the gold standard PCR test – known scientifically as polymerase chain reaction testing – which is more expensive and more labour-intensive but more accurate.

PCR tests also use a swab but this is then processed using high-tech laboratory equipment to analyse the genetic sequence of the sample to see if any of it matches the genes of coronavirus.

This is a much more long-winded and expensive process, involving multiple types of trained staff, and the analysis process can take hours, with the whole process from swab to someone receiving their result taking days.

It is significantly more accurate, however. In ideal conditions the tests are almost 100 per cent accurate at spotting the virus, although this may be more like 70 per cent in the real world. 

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