Ever since the coronavirus began to spread in the UK, the issue of testing has been the single biggest hurdle for the government and national health officials to try to overcome.
From the very offset, Public Health England chose to develop and encourage the use of its own diagnostic tools, rather than decentralising testing and embracing a mixture of public, non-government and private laboratories. When the number of people showing symptoms shot up in the second week of March, rather than outsource the testing, the NHS simply gave up testing all but patients in hospital.
Following by example
We only have to look at our peers around the world, such as Germany, South Korea and, more recently, the US, to see that this approach has severely held the UK back.
Since 16th March, the UK has just over doubled daily testing capacity whilst, in the same time, the US has increased daily testing by a factor of 21. It is no coincidence that the US achieved this after decentralising its testing regime and embracing private laboratories.
Whilst the impact of the disease has already caused huge devastation across our nation, if the government acts now, there is still an opportunity for it to reach its testing targets and find a way through the crisis.
Test, test, test
In order to track the spread of the disease, the need to ‘test, test, test’ has become a slogan of the coronavirus pandemic since it was voiced last month by Tedros Adhanom Ghebreyesus, head of the World Health Organisation. However, to date, the UK has still only administered 151,979 tests, putting it in the bottom 25 per cent of OECD countries.
For these figures to be improved, the government must undertake rapid approval of private sector developed tests and reduce testing red tape, including any requirements that initial positive tests must be retested centrally by Public Health England.
Whilst a mass community testing plan would be challenging, it would be achievable if the government were to tap into all the available resources, including laboratories, pharmaceutical companies and universities. In the meantime, both frontline workers will continue to rely on private sector firms that are providing physician-approved lab tests, allowing them to see if they can get the all clear to go back to performing their duties safely.
Antibody vs swab tests
As of 2nd April the government has announced that frontline workers and the general public will be able to conduct coronavirus antibody tests at home, using finger-prick kits that will be available from high street chemists and leading online retailers. Whilst the Prime Minister has said these tests will be a ‘game changer’, this may not quite be the case. It’s vital that people understand the difference between these antibody tests and the swab tests used on patients to detect the disease.
The genetic tests used in hospitals detect active infections, whilst antibody tests detect only antibodies our bodies produce to kill the virus, which we keep producing even after the virus is eliminated. These tests can reveal who has been infected even after they have recovered, but the antibody response to the coronavirus may be delayed compared with other infections, meaning antibody testing will be of limited use for tracing the contacts of infected people – crucial for controlling the outbreak.
Added to this, health officials are concerned the tests are not accurate enough to be rolled out yet. We instead need to use swab tests to find out whether the thousands of health workers who are currently self-isolating because they or someone else in their home have symptoms that might be coronavirus can get back to work.
A call for action
The government’s tight control over who can do diagnostic work for the coronavirus disease has been a huge failing, and we have lost valuable time. However, by leveraging the resources of private sector labs to increase the number of tests available, there is still time to contain the virus. By working together, we can not only start to put the health of our frontline workers and the wider nation back into their own hands, we can keep our healthcare systems from being overwhelmed.
Written by Abdullah Sabyah, CEO, Rightangled
Abdullah Sabyah is a scientist-entrepreneur, experienced healthcare professional, and the CQC registered manager and CEO of private DNA testing lab, Rightangled.
Rightangled have launched its own COVID-19 test that allows members of the public to test from the comfort of their own homes. There has been some controversy regarding the private buying of test kits, but in the case of Rightangled, the company offers a 50% reduction for NHS and vulnerable workers, and actually make a loss on each purchase once production costs are taken into account.