Up to 10% of England’s population could be tested for coronavirus each week after government officials asked local health chiefs to release saliva packs for 30 minutes speeding up Boris Johnson’s controversial blanket screening plan, “Operation Moonshot.”
In a letter seen by The Guardian, NHS Test and Trace asked all public health administrators to sign up to receive rapid results test kits for up to one-tenth of their residents every week as part of “an exciting and important new front on our site fighting the Coronavirus.”
If delivered, it could lead to a massive increase in national testing – up to 5 million tests per week from the current rate of around 300,000 so-called daily PCR tests, which are performed by scanning the nose and throat.
But local health chiefs raised serious concerns about the logistical challenge and the cost of starting tests and tracing contacts of those who tested positive. This came at a time when Corona virus deaths in the United Kingdom exceeded 300 cases for the second day in a row, with 24,701 other cases and more than 9,500 people in hospital.
Last week, Health Minister Matt Hancock told Parliament that the government had bought “many millions” of saliva tests conducted by Innova. Johnson said on October 16 that tests would become available “to help control localized outbreaks,” but that the latest strategy also extends beyond the announced saliva-testing trials of schools, universities and care homes.
In the leaked letter, Alex Cooper, director of rapid tests at NHS Test and Trace, said: “Every public health director will be eligible to receive a test count equivalent to 10% of their population on a weekly basis.”
The project will be “implemented in phases” with priority given to areas subject to Tier 3 restrictions – such as Liverpool and Manchester – with the ability to test all local residents every 10 weeks.
But Cooper said: “We aspire to be able to make this technology available to local areas to be introduced at a rapid pace,” adding that the program will move nationwide “as quickly as possible.”
Some local public health managers have already rejected the idea. One said he would refuse to participate because the tests were “lacking in scientific support” and because their overworked staff lacked the ability to provide this scope. Another said the lack of any support proposed to trace close contacts of people if they tested positive made it useless.
Saliva tests, known as lateral flow tests, provide results much faster than PCR tests, which in many cases take more than 48 hours to process. It aims to test people who are asymptomatic “to protect those at greater risk, find the virus, break transmission, and enable broader social and economic activity,” NHS Test and Trace told public health administrators.
Aside from the two main factors, PCR tests are only available for people with symptoms of Covid-19.
Saliva antigen tests do not require laboratory RNA extraction. Clinically validated, according to NHS Test and Trace, but still requires operational verification. The government bought up to £ 20m out of the reported £ 15.
The first details of the Moonshot came to light in September when leaked documents showed how it was using private advisors including Deloitte to spend up to £ 100 billion on mass vetting.
On Wednesday, academics at the universities of Glasgow, St. Andrews and Newcastle warned that its stated goal of reaching 10 million daily tests “will generate 10,000 false-positive results per day and result in unnecessary isolation and hardship for them and their callers.”
Local authorities have been asked to show interest in the program by Monday this week. Eugene Milne, Newcastle’s director of public health, said he wanted to explore using tests to screen relatives of residents in care homes across the north-east of England so that visits can resume and care workers can work between nursing homes and homes.
However, others are less careful. “I’m not going anywhere near it,” said Greg Vail, Director of Public Health at Sheffield. It’s an interesting idea, but it lacks scientific support and huge logistical challenges. I do not have the ability to. We should focus on presenting the things for which there is a scientific basis rather than on the things that are not established yet. “
Another senior director of public health, who requested anonymity, said, “They came to us with a proposal that was not well thought out. It is not clear what the cost or the volume of work is required and there is nothing about contact tracing.”
NHS Test and Trace, headed by Dido Harding, wants local authorities “to be responsible for selecting and publishing the site.” [lateral flow] Test in line with their priorities. “
Local health chiefs will also have to recruit and train their workforce to conduct the tests and will be responsible for clinical protocols. Boards will have to provide digital notification of positive tests and organize standard PCR swab tests to confirm results.
The anonymous public health director continued: “There’s no point in testing large numbers of people unless you do something with the results. We really, really want to improve testing and tracking, but again this is the wrong way to do it.”
The offer comes as NHS Test and Trace has seen its performance deteriorate in recent weeks. After last week’s numbers, the prime minister expressed his “frustration” at the system’s shortcomings and Sir Patrick Vallance, the government’s chief scientific adviser, admitted that the growing number of cases “reduces its effectiveness”.
A senior public health source who was on calls about the project with the Department of Health and Welfare (DHSC) said the attempt to roll out the project nationwide seemed urgent.
“We don’t know who is keeping track of the contacts or how the workforce is functioning [to carry out the tests] They said. “We are trying to figure out how this fits into the testing and tracking strategy with the PCR test and how to track any positive results and isolate people.”
DHSC has been contacted for comment.