Is 100,000 enough for tracking and tracing? The government has been accused of counting some tests prematurely, reportedly expanding its daily count to include tests that have been sent out in the post, rather than those actually carried out in labs. While it denies the charge, regardless of whether the 100,000 target has been met, countries that have taken a “test, trace, isolate” approach are running a far higher proportion of tests to positive cases than the UK. Germany, which is down to fewer than 1,000 daily positive cases, is performing nearly 1m tests per week. South Korea is doing 15,000 tests per day, but has had no more than 100 daily cases since the beginning of April. So, for a robust “test, trace, isolate” regime in the UK, the number of tests would need to be vastly increased or we would need to wait for the number of cases in the community to fall significantly. Will healthcare workers be screened? There have been calls for healthcare workers to undergo routine weekly screening to ensure that transmission between staff and patients is minimised. This is particularly important as people are known to be infectious before symptoms appear, meaning that hospitals could become hotspots for infection. However, regular screening of staff requires testing to be performed in hospitals or very nearby, and may also require staff to be available to take swabs. The government’s approach of centralising testing raises questions about how quickly local capacity could be rolled out to facilitate this. Is the right data being collected and reported? Questions have been raised about whether the data currently being collected is sufficient to support a “test, trace, isolate” programme, and community surveillance to pick up early signs of upticks in transmission in an area. Are testing centres starting to collect postcode information of those tested, for instance, or are they merely recording whether samples come back positive or negative? There are also concerns among statisticians that data is not being reported in a way that allows useful analysis. For instance, breakdowns of the number of positive tests from hospital patients, health workers and other groups have not been provided, and it is not clear why so many of the tests being performed appear to be repeat tests of the same person on the same day. Are the right people getting the tests? The rationale of the prioritisation of different groups – testing has this week been expanded to key workers, those who need to go out to work and over-65s – has not been clearly explained and there are still some groups reporting serious problems getting access to testing. Care home staff, in particular, have struggled to access tests, despite signs that the numbers of deaths in care homes will be very high. Given that care home residents do not have the option to self-isolate, it is crucial that staff are tested – and ideally regularly screened – to keep the virus out. Is the quality of testing good enough? In the rapid surge of testing, including at drive-throughs around the country, concerns have emerged about the reliability of test results and delays. Staff working in “mega-labs” have reported concerns about mislabelling of samples and lost results. Some people, including healthcare staff, have complained of waiting days or weeks for a result. There are also concerns that many drive-through sites are asking members of the public to self-administer swab tests, which could result in the samples being suboptimal.
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