The researchers say the UK has a relatively high testing capacity but is failing to use it efficiently in tackling COVID-19, raising concerns including a lack of follow-up and adequate financial support for those who are isolated.
Researchers have now compared it to systems in five other countries – Germany, Ireland, South Africa, Spain and South Korea – and found that while the UK has the highest proven testing capacity, its system has serious flaws.
Professor Michael Hopkins said: “There is no point in having a relatively large number of tests, as we did, if it does not isolate people and support them until we break the chains of infection.” University of Sussex Business School, co-author of the work.
The study, which has not yet been reviewed, Comparing testing and tracking systems in the six countries with the five principles of optimal program, as stipulated by the UK Independent Sage Commission, such as the need for rapid and accessible testing and isolation of infected individuals. The team also looked at WHO recommendations.
While the lack of data meant that the performance of the systems could not be compared, the team was able to look at gaps in the methods. The results, based on the software as of the end of August, showed that all countries’ systems had problems, for example South Korea’s approach raised privacy concerns, while Spain lacked contact tracing tools.
Although the UK has the highest proven testing capacity in the six countries, the team found flaws in the testing and tracking system, including access to tests and individuals taking their own swabs. The researchers said that people who want the test should be screened by GPs, and if the test is required, it should be performed by a healthcare professional to avoid poor sample collection.
“Any other scarce resource in the NHS, you have primary care as gatekeepers,” said Hopkins.
The team also expressed concern about where the tests would be conducted. “In the UK in particular, commissioning of new large-scale private testing at Lighthouse laboratories has exceeded accreditation and raised quality concerns,” the researchers said.
What the UK government said about the COVID-19 test
“Not only is the epidemic under control, with fewer deaths and hospitalizations, but we will continue to address it, through local closures and a super-test and tracking system.”
“The NHS Test and Trace does a heroic feat, and today most people get a test result in person within 24 hours, and the average flight is under 10 miles if someone has to take a trip to get one … [To Keir Starmer] We’re making the tough calls – all he’s doing is sitting on the sidelines and carp. “
[On the ‘moonshot’ proposal for mass, near-instant testing:] “Hopefully this approach will spread widely by spring, and if everything comes together, it might even be possible for challenging sectors like theaters that life is closer to normal before Christmas.”
“We don’t have enough testing capacity right now because, in a perfect world, I’d like to test everyone who wants to get tested right away … Yes, there’s a long way to go, and we’ll work day and night to make sure we go there.”
“Of course there is a challenge in the test … We have sent the exams to all schools to make sure that the tests are available. But of course I also recognize the challenges in taking the tests … The tests are available, although getting them is a challenge.”
They cited concerns about the low effectiveness of the UK’s contact tracing system, saying it lacks measures for those who self-isolate, with insufficient checks on adherence and their health and well-being. Moreover, while a complete guidance on self-isolation was available, it was only online and not in all the required languages. The team added that the financial support available for isolation may not be sufficient. “You don’t have to have a choice between paying the bills and going to work and injuring people,” Hopkins said.
Professor Chris Bonnell, from the London School of Hygiene and Tropical Medicine, said there was an urgent need to improve the availability of testing and tracing in the UK. We also need to provide more generous financial support to those called in to seclusion. This will encourage those who test positive to report all of their contacts. It would also enable those who were called to isolation to do so. “Unless we make these changes, it is clear that we are heading towards a big problem.”
However, he had reservations about the proposal calling on GPs to screen people, saying that access to testing should be as quick and easy as possible. “Given the current capacity shortage, there must be some prioritization,” he said. “However, expecting GPs to manage this alongside their other business seems to be a bad way to manage it.”