Ministers have set out plans to ramp up testing for coronavirus, as NHS leaders expressed deep concern about problems in the test-and-trace system. With figures showing a steady rise in the number of new infections, the government announced a new laboratory in Loughborough that it said would be able to process 50,000 tests a day by the end of the year. It also revealed two new pilot projects for saliva tests as a part of a £500m investment in what it called the “next generation” of testing. One of the pilots in Salford will investigate the possibility of mass screening whole populations, which could if successful be used in schools, care homes or communities where outbreaks have occurred. The health secretary, Matt Hancock, said mass testing was a key tool against the virus before a vaccine is developed. “In fact, if you had population testing there’s no reason why you theoretically would need to have social distancing,” he told ITV. “You could pretty much carry on life as normal because you’d just know that everyone you’d mix with had been tested very, very recently.” NHS sources played down the idea that mass testing could be a “silver bullet”, however, pointing out that the basics of hand-washing, social distancing and covering the face where necessary would still be required and that a high-functioning test-and-trace system would still be vital.
The latest figures from the NHS test-and-trace programme showed that 80% of people who tested positive in England in the week to 26 August were contacted by tracing teams and asked to self-isolate. But almost a third (30.6%) of their contacts – the people with whom they had been mixing prior to the test – went unreached. The number of people testing positive for Covid in England was up 6% on the previous week at 6,372, equating to an average of 961 cases a day, the highest for any week since May. On Thursday 1,735 new cases were reported across whole of the UK, compared with 1,522 on Thursday last week. NHS leaders expressed concern at the data. Saffron Cordery, the deputy chief executive of NHS Providers, said: “It is deeply worrying to see more people test positive for Covid-19 this week, with the number of positive cases in England now the highest since May. It is also concerning that infrastructure problems may still be delaying some cases being transferred to the test-and-trace system. “We are also continuing to see a mixed picture within the system. Of those cases that were transferred, a higher proportion of positive cases were reached, and a higher number of close contacts were identified, but a lower proportion of the close contacts were reached. “The turnaround times for swab testing within the community also remains below what we would like to see, despite small improvements this week. It is vital improvements are made quickly as we move towards the winter months.” Dr Layla McCay, a director at the NHS Confederation, said: “The government is making progress on test and trace, with increases in capacity and numbers being reached, but these improvements are small steps when its own aspirations are for giant leaps. The new funding for trials to scale up testing capacity can’t come soon enough because we know that alongside effective tracing, testing is vital to reduce the transmission of coronavirus.”
The saliva sampling, or “spit test”, that will be offered in Salford gives results in 20 minutes. It has the advantage of being non-invasive and more comfortable than swab tests. It has been trialled already in Southampton, where it is said to have proved fairly accurate, but not enough people were infected there to make the data conclusive. The government is also investing in other kinds of rapid tests using nasal swabs, which – if they work well enough – will overcome the issue of sometimes long turnaround times for the swab tests that have to go to labs. The government’s target is to have all tests reported within 24 hours, so that contacts of people who are infected can be reached quickly to reduce the risk that they may spread the virus. The median times for getting a result from home tests and from satellite testing centres was 86 and 76 hours respectively in the week 20-26 August, while regional and mobile test units achieved median times of 24 and 22 hours. Dr Joshua Moon, of the science policy research unit of the University of Sussex Business School, said: “Rapid tests are a good thing in general and, if they have the same reliability and accuracy as the PCR test, have the potential to be of real benefit to the response. The key, however, is to remember that these tests exist within a whole system of response rather than being the sole component. “Having a rapid test is useless if positive cases can’t or won’t isolate because support and enforcement is absent or if contacts can’t be identified because the tracing system is overwhelmed. As such, while a rapid test is a useful thing to have, it needs to be supported by a whole system of policies and strategies around contact tracing, case and contact isolation, support for those self-isolating, and evaluation of the system itself to ensure better functioning as the pandemic continues.”