‘There’s been absolutely no scrutiny’ of mass-testing project, say researchers
Screening experts are growing increasingly concerned about the government’s plans for mass Covid-19 testing via its £100 billion Operation Moonshot project.
The government claimed last week that an evaluation of the rapid tests that are currently being piloted in Liverpool showed that they worked well enough for a wider rollout.
Reportedly a project championed by Dominic Cummings, the prime minister’s outgoing chief aide, the Moonshot scheme plans to test millions of people, in an effort to facilitate a return to some kind of normality, even in the absence of a vaccine.
But the plan came under fire from researchers and public health experts, who questioned its feasibility and value for money.
“There’s been absolutely no scrutiny of the Moonshot proposals by anybody who understands screening,” said Angela Raffle, a public health expert at the University of Bristol.
“It worries me that ministers, or whoever, can wake up one morning saying let’s spend £100bn on this and not have it scrutinised—it would be like building the Channel Tunnel without asking civil engineers to look at the plans.
“We will have a chaotic scramble to have tests, which we don’t know bring any benefit. It will fail miserably.”
Sian Taylor-Phillips, professor of population health at the University of Warwick, said the government had been focusing on how many tests were being done rather than the effect of that testing on public health.
A risk-benefit evaluation of mass testing was needed, she urged, which would consider, for example, the impact of unnecessary isolation for false positives and the effects on future public enthusiasm to take part in vaccination.
Other experts said questions remained about the tests themselves. Jon Deeks, professor of biostatistics at the University of Birmingham, said studies that evaluated the efficacy of rapid Covid tests were mostly done in labs, but “that doesn’t tell us how well it works when it’s being used in field”.
The Innova test the government is using in Liverpool might only detect about 50 per cent of positive cases in a real-world setting, he said, pointing out that results varied in different settings. (The government says the Innova test has “an overall sensitivity of 76.8 per cent…but detects over 95 per cent of individuals with high viral loads”.)
He added that with such tests, many cases will be missed, even when people are still infectious.
Given such concerns, as well as the high cost of testing millions of people regularly, Allyson Pollock, clinical professor of public health at Newcastle University, said mass screening “ought to be paused [and] thought about very carefully while testing and tracing is reintegrated into” public sector labs and local NHS bodies.
“We have to think very carefully before we spend £100bn on programmes that we do not know–we have no evidence–that they will work,” she said.
“The evidence around the tests is poor and weak at the moment, and needs to be improved. The Moonshot programme really should be paused until the cost-effectiveness and the value for money is well-established.”
But the Department of Health and Social Care maintains that “these lateral flow tests are accurate, reliable and successfully identify those with Covid-19 who don’t show symptoms and could pass on the virus without realising”.
The department’s spokesperson told Research Professional News: “We are confident that these new tests, which have been rigorously evaluated, will make a real difference in how we protect people from this disease and help break chains of transmission.”
Susan Hopkins, chief medical adviser for the NHS Test and Trace, added: “Our evaluation work and the ongoing pilots are helping us to understand how lateral flow tests work in the field and how we may use them to help stop the spread of the virus.
“We are confident that these new tests, which have been rigorously evaluated, will make a real difference in how we protect people from this disease and help break chains of transmission.”
UPDATE 17/11 – Added a comment from the Department of Health and Social Care and Susan Hopkins