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UK’s lack of testing capacity ‘set stage for lockdown strategy’

MPs told lack of capacity was key reason for not testing and tracing Covid-19 cases

The UK did not adopt a strategy of testing for and isolating cases of Covid-19 because it did not have the capacity to make enough tests, MPs have been told.

But it is now hoped capacity will ramp up enough over the next few weeks to enable the UK to follow South Korea’s model of fighting the disease through testing and tracing, a key expert from the government’s Scientific Advisory Group for Emergencies (SAGE) told the House of Commons Science and Technology Committee hearing on 25 March.

The government has come under heavy criticism for its lack of quick and widespread testing for Covid-19. Instead it focused on a general social isolation and then a national lockdown after initially referring to plans to generate ‘herd immunity’ by allowing the majority of the population to become infected.

Richard Horton, editor-in-chief of the Lancet and a prominent critic of the government’s response so far, told the committee that testing, isolation and quarantine “are basic public health interventions”.

“One of the surprises of the public health community is that dimension of the response hasn’t been more forthrightly presented by SAGE, and that might reflect a fact that there isn’t a strong public health presence on SAGE,” he said.

Greg Clark, the chair of the committee, which is undertaking a public inquiry on the issue, said it “was notable” that the published SAGE evidence has “comparatively little” information on testing and contact-tracing versus social interventions and closures.

“In fact,” Clark said, “the evidence includes a couple of quite striking papers that point to the importance of that, as background papers, but they don’t appear in the report of the deliberations.”

One of key epidemiologists in SAGE, Neil Ferguson, who is director of the MRC Centre for Global Infectious Disease Analysis at Imperial College London, said: “Testing has always been discussed significantly. The reason it wasn’t included in initial modelling was the projections by Public Health England of how quickly this country can ramp up testing capacity.”

In January, February and early March, he said, “it was very clear from messages from Public Health England that we would have nowhere near enough testing capacity to adopt that strategy”. That information then informed the discussions at SAGE and the subsequent government strategy.

But Ferguson added that leaving the lockdown and restarting the economy will “likely rely on very large scale-testing and contact tracing”. He said: “If we have to transit from this suppression and the lockdown strategy into something that country can maintain in the long term, undoubtedly, much more wide-spread testing, contact-tracing and other methods will have to be deployed.”

South Korea is seen by many as a successful example of a country that relied heavily on testing, contact tracing and isolation of cases to keep Covid-19 at bay. Ferguson described the data coming out of South Korea as “most encouraging”.

“They have relied on very rapid and intensive testing, and case isolation perhaps more than most other countries, with some degree of success. So, we’re looking at that at as a model. The UK does not have testing capability to replicate South Korea right now, but I think it is likely that in the next few weeks we will do.”

Policy decisions over the next few weeks will determine whether we get resurgence in the transmission, said Ferguson. “The effectiveness of the measures we put in place to replace the current regime—comes back to the issue of [whether we can] move from a complete lockdown, which almost certainly isn’t sustainable for the rest of the year, to something perhaps making a better and more use of intensive testing and contact tracing.”

“Testing is key,” health minister Edward Argar told the BBC Today programme on 26 March. “Of course, we want to do more.” He said the UK is “ramping this up at pace”, but added that the volume of tests needed “is a challenge”.