Categories
Testing

UK “Rapid Turnaround” Covid-19 Tests

Here’s another extract from Boris Johnson’s Covid-19 “lockdown 2” briefing on October 31st:

I am optimistic that this will feel very different and better by the spring

It is not just that we have ever better medicine and therapies, and the realistic hope of a vaccine in the first quarter of next year

We now have the immediate prospect of using many millions of cheap, reliable and above all rapid turnaround tests

Tests that you can use yourself to tell whether or not you are infectious and get the result within ten to 15 minutes

And we know from trial across the country in schools and hospitals that we can use these tests not just to locate infectious people but to drive down the disease

And so over the next few days and weeks, we plan a steady but massive expansion in the deployment of these quick turnaround tests

Applying them in an ever-growing number of situations

From helping women to have their partners with them in labour wards when they’re giving birth to testing whole towns and even whole cities

The army has been brought in to work on the logistics and the programme will begin in a matter of days

Working with local communities, local government, public health directors and organisations of all kinds to help people discover whether or not they are infectious, and then immediately to get them to self-isolate and to stop the spread

The precise nature of all these “cheap, reliable and above all rapid turnaround tests” is rather vague though. Presumably Boris has his “Operation Moonshot” in mind?

Shortly after the initial Moonshot revelations in September the BMJ had this to say:

The documents talk about “buying large scale capabilities” from partners such as the drug company GSK to “build a large scale testing organisation.” However, under “potential partners for increasing laboratory capacity” the documents list only the company AstraZeneca. Under logistics and warehousing, the documents list potential partners as Boots, Sainsbury’s, DHL, Kuehne+Nagel, G4S, and Serco. Under workforce are listed universities, the Society of Microbiologists, and the British Society of Immunology.

Alongside mainly commercial partnerships, the documents also state that a number of new tests and technologies would need to be used, including some that do not yet exist.

“Delivering testing at the scale and level of ambition set by the prime minister is likely to mean developing, validating, procuring, and operationalising testing technology that currently does not exist,” the plans state. Lower sensitivity testing for “screening/enabling purposes” could also be used, with polymerase chain reaction (PCR) testing then used to “confirm positive results or in situations where accuracy is needed for highest risk individuals.”

Testing technology listed in the documents includes qrt-PCR, Endpoint PCR, LAMP, LamPORE, lateral flow antigen test, and whole genome sequencing. Two of these tests—lateral flow antigen tests and LAMP—are listed as having a “lower sensitivity” of between 80% and 100%.

I cannot help but wonder how development of those “tests that do not yet exist” is coming along? According to the Financial Times today:

As England prepares to enter its second national lockdown on Thursday, the government’s Operation Moonshot plan to deliver a mass population testing programme is back under the spotlight. According to documents reviewed by the Financial Times, the Department of Health has awarded contracts worth at least £1bn to companies providing rapid testing. Many of the technologies relating to these contracts will feed into the Liverpool trial, in which everyone living or working in the city will be eligible for a test from Friday. The strategy will hinge on new lateral flow tests, which give results in 20 minutes and can be performed on a throat or a saliva sample, as well as conventional swab tests and loop-mediated isothermal amplification (LAMP) technology.

The pilot is expected to last about two weeks, with tests being deployed by the army, and could allow teachers, pupils and hospital staff to be tested weekly. But scientists have raised concerns over the accuracy of some of the lateral flow tests being used, which are prone to missing cases of active infection. Meanwhile, delays in assessing technologies produced in the UK have led to frustration over government contracts being awarded to overseas companies.

The government has signed at least 10 contracts with companies based in the UK, US and China, totalling more than £1bn, for rapid testing technology and logistics, according to publicly available contracts on the EU public procurement site, Ted, and information shared with the non-profit legal firm the Good Law Project.

Categories
News

England’s Covid-19 Lockdown Redux

My apologies for the rather more than brief hiatus in this series of articles. One reason is that on June 18th The Guardian reported that:

The government has been forced to abandon a centralised coronavirus contact-tracing app after spending three months and millions of pounds on technology that experts had repeatedly warned would not work.

In an embarrassing U-turn, Matt Hancock said the NHS would switch to an alternative designed by the US tech companies Apple and Google, which is months away from being ready.

Another reason is that I am currently sat at my keyboard on Burrator Ward at Derriford Hospital in Plymouth, where I am recovering from a non trivial triple coronary artery bypass operation, and have just washed my hands in accordance with the instructions in the unisex toilets:

There are other reasons too, but for now let’s continue with the latest news from the Downing Street propaganda machine:

Amongst a variety of other words uttered during yesterday evening’s press conference Boris Johnson had this to say:

Even in the South West, where incidence was so low, and still is so low, it is now clear that current projections mean they will run out of hospital capacity in a matter of weeks unless we act.

And let me explain why the overrunning of the NHS would be a medical and moral disaster beyond the raw loss of life

Because the huge exponential growth in the number of patients – by no means all of them elderly, by the way – would mean that doctors and nurses would be forced to choose which patients to treat

Who would get oxygen and who wouldn’t

Who would live and who would die,

And doctors and nurses would be forced to choose between saving covid patients and non-covid patients

And the sheer weight of covid demand would mean depriving tens of thousands, if not hundreds of thousands, if not millions, of non-covid patients of the care they need

It is crucial to grasp this that the general threat to public health comes not from focusing too much on covid, but from not focusing enough, from failing to get it under control.

I am told that it is quite normal to experience a wide range of emotions when recovering from a major operation.

This morning I awoke in a howling rage. My blood pressure is currently 134/82.

[Edit – November 6th]

A video update from Ann James, Chief Executive of University Hospitals Plymouth NHS Trust:

Our [Covid-19] numbers are beginning to rise, and they’re rising quite quickly. So at a really important time, a critical time, we set out what our next steps are to make sure that we can keep everyone safe and supported during what I know is another really difficult time for everyone.

We have already needed to make some changes to the hospital. We’ve had to change the use of some of our wards as we increasingly care for a growing number of Covid patients, and we’re looking to change some of our other services.