Testing Times: The urgent need to decentralise Covid-19 diagnostic testing

COVID-19 is the biggest public health emergency since the Spanish Flu, with over 875,000 confirmed cases and 43,500 deaths worldwide. These numbers are expected to continue growing exponentially. In the UK we have seen a doubling of deaths around every 3 days.

We need more COVID19 tests. These identify those affected, enable more effective tracing and isolation to minimise the spread of disease, support epidemiologists to track the virus and allow the return of healthcare workers to the frontline.

Unfortunately, the UK is performing dreadfully and urgent action is needed. Matthew Lesh’s new paper makes this case very convincingly and provides answers to how we can respond, and thus ultimately save more lives.

The UK has fallen to the bottom quarter of OECD countries for COVID-19 diagnostic testing, on a per capita basis. South Korea has tested four times as many people as the UK, Germany almost three times and the United States now almost twice as many, per capita. Since March 16, the United Kingdom has just over doubled daily testing capacity. In the same time, the United States has increased daily testing by a factor of 21.

A root cause of this problem was a decision to centralise testing to a single Public Health England lab. Whilst testing has since expanded, it is still heavily centralized. By comparison, the most successful countries decentralised testing, using a mixture of public, non-government and private laboratories.

What next? Matthew recommends the following:

• fast-track approval for private sector laboratories to conduct COVID-19 testing; 
• substantially expand usage of NHS and university laboratories to conduct COVID-19 testing; 
• undertake rapid approval of private sector developed tests, including mutual recognition of tests approved by other regulatory bodies such as the FDA;
• reduce testing red tape, including any requirements that initial positive tests must be retested centrally by PHE; and
• explicitly call on companies to help make testing kits and develop lab capacity for COVID-19 testing, modelled on the successful call for businesses to make ventilators

Read the full report here.