Britain’s coronavirus testing system has come under intense scrutiny in recent weeks amid reports that people are unable to get tested for the virus.
Hospital staff now warn they are staying home from work, teachers and pupils are being kept out of classrooms and even care home staff are struggling to get tests as the vital system buckles under the pressure of rising case numbers.
The system is floundering and appears to have hit its ceiling at just over 200,000 tests per day, despite the Department of Health claiming it can do 244,000.
This has prompted serious concerns as a second wave of cases is thought to be on the horizon for the UK.
Testing was abandoned completely in the first wave, in March, which let the virus spread unchecked across the country.
Allowing this to happen again would be a disastrous mistake for the Government and it is now under immense pressure to keep the testing system on its feet.
People using the online booking system – Pillar 2 tests – report being directed to test centres dozens or hundreds of miles from home, or simply being denied one completely.
Officials are pointing the finger at the laboratories to explain why there is a backlog of 185,000 tests still in processing, as leaked documents showed in The Sunday Times.
Here’s a step-by-step breakdown of what is happening to the testing system:
Public are being denied tests or told to travel cross-country
People all over England are being denied access to coronavirus tests or told they must travel across the country, dozens or hundreds of miles, to get one.
Twitter user Ian Spencer said he had been met with this message when trying to book a coronavirus test, echoing the experience of many others
Members of the public must use the online booking system to arrange a coronavirus test to be sent to their home or to make an appointment at a drive- or walk-in centre.
But many say they are simply being met with a page that says ‘This service is currently very busy’ and ends their attempt to book the test, advising them to try again later.
Others say they have been told they can go for tests at centres in different towns, cities, counties or even countries which could take hours to drive to.
Speaker of the House of Commons and MP for Chorley in Lancashire, Sir Lindsay Hoyle, this morning said the situation was ‘unacceptable’ in a tweet.
MPs are furious that their constituents cannot get tested near to their home when the Government is so insistent that people should get a test if they feel ill.
Bosses at hospitals, care homes and schools say their staff are having to stay home from work and self-isolate because they feel ill but can’t get tested.
In its most recent week of full data – up to September 7 – the Department of Health claimed it had capacity to carry out and process 243,817 tests per day in Pillars 1 & 2.
But it was doing an average of 182,564 per day and still ended up overwhelmed.
Access is even being restricted in Covid-19 hotspots
Even people living in some of the worst-affected parts of England say they are struggling to get tested for Covid-19.
These areas, which receive ‘enhanced support’ from Public Health England, are supposed to have extra testing facilities and mobile units set up.
MPs said a mobile unit that was meant to set up in Oldham, Greater Manchester, never arrived.
And shocking footage showed a huge queue reportedly five hours long outside a test centre in Bury, Manchester, last Thursday.
Bury has one of the worst infection rates in the country, with 47 cases of coronavirus per 100,000 people, according to PHE.
People were also struggling to get swabbed in other hard-hit places including Bolton (122 cases per 100k), Blackburn (62) and Pendle (58).
Local man Tony Kirvin, 43, took this image of people waiting in a ‘five hour’ queue for Covid tests at Mosses Centre in Bury, Manchester, on Thursday, September 10
Officials blame ‘laboratory capacity’ for shortcomings
The crux of the problem is that the Government’s laboratories can’t process the coronavirus tests as quickly as people are taking them.
Every test – which uses a swab like a large cotton bud – has first to be used by the person, then posted back to the lab, then processed in a specialised machine, then interpreted by a lab technician and the result put through a database and texted to the person who took the test.
This is supposed to take 24 hours but often takes longer.
The process inside the laboratory – the swab running through the machine and the result being noted by a technician – is the ‘pinch-point’, officials say.
Director of testing at NHS Test & Trace last week said on Twitter: ‘Can I please offer my heartfelt apologies to anyone who cannot get a Covid test at present.
‘All of our testing sites have capacity, which is why they don’t look overcrowded; it’s our laboratory processing that is the critical pinch-point. We are doing all we can to expand quickly.
‘We have additional NHS, Lighthouse, University and Partner Labs all due to open up imminently and we are also expanding the use of non-Laboratory based tests. The testing team work on this 18 hours a day, seven days a week. We recognise the country is depending on us.’
Health Secretary Matt Hancock echoed this in Parliament today. He said the country has ‘record levels’ of lab capacity but admitted: ‘It is in the labs that the constraint is’.
A new giant lab is set to open near Loughborough by the end of this month. It is not clear by how much this will boost test capacity.
Are test-processing labs short-staffed?
Part of the reason for labs not being able to keep up, some have claimed, is that they may not have enough qualified staff to operate the test-processing machines.
Jonathan Ashworth, Shadow Health Secretary for Labour, claimed the system was in difficulty because post-graduate science students who had been working in the labs over the summer were now leaving.
He said in Parliament today: ‘Extra demand on the system was inevitable. So why didn’t [Matt Hancock] use the summer to significantly expand NHS capacity and fix contact tracing?
‘And just as demand is increasing, the ability to process tests is diminishing. Post-grad students working in the Lighthouse Labs are returning to university, so why did we not plan for these inevitable staff shortages in the Lighthouse Labs?’
An expert in the field said many technicians had been drafted in on intense short-term contracts during the crisis but were now going back to their everyday jobs.
Doris-Ann Williams, chief executive of the British In Vitro Diagnostics Association (BIVDA), told The Telegraph: ‘People worked really, really hard for the first three or four months.
‘I think everyone just ran out of steam, needed to recharge their batteries.
‘It could be that it’s just getting back up to strength again after everyone has had a bit of a break in August.’
But one leading scientist was not convinced that the problem was quite as simple as ‘lab capacity’.
Professor Alan McNally, a University of Birmingham expert who helped set up the Government’s Milton Keynes Lighthouse Lab, said a ‘perfect storm’ of events have crashed the testing system.
He told BBC Breakfast there were ‘clearly underlying issues which nobody wants to tell us about’.
He said: ‘The labs are still fully staffed, they are still churning through huge amounts of samples per day – the same number as they were a couple of months ago – so there are problems elsewhere in the chain…
‘I think this is multi-factorial. I think you almost have a perfect storm of events that have come together to almost essentially crash the testing system.
‘I think there is a surge in demand [and] I think our stated capacity is very different from actually how many tests can be run in a given day.’
What is the impact of growing pressure on test labs?
A large workload for testing labs around the UK means that people’s results are taking longer to process – many people have to wait more than the target 24 hours to find out their result.
This means that the government is throttling the number of tests that are sent out to avoid completely overwhelming the system.
So people in some areas are finding it difficult to access swabs, and in lesser-affected areas the number of tests available may be cut so there are more to distribute in hotspots.
The Health Secretary confirmed today that yesterday testing in the 10 worst affected areas accounted for 9,278 of the total. The total has not been published but this is likely to be around five per cent of all tests.
There are concerns that a system that is frustrating or slow to use will put people off and members of the public will stop bothering to use it.
Should people still be ordering tests?
Yes, anyone who has symptoms of coronavirus (a cough, fever or lost sense of taste/smell) must order a test however they can.
People who do not have symptoms, and have not been instructed by a medical professional to get tested, should not order a test.
Matt Hancock last week vented frustration at ‘ineligible’ people ordering tests but this was a reference to those who were getting swabs just because they thought they might be at risk because their child had gone back to school or they had been on holiday.
Tests are still reserved mainly for people with symptoms and essential workers who are officially referred by their employer. The rules are laid out here.