What is the problem with coronavirus tests?

Many people with coronavirus symptoms have struggled to obtain a test nearby in recent weeks. Reports have emerged of people being asked to drive long distances to test centres even when local ones are quiet. The problem is nationwide, with people in Manchester being sent to test sites in Scotland and Leicester, people in Loughborough being sent to Wales, and others in Surrey being sent to the Isle of Wight, despite the need to hop on a ferry. The Labour MP Helen Hayes said one of her constituents in south London was told to get a test in Fife, 355 miles away.

What has gone wrong?

Sarah-Jane Marsh, the director of testing at NHS test and trace, said on Tuesday that the problem was not a lack of capacity at testing centres themselves but at the labs that process the swabs, which she described as “a critical pinch-point”. When demand is high, access to tests is paused to control the flow of swabs into labs. This prevent backlogs, which can lead to voided tests and delayed results. But it also means people are offered tests at sites further from home. Marsh added that further NHS, Lighthouse, university and partner labs would open “imminently” to alleviate the pressure.

The health secretary, Matt Hancock, said it would take “a couple of weeks” to boost capacity and solve the issue in the short term. But Prof Alan McNally at the University of Birmingham, who helped set up the Milton Keynes Lighthouse Lab, was puzzled by the explanation. “If people are asking for tests and being sent hundreds of miles, that doesn’t suggest a lab problem, it suggests an access to being swabbed problem. It’s confusing. Why doesn’t someone come out and tell us what the problem is?” he said.

Why has this happened now?

The demand for testing has risen with the easing of lockdown restrictions, up 63% for first-time testers since mid-June. More people are mixing socially and coming into contact with each other as shops, gyms and cafes open and people return to school and work. On Sunday, the number of people testing positive for coronavirus in the UK leapt 65% from the previous day’s figure to 2,988, with the number on Monday similar at 2,948. On Tuesday, 2,460 positive tests were reported.

Who is getting the virus?

The surge in cases appears to be driven by the under-25s, particularly “affluent” 17- to 21-year-olds, Hancock said on Monday. While younger people are less likely to die from coronavirus, it can still have long-term health impacts, and a rise in cases among the young will inevitably spread infections to older, more vulnerable people.

What is the UK’s test capacity?

Overall, the UK has a stated capacity of about 250,000 virus tests a day, with about 100,000 more antibody tests, but this is across a number of different “pillars”, which are divided up into hospital tests for staff and patients, tests for those who develop symptoms in the community, and other tests performed as part of national surveillance programmes. Substantially fewer tests, about 175,000, have been performed daily this month.

What is the hold up?

It is unclear what might be causing a bottleneck in testing given that testing numbers are well within the UK’s stated capacity. Some scientists contacted by the Guardian complained that the Deloitte-run network of Lighthouse Labs, which perform community tests, are being less than open about any difficulties they face and speculated that problems may be driven by high demand, a shortage of reagents needed for the tests, staffing issues, or testing capacity being overstated.

Are there other ways to test?

One procedure that is being looked at involves testing pooled saliva samples. This could allow rapid mass testing for the virus because saliva from hundreds of people can be tested at once. If the result comes back negative – as it often will, since only a small percentage of people have the virus – all those who contributed saliva can reasonably sure they are free from infection. If the batch tests positive, all those who supplied saliva would have individual tests to identify the infected.

The Guardian

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