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The shortage of coronavirus tests appears to be the result of a perfect storm of factors that have combined together, just as a second wave of the disease is emerging.
Boris Johnson insisted at PMQs that 89 per cent of people who have “in person” tests receive the results the next day, and that the UK is conducting 2.54 tests per 1,000 people, which he said was more than any other country in Europe.
He added that the system was on course to carry out an average of 240,000 tests per day this week, compared to 210,000 last week. But these figures are very selective, given MPs from all parties and all parts of the country are reporting constituents unable to get a test.
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Here is a list of reasons why testing is turning into a crisis:
Website issues
The centralised testing website on gov.uk is supposed to be the main port of call for anyone who needs a test. But there have been scores of cases where people have been offered an appointment hundreds of miles from where they live – including a woman in south London who was offered a test in Aberdeen.
Ministers claim that these are outlier examples and that, on average, people are able to get a test this week within five miles. However, it should never have been the case that a system based on geographical location offers results 500 miles away.
There are claims, unverified, that people have been able to “cheat” the system by putting in an Aberdeen postcode from their home in London, suggesting either that the software is faulty, with a coding problem, or the Government may be trying to suppress demand by deliberately making the website throw up “impossible” results.
Fragmentation of the service
In May the Government contracted out its testing service to different organisations, science labs and private firms. One of these firms is Serco, which runs coronavirus testing facilities as well as call centre contract tracers. Deloitte is also involved in overseeing parts of the service, including logistics and scaling up of mass testing. The processing of the tests is carried out by Public Health England labs, universities and private scientific facilities.
In response to backbench MPs and to Freedom of Information requests from members of the public, the Government has refused to give full details of exactly which firms and organisations are involved in which parts, but the Labour MP Stella Creasy has raised concerns that this has caused a rail privatisation-style fragmentation of the service, leading to breakdowns in communication and processing.
Problems at laboratories
At the weekend, it emerged that a backlog of 185,000 swabs had built up in the labs that are processing the tests, meaning some were sent to centres in Italy and Germany. There are capacity problems in the UK government’s Lighthouse Lab network of seven centres created to allow the scaling up of mass testing of people in the community, known as pillar 2 tests. NHS labs, which only deal with pillar 1 tests from hospital patients and staff and people in care homes, do not process swabs from members of the public in the community.
This again raises concerns that the system is not joined up. More than half of the problem in the labs is down to logistics and the actual handling of samples, according to those processing the tests. Dr Mike Skinner, a virologist at Imperial College London who volunteered to work in a Lighthouse Laboratory dealing with Covid-19 tests, said half of the staff in the lab had to deal with handling issues, such as “barcoding, leaks”.
He said: “We actually had to remove the swabs from the tubes so they didn’t gum-up some of the robots down the line. It really is very much about logistics.” Dr Skinner said unwrapping samples to run the tests also delayed the process. “
To be handled safely through the distributors, like Royal Mail, those samples are multiply wrapped. We spent a lot of time safely unwrapping those, removing all the plastic and getting those samples ready. That’s a big complication of the process,” he told Radio 4’s Today programme.
Superficial demand outstripping supply
Health Secretary Matt Hancock said last month that anyone with symptoms who wanted to get a test should be able to, and if they were in doubt they should do so.
During the summer, when demand was low, many people used the service without problems. But there are claims – mainly by ministers – that workers returning to the office after a summer holiday abroad are being sent for tests by their employers, even if they don’t have symptoms, and that some schools have sent whole year groups for tests when the pupils also don’t have symptoms.
This is causing an artificial drag on demand. The Government claims that 25 per cent of people seeking tests do not have symptoms, but has so far not backed up this claim with any evidence.
Genuine demand outstripping supply
At the same time, genuine cases of Covid-19 have been soaring in the community – over the summer this rise occurred in younger groups, who display fewer symptoms, but since the start of September there has been a sharp uptick in cases among older age groups, who are more likely to experience symptoms and in turn seek a test.
The case rate per 100,000 people in age groups over 30 doubled between the last week of August and the first week of September. At the same time, schools in England have gone back. Children with mild symptoms of cold and flu – such as fever or a cough – are being sent home from school and their parents told to get them tested.
This double effect has sent demand for tests from people with symptoms rocketing – casting doubt on the government’s claim that the pressures are coming from asymptomatic cases.
Priority for hospitals/care homes
Yet senior Whitehall sources admit that this prioritisation was already in place, with 100,000 test kits a day going to care homes, meaning that supply for community tests is effectively already capped. It is the community cases who have been the most vocal in contacting their MPs to complain they cannot get a test, which is why we are hearing about that more than shortages for care homes.
But even in hospitals there is a shortfall in tests for health workers, according to the head of NHS providers, Chris Hopson. There is also a suspicion that the Government may have begun imposing caps on tests in each area via the testing website to suppress demand and ensure that kits are directed to hospitals and care homes. This is difficult to verify, because the government has not published its daily testing data – including capacity – for five days.
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