Testing times in Liverpool – why Merseyside trial might be key to lockdown exit

England’s second national lockdown may only be two days old but politicians already have an eye on the exit. Here are some of the key questions on why testing will be crucial to the country emerging from restrictions in time for Christmas:

Coronavirus – Thur Nov 5, 2020
Coronavirus – Thur Nov 5, 2020

Will the lockdown in England end on December 2?

Yes – that is the message from Downing Street. Prime Minister Boris Johnson told Thursday’s news conference that the advice he received from scientists was that the four-week lockdown period “is enough for these measures to make a real impact”.

The country will then be expected to return to the tier system, although what restrictions will remain in place over the Christmas period will be decided nearer the time.

“There is light at the end of the tunnel,” Mr Johnson said on Thursday. He will be hoping it is not a freight train of further bad news.

Coronavirus – Thu Nov 5, 2020
Coronavirus – Thu Nov 5, 2020

A freight train of bad news?

Yes. The whole point of shutting businesses, leisure centres and shops, asking people to stay at home, minimising contact with others, and cancelling weddings – all of it is designed to reduce the rate of infection heading into the crucial winter period where pressures on the health service usually intensify.

A failure to adequately get that R-rate down will surely lead to questions of whether the second national lockdown was worth it.

Coronavirus – Thu Nov 5, 2020
Coronavirus – Thu Nov 5, 2020

So what is happening in Liverpool – the army’s been sent in, hasn’t it?

Er, yes, the army has been sent in. But to assist with a pilot testing scheme, not to help enforce law and order.

Liverpool has been selected to trial the new system, which will allow anyone in the city to be tested – repeatedly – for coronavirus regardless of whether they have symptoms.

The idea is to gauge the effectiveness of a testing regime which relies on a rapid-turnaround lateral flow test which can give you results within 15 minutes. They will be used alongside existing swab tests.

Director of Public Health for Liverpool Matt Ashton said: “The aim of this project is to quickly identify people who have the virus and reduce transmission substantially.”

Coronavirus – Fri Nov 6, 2020
Coronavirus – Fri Nov 6, 2020

Ah, great news!

Whoa, Nelly. A group of academics, including Allyson Pollock, Professor of Public Health at Newcastle University, said plans to test asymptomatic people in Liverpool went against SAGE advice to prioritise testing for those who were displaying symptoms.

A letter sent to the city’s MPs on the eve of the testing trial read: “Searching for symptomless yet infectious people is like searching for needles that appear transiently in haystacks.

“The potential for a harmful diversion of resources and public money is vast.

“Also of concern are the potential vested interests of commercial companies supplying new and as yet inadequately evaluated tests.”

The experts suggest the National Screening Committee conduct an immediate review of the pilot.

Coronavirus – Fri Nov 6, 2020
Coronavirus – Fri Nov 6, 2020

Okay, well at least we have Operation Moonshot to rely on, right?

About that. Moonshot is the Government’s ambitious mass-testing scheme, announced by Mr Johnson in September.

But there have been similar concerns raised about Moonshot. Dr David Strain, clinical senior lecturer at the University of Exeter and chairman of the BMA’s medical academic staff committee, said previously: “The mass-testing strategy is fundamentally flawed, in that it is being based on technology that does not, as yet, exist.”

Earlier this week, fresh worries were aired about the effectiveness of a Moonshot trial in Greater Manchester – where even though test results were turned around in 20 minutes, they missed more than half of Covid cases.

Coronavirus – Thu Nov 5, 2020
Coronavirus – Thu Nov 5, 2020

That doesn’t sound positive, does it?

And there was further criticism on Friday of the Government’s Test and Trace system, which strives to reach the contacts of those with coronavirus symptoms.

James Naismith, professor of structural biology at Oxford University, said the system was only reaching a fraction of the number of people who should be contacted.

“It hasn’t been effective at all,” he told BBC Radio 4’s Today programme.

“The only ways we are currently able to control infection spreading are social restrictions. Tracking and tracing hasn’t really made any difference to the spread of the epidemic.”

Earlier this week, latest figures showed just 59.9% of close contacts of people who tested positive in England were reached through the system in the week ending October 28.

This represented the lowest figure since Test and Trace began and was down from 60.6% for the previous week.

Coronavirus – Fri Jul 17, 2020
Coronavirus – Fri Jul 17, 2020

So what next?

All eyes on Liverpool. The Prime Minister said the rapid testing being piloted for the next 10 or so days in Merseyside could be a “real way forward through the crisis”.

“The advantage of this approach is that you can tell whether people are infectious or not immediately – within 10 to 15 minutes,” he said during a news conference on Thursday.

“Without having to worry about the time taken to get the answer from the current testing system, you can help those people to self-isolate if they test positive, and if they test negative, then of course, they’re free to do things with other people who test negative in something close to a normal way.”