The United Kingdom hopes to become one of the first countries in the world to offer nationwide testing, as it purchases 200 million 15-minute COVID 19 tests to be rolled out nationwide in January.
Plans call for the purchase of more than 60 million rapid tests per month, with 192 million planned by March. This would mean that almost every resident could be tested once a month. This was preceded by a trial in Liverpool, Northwest England, where an attempt is being made to test every inhabitant of the city and the surrounding region, which comprises about 600,000 people.
As the British Minister of Health, Matt Hancock, announced, there are already plans to introduce the test in 70 local authorities, including London, Birmingham and Manchester, if the Liverpool trial goes well.
This is part of what is known as “Operation Moonshot” and would make inclusion easier, as people would be able to carry a certificate over the phone stating that they are COVID-19 free, which would give them access to sporting events, bars or restaurants and allow them to return to a more “normal” version of everyday life.
These tests give a result in about 15 minutes and are a different method from the one used in the US and UK so far.
“We rely on slightly less good tests to test so many,” Dr. Henrik Salje of the Cambridge Infectious Diseases Research Center at the University of Cambridge told Washington Newsday. “This means that you have to have quite a lot of the virus to detect it, so people who have been infected earlier or at a lower level will not necessarily show a positive infection.
Slovakia was the first country in the world to introduce nationwide testing. All Slovaks over the age of 10 – around 3.8 million people – are encouraged to get tested. This is then repeated in monthly test rounds. On the first weekend of the program, Slovakia tested about 3.6 million people.
A similarly aggressive testing program was introduced in Luxembourg, although the population there is around 600,000 people. Both are much smaller than the logistical challenge facing the UK. The adult population of the United Kingdom is estimated at around 52 million people.
Previously, the UK relied on tests that required laboratories to process the tests and return the results to the people. The government promised that this testing capacity would reach 500,000 per day, a target that was met by the end of October according to official figures. The actual number of tests processed that day was around 300,000, and critics have questioned whether 500,000 is feasible in practice. But this new type of tests would solve this problem at least partially, as they do not require a laboratory.
“It’s all about the details, and the tests are different,” says Dr. Salje. “The antigen test is easier to perform on a mass scale. The current tests in the UK are based on PCR, require more facilities and are more difficult to perform on a mass scale.
“There is a trade-off – how sure do you want to be that this person has the virus or not and in this huge body, who is infected and where they are, with the risk of missing something. Both are important, but it depends on what you want to achieve with the test. The introduction of testing at population level can contribute a lot and is useful for the UK to investigate”.
This research is not without criticism. The accuracy of this new antigen test is about three out of four positive COVID cases. In people with a high viral load, the accuracy is up to 95 percent, but it is unknown whether people with less virus or fewer symptoms can transmit the virus just as easily.
“It could be that people with lower levels can transmit the virus less easily, we are not sure yet,” says Dr. Salje. “So these false negatives may not play a role. People who are infected earlier may end up with more viruses and be more contagious. In Slovakia, they plan to go back and retest, and that seems like a reasonable strategy.
The timing is crucial, because Christmas and the prospect of a vaccine are just around the corner. It remains to be seen whether the strategy of “Operation Moonshot”, where all people are tested, will not be fully implemented until the vaccine is available, making it redundant. But the British government has promised to “do whatever it takes” to deal with COVID-19, and a vaccine is still not safe.
The officials hope