Coronavirus test: what is wrong?

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People line up for tests in Southampton


People across the country have been barred from getting coronavirus tests in recent days as appointments have been suspended as the system struggles to cope. Yet the government says the capacity is higher than ever.

So what is going on in the UK testing system?

Growing demand

The demand for testing has skyrocketed, no one disputes that. What is not clear is how much. It’s hard to know by exactly how much – the numbers don’t represent all of the people who tried to book and couldn’t pass a test.

The combination of people returning from vacation and children returning to school will have put pressure on the system. And the onset of fall will have brought other respiratory viruses, with symptoms similar to the coronavirus – perhaps especially in children.

For many, the message that it is essential to get tested if you have symptoms will have faded. Dozens of people have told the BBC to do so out of a sense of civic duty.

This is something the government seems to have underestimated the impact of, says Sir John Bell of the University of Oxford.

At the same time, sources have expressed concerns about the “worried good” – people who request tests even if they do not have the relevant symptoms. Health Secretary Matt Hancock said a quarter of those seeking testing did not show symptoms, although when questioned the government said the figure was not an official tally.

But he highlighted reports that groups throughout the school year were being asked to get tested and people asking for tests before and after they went on vacation.

Empty driving

There is no shortage of swabs, the test centers to have the samples taken and the staff to take them.

There are almost 400 testing centers in total across the UK, including drive-thru and walk-in sites, mobile units in hot spots and satellite sites in hospitals and homes of care.

But getting an appointment on one of these sites was a challenge.

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The limited capacity of the laboratory means that the publication of new appointments is delayed.

This is because once you take a swab, there is a window of time to process it before it becomes invalid.

So once the labs have fallen behind, there’s no point in opening new appointments for people.

If the labs can’t get to them in time because they’re struggling with yesterday’s tests, those samples will be wasted.

Test capacity increases

The government says testing capacity – which it defines as the number of people who can be treated in the lab each day – is higher than ever.

It is true. Capacity has grown rapidly, with the latest figures showing that almost 375,000 tests per day can be processed.

But it covers all types of tests in all types of settings.

The testing program has four pillars.

The first is essentially hospital tests, which are processed in hospital and university laboratories and are reserved for patients and staff.

The second is community testing – and that’s the part of the system that we are focusing so much on right now.

The other two are the antibody testing program, which checks to see if people have ever had the virus, and the surveillance program run by the Office for National Statistics, which is seen as a critical way to track the spread of the virus.

But community laboratories are at their maximum

Community testing capacity is less than half of the total.

And once we dig deeper into this data, it becomes clear why the tests had to be rationed.

Almost all of the community’s tests are processed in one of the five mega-labs.

By August, it was clear that they were close to capacity – in fact, all testing capacity was exhausted by August 23.

And that gets to the heart of the matter.

These laboratories were built in record time. Ministers often refer to it as the biggest expansion in diagnostic testing in history. Indeed, the United Kingdom had very few diagnostic testing facilities of this type.

He therefore chose to centralize the system in these large laboratories and worked with various partners, including private companies and universities, to manage them.

What is happening in the laboratories?

Professor Gordon Dougan, of the University of Cambridge, says it’s no surprise that they have encountered problems and struggled to increase their ability to keep pace with demand.

He says that despite valiant efforts, the system is not robust enough “and is vulnerable to failures on many levels, from equipment procurement to finding the right personnel.

It is understood that one of the biggest limitations is recruiting enough qualified people to perform the tests.

This has become a particular problem as academics and postgraduates have returned to their usual roles.

Laboratories were unable to offer academic staff contracts and more experienced staff had to return to their institutions.

This has led Prime Minister Boris Johnson to write letters to universities asking them to lend their staff and students a little longer. It is not known how many, if any, accepted this.

In order to process more tests, laboratories will need more space, machines and staff. It is happening, but it doesn’t seem fast enough to keep up with demand.

And then?

Laboratory capacity is increased. A sixth mega lab in Newport is being opened, and a seventh near Loughborough will follow in the coming weeks.

This is expected to have a significant impact on capacity, but in the meantime the government has said it will have to prioritize – this means ensuring that hospitals, care homes and areas with outbreaks can access the drugs. tests.

But even when these new labs are fully operational, there are fears that demand will exceed supply.

Cases of coronavirus and other respiratory illnesses are on the rise, so it seems inevitable that more people will seek access to testing.

An analysis from Health Data Research UK has warned that if just 80% of people with annual coughs and fevers request testing, capacity could be exceeded all winter.

Problems getting the tests can be a lingering problem throughout the winter.

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