For Americans, the entire subject of testing for Covid-19 is fraught with Federal government incompetence and mendacity. But how about in other places? NewScientist’s (13 June 2020) Adam Vaughn reports on UK testing efforts:
Officially, more than 5.7 million tests have been conducted in the UK so far, with 142,123 tests on 6 June. However, those simple totals mask a complex series of different tests.
A sizeable chunk of that daily count, 26,802, are antibody tests carried out under testing strategy pillars 3 and 4. These tests are used to see if someone has previously had the coronavirus, and for research on the virus’s spread. Such tests aren’t informative for detecting or tracing new cases, or advising someone on whether they should self-isolate.
The bulk of the daily number, 79,685 on 6 June, are “have you got it” nose-and-throat swab tests for people outside of hospitals, known as pillar 2. Those include tests posted to people at home, although these may not ever be taken or processed. There has also been a degree of double counting – for example, if a person’s nose and throat is swabbed separately, that may be counted as two tests.
The remaining 35,636 on 6 June were swab tests to confirm infection among hospital patients and staff, called pillar 1.
When tests are combined and counted up in this way, the government has been able to say it has met its targets – the most recent of these was 200,000 daily tests by the end of May. But without knowing how many people are being tested and to what extent double counting and unprocessed tests contribute to the totals, it is difficult for independent experts to say whether enough testing is taking place to understand and control the UK outbreak.
“Early on, what we really wanted to know was how lethal this condition was and we can’t get anywhere close to that until we know how many people have had the infection. If we wanted to know the infection fatality rate, we can only guess at the moment,” says Jason Oke at the University of Oxford.
Additionally, for monitoring how the country comes out of lockdown, Oke says “what we really need to do is have a system where we can monitor potential spikes in positive cases. We can only do that if we have clear data on who’s getting tested and how many people are getting tested, not just total numbers of tests.”
And more and more. It all smacks of political check-marking, which is not useful to scientists trying to understand the nature of the epidemic. Understanding leads to more effective reactions on our part, from treatments to prevention, and if we don’t let it be guided by science, rather than politicians frantic to meet goals set by other politicians, then we’re not going to have an effective response.
One item I wish the article had addressed but did not was the matter of economics: is testing constrained by financial concerns? The attentive reader will note that I used a very standard phraseology as not to activate the fight or flight response, but my own reaction is that letting financial concerns play into testing is a mistake: wealthy countries such as the UK and the US should be able to attack problems like this head-on, not cutting corners and thus endangering data completeness and integrity.
In other words: No accountants should be anywhere near the top of the decision making pyramid! We’re not the sort of societies which must make a choice between lives and wealth.
