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‘The whole thing needs ramping up’, says leading bacteriologist on testing

Expert calls for more tests, faster turnarounds and more EHP involvement before lockdown can be eased.
12 May 2020 , Katie Coyne

Lockdown can’t be significantly loosened until testing has exceeded 200,000 per day across the UK, an expert has suggested.

Professor of bacteriology at Aberdeen University, Hugh Pennington, who has chaired two major inquiries into E.Coli O157 outbreaks, argued that testing needed to be ramped up significantly. 

But he added: “I’m pretty confident that even 200,000 will not be anywhere near enough.”

Pennington suggested that testing levels were too low – and that “ideally” you almost needed unlimited testing – and this could be the reason behind the delay in the government re-establishing contact tracing. 

He said: “I suspect the reason for that, they won’t want to talk about it, is the number of tests you’ve got available, because you’ve got to have the testing capacity. 

“The whole thing needs ramping up, not just in terms of numbers, but in terms of turnaround time. If somebody is positive, you want to be going in there, asking them who they’ve met in the previous week. Then some of those people will have been exposed, and then they will need testing. I’ll be very surprised if they have that sorted anytime soon.”

The government target is to hit 200,000 tests a day by the end of May but it has been falling short of its 100,000 tests a day target set for the end of April.

Pennington added: “If schools start to go back in a bigger way, they’ve got to be able to persuade the teachers, and the parents of the children, that there’s a testing regime that will pick up any problems ASAP and close the school or whatever is required.”

He said current testing looked “feeble” and noted that a national network of testing centres, needed to back up track and trace, did not appear to be in place.

He also expressed frustration over the lack of detail around what the new contact tracing offering would consist of, and that local authorities were not being involved more when they had local on-the-ground knowledge.

“Local authorities and EHPs could play – and should play – a fantastically important role, because they’re already sitting, waiting almost, to be called in to get things organised.

“I would have thought EHPs were really ideal because it’s the nature of the job to be asking questions with that slight degree of scepticism in mind.”

He added: “That does seems to be an issue both north and south of the border, that government wants to control everything. I don’t know why they are not bringing local authorities far more into the whole exercise because, at the end of the day, they know their patch.

“These outbreaks of the virus are not evenly spread around the country, and as soon as you start to do contact tracing, that will be revealed. And that’s going to be absolutely crucial to getting a grip on the virus, really focusing on areas where the virus is busy.”

Blasting the idea that all of the contact tracing work could be done over the phone, Pennington argued that at least some of it would require in-person interventions. He said: “I would have thought that you’d need a lot of people doing face-to-face, as long as they’ve got the proper PPE. You do a lot of phone work, obviously, but sooner or later, you’re going to have to go into a family and test everybody and who’s going to do the tests?

“The idea that they’re going to be self-testing is rubbish because people aren’t going to do it vigorously enough, and get the right samples. It’s like asking a restaurateur to do his own swabbing of his surfaces and his food. Would you rely on the results? No.

“They will get a little coloured brochure telling them how to do it [testing]. But, you know, it’s daft. I suppose it’s trying to save on resources and save on people. But at the end of the day, it can’t be done properly. And they’ve got to have a whole raft of people properly trained, properly supervised, properly managed.

“This is where EHPs come in to act as leaders. Not actually doing much of the contact tracing themselves, because clearly they’ll be required in a role in observing what’s happening, making sure no mistakes are being made, and running the show. It’s going to be essentially a sort of managerial thing but based on their very vast experience of doing that kind of work, that’s where I would see it anyway.”

Controversy has surrounded the appointment of Baroness Harding on 7 May to head up the government’s track and test taskforce, as she was at the helm of broadband TalkTalk in 2015 when it experienced a huge cyberattack and data breach. A central part of the government’s track and test approach is its NHSX tracking app, which has also raised concerns around data privacy.

Pennington argued that the important part of this role would be “smart management”, getting the right people organised, and signed up, and telling them what’s required, and utilising local authorities who are “ideally placed, rather than having some person sitting in an office in London calling the shots”.

He added: “Certainly case numbers aren’t going up. They’re going down, but they’re going down rather slowly and more slowly than anybody would really like. What just doesn’t seem to be getting across is that we’re really in a major emergency here. We’ve got to get those case numbers down to save lives.”

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