‘Limiting testing to symptomatic people is not good enough’

Wider testing for COVID-19 is needed to catch early and asymptomatic cases, according to Hugh Pennington, emeritus professor of bacteriology at Aberdeen University.

Early in the pandemic Pennington called for much greater testing, and reiterated this call as figures show the virus has grown among younger people and there is concern about infections being passed to more vulnerable members of society.

Asked what lessons we had learned six months into the pandemic he said: "Many of the cases are asymptomatic – or asymptomatic early in the infection. The testing system, it's been rationed on the basis of symptoms and we should have learnt by now that's not good enough.

“We have got to roll out more testing, and we’ve got to make testing much less dependent on having symptoms. That's an absolutely crucial, fundamental thing that we're still coming to terms with. This virus is different from other viruses in that respect.

“The only thing that's going to save the day is having a really adequate testing capacity, which is a lot more tests being able to be done than are being done at the moment - and with quick turnaround times. And if we can't get that, the contact tracing isn't going to go anywhere near as well either.”

Pennington pointed to universities that are still following a policy of only testing students with symptoms. He said: “We should now – months and months into the pandemic – have a testing capacity that could cope with any surge in case referrals.”

When the schools went back in Scotland there was a surge in demand for tests, which the system ought to have been able to accommodate, he said. “And there was all these problems of people in London being told to go to Inverness, and people in Scotland were told to go to Ireland to get their test. That should not have happened”.

Pennington said he had felt relatively optimistic about our measures to get out of the pandemic, until recently. He added despite all the “jumping up and down, and the carping on” about having a world beating test and trace system, we haven’t. This, he said, was due to not paying attention to getting it rolled out properly and using local expertise.

Taking a centralised approach hasn’t worked he argued - notably because it meant bypassing local expertise including EHPs. He questioned why different tiers of testing were established that has complicated matters. The professor summed up the scenario as, “administrative incompetence: they know what's to be done, and they should be doing it, and should be doing it a hell of a lot better than it is being done.”

See the October 2020 print issue of EHN (login required) for more views from around the EH profession of lessons learnt in the past six months.