Spectator: Is Mass Testing Still Necessary?17 Nov 2020 16:10
Is mass-testing still necessary?
by Ross Clark
Now that we appear to have two Covid-19 vaccines which work, do we really need Operation Moonshot – the government’s programme to test ten million people a day by early next year? It is an imporant question, not least because of the extraordinary sums which appear to have been committed to it: briefing documents leaked to the British Medical Journal in September suggested that it could cost £100 billion – which is equivalent to 77 per cent of the annual NHS budget in England. What would be the point in testing the entire population of Britain once a week if the virus was being controlled by a vaccine?
The cost aside, there is growing medical opinion against the idea. The latest criticism appears in a letter to the BMJ today from Mike Gill, a former regional director of public health, and Muir Gray, visiting professor at the Nuffield Department of Primary Care Sciences, University of Oxford. They point to the pilot testing programme currently being undertaken in Liverpool using a ‘Lateral Flow Test’ made by Innova, results of which are available within the hour. The programme, to judge by the long queues of people wanting the test, has proved popular, but they argue: ‘The ethical basis looks shaky.’ Mass-testing of asymptomatic people, they argue, is of limited use because such people are unlikely to be very infectious. Moreover, false positives related to the tests face condemning large numbers of people to self-isolation when they do not, in fact, have the virus.
They also point to a study by Porton Down and the University of Oxford, published last week, which assessed the Innova Lateral Flow Test, which suggested that it had an overall false positive rate of 0.32 per cent. However, that includes laboratory tests. When used in the ‘field’ by locally trained testers – i.e. how they will be used in a mass screening programme – the false positive rate, they say, could climb up to 0.6 per cent.
While that might seem small, if you are going to test the entire population once a week it would mean that, at any one time, we would have 390,000 people self-isolating when they did not in fact have the disease. Even if you take the lower, false positive rate of 0.32 per cent, which covers laboratory tests, it would mean more than 200,000 at a time forced to self-isolate when they didn’t have Covid-19. The virus could become entirely extinct and still we would have a city the size of Portsmouth confined to their homes for no reason at all.
No person’s freedom, they argue, should be contingent on the result of a novel rapid Covid-19 test. Instead, the government should seek to improve the performance of the current Test and Trace system, which revolves around identifying symptomatic individuals.
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