How did the UK’s “world-class” COVID-19 test system fail in the face of its first serious test?
This is a question asked by Whitehall and indeed nationwide this week as the Ministry of Health and Human Services is forced to distribute the availability of tests across the country.
It’s a riddle with a very important meaning.
Image: Boris Johnson and Matt Hancock said testing and tracking systems will be critical in helping the country beat its second surge.
Earlier this summer, Prime Minister Boris Johnson and Health Secretary Matt Hancock said the UK’s testing and tracking system will be critical in helping them beat the second coronavirus surge.
After all, forensically locating infected people, tracking and testing their contacts is the main way other countries have been able to fight the disease without forcing a nationwide lockdown.
This was the British plan this fall. In the worst case, testing, tracking, and quarantine were performed only with some small area closures as needed.
But now, there is growing fear that the system will bend in situations where many people do not get tested even if they have symptoms, and there is a risk that Corona 19 will spread unconfirmed, such as in spring.
Although the infection rate is relatively low, epidemiologists warn that infections are increasing and that the next few weeks will be a pivotal period.
So, what happened to the British system, once again struggling to catch up, despite the rapid increase in cases in this country and many other European countries facing a surge in disease?
The mystery deepens when you think about how much time and investment you have put into the system since spring.
The Treasury provided about £10 billion (almost twice the cost of two new British aircraft carriers).
Image: Baroness Dido Harding was initially hired to create a struggling operation.
Baroness Dido Harding, former chief executive of the phone company TalkTalk, was hired to shape operations that initially struggled to provide ample testing.
With the help of Deloitte’s consultants, a new centralized system was built and thousands of employees were brought to work in the so-called Lighthouse Labs across the country.
The test system may have turned out to be lacking in the first wave, but according to Whitehall insiders, the same mistakes will not be repeated again.
And it seemed like everything was planned for the next few months.
Initial IT flaws have been fixed.
Initially, most of the database issues I was struggling to match with other details like the NHS number and what I was testing with were resolved.
Above all, the capacity of the system has quietly increased.
The prime minister was sometimes ridiculed when he declared that Britain was doing more experiments than anywhere else in Europe, but he was right.
In the spring, the UK conducted far fewer tests than most other major countries, but in recent weeks this country has absolutely more tests than any other country in Europe. There are far more than Spain than Germany and France.
Even on a per capita basis, the country carries out more testing than almost any other major country except Denmark.
So how did this system, with more capacity than almost any country in the world, suddenly run out of capacity?
This article seeks to answer that question based on conversations with many people involved in different parts of the test device.
As with many others during this pandemic, there are many competing papers about what went wrong, but they can be summed up in three fateful decisions that led us to where we are today.
1. Nursing home protection
The first of these dates back to spring, where the UK has a higher rate of disease mortality than other major countries.
Among the mistakes made at that time was the failure to protect a nursing home. Too few tests were given to both residents and nursing home workers.
Image: 100,000 tests per day conducted on people working and living in nursing homes.
To avoid the same mistake this time, officials from the Department of Health and Human Services (DHSC) insisted that a significant amount of tests would be assigned to nursing homes.
This was non-negotiable and completely understandable, but it affected the capacity.
The official capacity of Pillar 1 (the testing infrastructure in or around the hospital before the onset of the disease) and Pillar 2 (the new centralized testing network), the core parts of the test system, is about 200,000 pieces. 250,000 per day.
However, according to government officials, about 100,000 tests have been conducted on people who work and live in nursing homes in recent weeks. For everyone else, only about 100,000-150,000 working power remained.
2. Sending children back to school
Even so, even that is more capacity than the UK had in the early days of the pandemic and more than many other countries, so why was the remaining capacity consumed so quickly?
It brings us to the second of three fateful decisions: sending the kids back to school at any cost.
This has become a key target for the government during the summer and in the aftermath of test results failure. Consensus has been strengthened that the school will be the last to close no matter what happens this fall.
However, those involved in the test system expected demand to surge, but the scale of the surge completely surprised them.
Image: Somehow sending students back to school, which became a key goal of the government during the summer
According to one source working on the test system, about half of the increase in test requests in recent weeks can be traced back to this “school effect”.
When the children returned to school, some institutions relaxed and others enforced strict rules that increased the demands for testing.
Some people have called for an immediate examination when the child has body temperature, even if there are no other symptoms.
Some families felt they had to order multiple tests from home to get their children back to school.
The Ministry of Education hastened to come up with new guidelines, but it’s too late to calm the initial surge in demand for kits for children aged 5-15 years has nearly quadrupled.
3. Early spread of disease
The rest of this surge in testing can be traced back to the fact that the disease is now spreading across the country and indeed across the continent.
The third of the fateful calls that occurred in the summer was the assumption that the second surge in the disease would not happen until the end of the year (perhaps until the end of October or November). Not early September.
This was a calculated guess. After all, it’s close to the traditional flu season.
Moreover, the government believed that although the disease was spreading in Spain and France from early summer, it would be able to prevent the kind that spreads ahead of the first wave.
Although stringent quarantine measures have been taken, the UK case trajectory as of this week is largely consistent with France and Spain, with a delay of about three weeks.
This means that within a few weeks the number of cases will increase to around 10,000. DHSC currently suspects that about 20% of test requests come from people who are asymptomatic and simply worry about a surge in the disease.
Image: Case trajectory in UK, France and Spain
However, the DHSC has not yet reached its target capacity, as it presupposes everything soaring for events that have not come for a month and a half.
The plan was to reach 500,000, a daily capacity sufficient to handle the current demand.
But crucially, its capacity will not arrive until the end of October. Sometimes they expect the lack of testing to continue, and the next six weeks will become even more uncomfortable.
In the meantime, the plan is to manage your testing needs. In short, distribution will continue for the time being.
The online reservation system is already filtering out areas with a high prevalence of COVID-19 and areas that have been absent for a while.
Those who asked for a test in Cornwall were far less likely to get the test for weeks than in Bolton, for example.
However, as demand increased, laboratories struggled to deliver tests to all regions of the country.
Image: According to DHSC sources, the average test cost is around 100.
In some cases, it is due to a lack of manpower. Many people have used students as temporary jobs, but some have now returned to college. In some cases, it’s because the lab wasn’t prepared for the surge in demand.
Nevertheless, this system is already very expensive.
According to DHSC sources, the average cost of the test is around £100.
The sloppy calculations already suggest £2 billion has been spent on testing alone.
If it had to operate close to capacity over the next six months, the cost of testing would exceed £8 billion.
In other words, despite receiving the most generous allowances in any part of the government, the testing and tracking system may have run out of its entire budget by next spring.
It adds cost, which is another headache.
Image: Prime Minister Rishi Sunak has promised to have all the resources it needs to test and track.
Prime Minister Rishi Sunak has promised that he will be able to get all the resources it needs testing and tracking, but the Treasury is raising eyebrows on how quickly that money is being used and what the taxpayer’s money was worth.
They worry about how much effort they are putting into unreliable new testing methods with little chance of success. But above all they worry about the system not preventing a second nationwide shutdown.
Within the DHSC, I get nervous over the next few weeks. The promising news is that authorities in Spain and France are still in their infancy, but appear to be under some control.
However, none of the countries have the same problems the UK has for testing.
As expected, if the system maintains capacity with a wide ration over the next few weeks, there are two consequences.
The first is anxious. We will be in the dark to some extent about the rate at which the disease spreads.
Daily test figures will no longer be a fair measure of disease spread (other survey-based measures should provide a more reliable community spread).
The second outlook is even more frightening. Without the means to identify and track cases, the disease will soon spread significantly in communities.
At that stage, the prospects of national or at least regional closures can be stricken again.
Additional pubs and restaurants may be closed. The school will be closed for the last time, but according to government sources, nothing.
A month or two ago, DHSC insiders proudly declared that testing and tracking were one of the main defenses against the second surge, but these days they have changed the message.
They say that a structure of behavior like the “Sixth Law” is the most important and the first barrier to COVID-19. They say testing and tracking are now the second line of defense.
Faced with repeated crises during the pandemic, whether at the forefront or backward, this “global” system faces the most difficult periods of its short lifespan.
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