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Clinical virologists were excluded from the UK covid-19 pandemic

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Corona 19 cases are on the rise again worldwide. This virus is likely to spread even if the vaccine has been distributed. Britain’s pandemic response, albeit incomplete, has evolved through learning from experiences at home and abroad. [1] The covid-19 pandemic should have pushed virology to the center stage. Instead, it was ruled out to practice clinical virologists.

Early in the epidemic, the opportunity to consolidate UK laboratory expertise was lost as a result of false assumptions about lack of capacity, which led to outsourcing the Pillar 2 test to the Lighthouse laboratory. [2] Separated from the NHS and UK public health diagnostic expertise, this approach has been challenged by test access, sample receipt and processing, test quality, public health, and data connectivity issues with other NHS structures. All of this would have been minimized if the testing program had been developed and expanded under the auspices of an existing NHS professional center. The same expertise has been used to develop and implement other emerging diagnostic, monitoring and public health management tools. Viruses such as HIV, HCV, HEV, SARS, MERS, Zika and Ebola. [3]We also recognize the slow disappearance of our network of high-quality diagnostic services along with surveillance and epidemiological functions following the dissolution of public health laboratory services (PHLS – an early pioneer in UK public health), the loss of the UK’s ability to manufacture high-quality diagnostics. Reduce and streamline costs. [4]

The distinction between current government scientific advice (through SAGE and other committees) and operational efforts (e.g. NHS testing and tracking) has further refined the response and notes the lack of clinical virologists in the advisory committee. [5] The role of these individuals and other laboratory clinicians is to bridge this gap, particularly by using new scientific understandings to advise on issues such as infectivity, proxy for disease progression, test performance, and infection control. It is not surprising that more and more discussion of covid-19 PCR performance and its low level viral relevance is pouring into the literature. This is what clinical virologists have been dealing with since molecular testing was first introduced in the 1990s. [6] The role of clinical virologists is even more important when monitoring SARS-CoV-2 vaccine response and evaluating the effectiveness of antiviral therapy.

69 clinical virologists representing most of the consultant-level specializations in the UK (and the Clinical Viral Network) recently wrote to the Chief Medical Officer and the Government Chief Science Officer due to the lack of government involvement and the structure of consulting with clinical virologists. . Torture to express their concerns. [7] The government’s response noted that SAGE would welcome documents for consideration, especially if there is a gap. We will pursue this proposal, pointing out that there are niches rather than niches.

Despite current testing and tracking programs and concerns about the Lighthouse laboratory, further extensions of the SARS-CoV-2 test have been proposed. [8] First, the 5 billion bid for public health microbiology is followed by the much more ambitious 100 billion Moonshot program, but the reasons are unclear and the required technology may not yet exist. [9,10] It takes very little a week without media coverage of a new and better test of SARS-CoV-2 in the pipeline. We welcome cooperation between academia and industry. However, clinical virologists, like all other laboratory and point-of-care testing standards, are required to participate in the design and evaluation of clinical settings for such services. This should include both diagnostic and screening services in all laboratory and non-laboratory settings as the role of testing expands, such as at UK airports. As winter approaches, it is not clear how current test systems will consider the role of influenza and other respiratory viruses. Again, this should be discussed with a clinical virologist.

And to wrap it all up, the UK Department of Public Health will be replaced by a new health agency, the National Institute of Health Protection. It is unclear what exactly will be achieved by this. This can only be welcomed if it leads to better infrastructure, more repetitive resources, utilization and expansion of relevant talent. [11]

Growing global population, overcrowding in many low- and middle-income countries, cheap air travel and the continuation of a humid market will lead to more new infections. Clinical virologists play an important role in mitigating these risks, but can you learn this lesson?

Jangu Banatvala, Kings College London School of Medicine.

Deenan Pillay, Department of Infection and Immunity, University College London.

Will Irving, School of Life Sciences, University of Nottingham.

Competitive Interest: Deenan Pillay is a member of the Independent SAGE.

Reference :

BMJ 2020: UK Public Health Response to COVID-19. Edit BMJ 2020; 369: m1932 https://www.lighthouselabs.org.uk/ Mahy BW. The history of new viruses in the late 20th century and the paradigm observed in new prion diseases. Perspective of Medical Virology 2006; 16: 5-14. PR Carter. UK’s NHS Pathology Services Review Report https://www.networks.nhs.uk/nhs-networks/peninsula-pathology-network/documents/CarterReviewPathologyReport.pdf (2008), accessed September 10, 2020 https: // www .gov.uk/government/publications/scientific-advisory-group-for-emergencies-sage-coronavirus-covid-19-response-membership/list-of-participants-of-sage-and-related-sub-groups Jefferson T , Spencer E, Brassey J, Heneghan C. Virus culture for COVID-19 infectivity assessment. Systematic review. medRxiv 2020.08.04.20167932; doi: https: //doi.org/10.1101/2020.08.04.20167932 https://www.clinicalvirology.org/ Roderick P, Macfarlane A, Pollock AM. Returning to normal: The community controls the COVID-19 outbreak. BMJ 2020; 369: m2484 Iacobucci G, Coombes R. Covid-19: The government plans to spend 100 billion on expanding tests to 10 million per day. BMJ 2020; 370: m3520 https://blogs.bmj.com/bmj/2020/09/10/martin-mckee-will-boris-johnsons-moonshot-become-lost-in-space/ Banatvala J. COVID-19 test delay and Pathology services in the UK. Lancet 2020; 395: 1831

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