18 September 2020

Tracing the outlines of a testing fiasco


“For the British people it’s become not so much test and trace, but trace a test”.

Aside from being a rather pithy turn of phrase, that quip from Labour’s Jon Ashworth neatly captured the absurdity of the UK’s Covid testing system. From ‘world-leading’ one day to overwhelmed and stalling the next – how, mid-way through September, has the Government still not got to grips with this?

We’ve known for months that a comprehensive, reliable, and efficient testing system would be key to understanding coronavirus, releasing the UK from lockdown, and paving the way to recovery. Yet here we are, many months and billions of pounds later, relying on a failing system.

Things didn’t always look this bad, relative to the rest of the world. We have been testing more people in both absolute and population-adjusted terms than most other European countries. Testing capacity was also ticking up and most results were coming back within 24 hours. It seemed that, while we got off to a slow and stuttered start, the authorities were finally getting this under control.

But in the last two weeks, that progress seems to have all but evaporated. Long queues, a total lack testing appointments, backlogs in labs, and rationing of tests have understandably provoked widespread discontent and unease.

The Government has now shifted to blaming the logjam on people requesting tests when they don’t actually have any symptoms – which should be a criterion for getting one. Much of this is also to do with children going back to school, as worried parents want to get their kids tested because Sally two classrooms over has the sniffles.

But although the need for tests has genuinely increased as cases spread, the real problem runs much deeper than a sudden surge in demand. What it boils down to is an over-centralised system for both providing and processing of tests, which has collapsed at the first hint of the unexpected.

Given there are a limited number of tests available, the Government is increasingly rationing them, prioritising care workers, NHS staff and other ‘essential’ workers such as teachers. They are also trying to avoid past mistakes by reserving 100,000 tests per day for care homes. That may sound perfectly sensible, but it effectively halves the number of tests available for everyone else.

Attempts to concentrate testing in hotspots such as Bolton is equally understandable, but the more areas which are seeing outbreaks, the fewer tests there are to go round.

Then there are the hundreds of thousands of tests which have been taken, but are waiting to be processed by our centralised laboratories, where staff and equipment shortages have restricted capacity. The Government claims capacity currently sits at 375,000 tests a day, but only 437,000 a week were actually being processed at the start of this month.

Meanwhile, the Prime Minister is promising millions of weekly tests under the much-vaunted “Project Moonshot”, a pledge which can only seem like wishful thinking when patients in London are being directed to Edinburgh for their nearest test.

Faced with this catalogue of calamity, the Government have switched tack. Where test-and-trace was once the solution to the crisis, we are now hearing a lot more about behavioural interventions – restricting movement, curfews, limits on gatherings, and even local lockdowns. But this cycle of moving in and out of restrictions, trying to carefully balance increased economic activity with controlling the spread of the virus cannot last indefinitely.

Back in April, we at The Adam Smith Institute called for testing to be fully decentralised. Sadly, the Government has done quite the reverse, expanding testing using a small number of ‘Lighthouse’ mega-labs, the same labs which have been central to recent testing failures.

We must not make the same mistake again. First, the Government should commission smaller labs as part of the national network. Secondly, as my ASI colleague Matthew Lesh has argued, we need to deregulate to allow for new cheap, fast and easy-to-use technologies and private sector initiative to carry testing forward.

The Government took a gamble on their centralised testing system and promised it would hold up. As thousands try to trace a test, it’s obvious that the gamble hasn’t paid off.

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Morgan Schondelmeier is Head of External Affairs at the Adam Smith Institute.

Columns are the author's own opinion and do not necessarily reflect the views of CapX.