COVID-19 TESTING Q&A: WHY RATE IS NOWHERE NEAR

“TEST, test, test,” was the message from WHO head Tedros Adhanom Ghebreyesus in mid-March in response to Covid-19.

But nearly three weeks later only now has the UK Government said it would ramp up testing, aiming to hit 100,000 tests per day by the end of April.

“That is the goal and I am determined we will get there,” said Health Secretary Matt Hancock during Thursday’s daily press conference – initially saying he was referring to the UK before later it was confirmed he was only talking about England.

The UK approach to testing has been starkly different to other countries, notably China, Germany, South Korea, Canada and the USA.

Here we have started slowly, threatened to speed up, slowed down again and only now indicated we’re taking it seriously.

At one point, Wales even witnessed the farcical scenes of testing facilities being shut down just days after they were opened up.

Today, health workers self-isolating at home are still unable to get a test to find out if they can return to work.

But why is testing so important, and just why has the Wales and the rest of the UK been so slow to follow Germany’s lead?

How many tests are other countries around the world doing?

The UK is not alone in not having tested widely. As of Wednesday, 152,979 people had been tested here. France had only tested 107,500 on the same day – despite having a more advanced outbreak. Yet other countries have tested far more.

Germany was quick to develop an effective test for mass production. It also signed up politically to mass testing from the beginning. It is carrying out 50,000 tests daily according to data on Wednesday. So far, it has carried out 918,460. Anyone displaying even mild symptoms is tested.

South Korea country prioritised identifying and isolating people testing positive for the disease, and developed capacity to run about 20,000 diagnostic tests a day. Tests are conducted free of charge, including in drive-through testing booths since replicated elsewhere.

After Germany, Italy has done the most testing. So far it has tested 541,000 people. However, different regions vary and in Lombardy, the worst-hit area, medical staff are unable to get tested.

In the United States, testing was slow to start, with the country now rapidly increasing its capability in light of the growing pandemic. But despite running around a million tests, the US is not far past the rate of testing that the UK is, due to its much larger population and sluggish start.

About 65,000 coronavirus tests are now being performed on Americans each day, but public health experts say that about 150,000 tests are needed every day, so that infected patients can be quickly identified and separated.

Canada, which is earlier in the epidemic than both the UK and the US, has scaled up testing much more effectively, running tests at three times the rate of the UK.

Japan’s approach has been to test on a smaller scale, and with strict restrictions, leading to criticism that the figures are not representative of the country’s real outbreak scale. As of March 9, the country had tested 9,600 people, compared to 26,261 in the UK

on the same date.

Switzerland tested its population at a rate higher than any other country, and much earlier in the outbreak. On March 19, it was testing around 2,500 people per day. By April 1, it was conducting 16,000 tests every day.

Why did other countries test more?

In contrast with the early stages in the UK, South Korean health officials have tested both widely and specifically. It is is one of the few countries that tests without strict restrictions. It rigorously tests contacts of infected people but also makes the tests available widely.

Targeted testing was an approach followed by other countries, including Canada and Switzerland. Canada scaled up testing while also targeting it, requiring people have a combination of symptoms – one or more of a new cough, fever or difficulty breathing – and be considered a risk due to travel to a place of concern or contact with someone who is positive for the virus. The country has also prioritised anyone with respiratory symptoms who is hospitalised, lives in a nursing home,

healthcare workers or is part of an outbreak.

Switzerland initially began systematically testing people who had travelled from high risk areas or anyone who had come into contact with an infected person in February, but this eventually fell away, and the approach became testing high-risk groups such as those with an underlying condition or the elderly, and people with severe symptoms, still a much more comprehensive strategy than the UK.

Other countries went for the mass testing approach.

Iceland is small and and relatively wealthy, giving it a few advantages when it comes to testing. It has tested a higher proportion of its citizens than anywhere else in the world, including many showing no symptoms of the disease.

Italy showed how widespread testing could be as politically contentious as insufficient testing, with some including the prime minister, Giuseppe Conte, initially appearing to blame the country’s high number of infections on the policy of testing people without symptoms.

As it turned out, the tests were an accurate warning of what was coming.

But perhaps Germany offers the best example of how accepting the problem early on and tackling it head on can help fight the virus. In early January a scientist in Berlin, Olfert Landt, recognised the similarity to Sars and realised a test kit would be needed.

Lacking a gene sequence for the new coronavirus, Landt and his company designed their first test kit based on Sars and other known coronaviruses.

The protocol was published by the WHO on January 17, before the Chinese test. The British government passed on this test.

By the end of February Landt had produced four million kits and was making another one and a half million a week.

The latest data from public health officials estimates that laboratories are carrying out as many as 500,000 coronavirus tests a week. Though official data has yet to confirm that number, it suggests that testing capacity has expanded fast in recent weeks.

Germany’s decentralised test and laboratory infrastructure means the work is carried out not just in hospitals and doctors’ practices but also in special drive-in stations.