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Coronavirus: Why did the UK need 100,000 tests a day? Coronavirus: What tests are being done in the UK?
(2 days later)
It's been a bumpy road for the UK government when it comes to fulfilling its promises on coronavirus testing. Health officials in England have approved a test that will show if someone has had coronavirus in the past. So how is the government's testing strategy developing?
It set a target of providing 100,000 coronavirus tests per day across the UK by the end of April, and managed to log 122,347 tests on 30 April. The new test - from Swiss pharmaceutical firm Roche - looks for antibodies in the blood to see if a person has had the virus and might now have some form of immunity.
But it was criticised for including in this figure around 40,000 testing kits which are counted when they are sent out rather than when they are actually used. The government has been looking for a reliable antibody test for some time. At the end of March, Health Secretary Matt Hancock announced that the government had bought 3.5 million antibody tests but these turned out to be ineffective.
The target was also met on 1 May. It was missed for eight consecutive days after that before being met again on 10 May. If the Roche test becomes available in large numbers, it might first be used on health and social care staff.
On 11 May, 85,293 tests were logged for 60,410 people (this figure is lower as some people need more than one test). There is an antibody test already in use at government research facility Porton Down, to make early estimates about what percentage of the population might have had the virus. But it is not accurate enough to give individuals information about their infection status.
On 6 May, the Prime Minister announced a fresh target to get to 200,000 tests a day by the end of May "and then to go even higher". What about the other type of test?
Statistical regulator the UK Statistics Authority has written to Health Secretary Matt Hancock to ask for clarification of whether that target is for testing capacity, the number of tests administered, the number of tests completed or the number of people tested. The Roche test is the "have I had it?" test.
A DHSC spokesperson told BBC News that the target was for a capacity of 200,000. It's not clear whether this means capacity in the labs or throughout the system. The daily government update on testing refers to the "do I have it now?" test.
Why was the 100,000 target set? Those tests, which take a swab up your nose or from the back of your throat, have been the main focus of the government's efforts so far.
Some, including NHS leaders, have suggested the reasoning behind the particular figure was unclear. Who can get tested - and where?
Health Secretary Matt Hancock said after the target had been reached that the "ambitious" goal had been designed to have a "galvanising effect".
Prof John Newton of Public Health England added: "We knew from our calculations that we would need something like this level of testing to be ready for the next phase of the response to the pandemic."
The UK significantly increased its testing capacity over the past month, although it lags behind many other nations. Germany, for example, was regularly averaging 100,000 tests a day by the start of April.
Who can get tested?
At first, across the UK, the focus was on the sickest patients in hospitals, followed by health, care and emergency services staff, then other essential workers and their families.At first, across the UK, the focus was on the sickest patients in hospitals, followed by health, care and emergency services staff, then other essential workers and their families.
Most recently in England, testing has been expanded to include anyone with symptoms who is:Most recently in England, testing has been expanded to include anyone with symptoms who is:
There have been serious problems containing the outbreak in care homes. After weeks of lockdown, it was announced that residents and staff of care homes in England could be tested even if they don't have symptoms. And residents and staff of care homes in England can be tested even if they don't have symptoms. There have been serious problems containing the outbreak in care homes.
Key workers across the UK who are self-isolating because they or a family member have coronavirus symptoms can be referred for a test by their employer or apply online.Key workers across the UK who are self-isolating because they or a family member have coronavirus symptoms can be referred for a test by their employer or apply online.
If a test is negative, a key worker can return to work if they are well enough, have not had a high temperature for 48 hours, and those living with them test negative.
How do the tests work?
The tests are done by taking a swab of the nose or throat, which is sent to a lab to spot signs of the virus's genetic material.
Those eligible can either attend a regional test site, or ask for a home test kit - although these have been in short supply.Those eligible can either attend a regional test site, or ask for a home test kit - although these have been in short supply.
The British Medical Association had said the accessibility of centres was a major problem, with some people having to drive hundreds of miles to their nearest site - especially difficult for people suffering symptoms of Covid-19. If a test is negative, a key worker can return to work if they are well enough, have not had a high temperature for 48 hours, and those living with them test negative.
The government has also admitted sending about 50,000 coronavirus tests to the US last week for processing after "operational issues" in UK labs. At first the British Medical Association said the accessibility of centres was a major problem, with some people having to drive hundreds of miles to their nearest site.
The Department of Health said sending swabs abroad is among the contingencies to deal with "teething problems". New testing centres have since been made available, although they still require people to have access to a car and someone to drive them - or be well enough to drive themselves.
The army was also enlisted to provide pop-up testing facilities in sparsely-populated areas far away from any of the main sites.
What was the 100,000 target?
The government set a target of 100,000 coronavirus tests per day across the UK by the end of April, and managed to log 122,347 tests on 30 April.
But it was criticised for including in this figure about 40,000 testing kits which are counted when they are sent out.
The target was also met on 1 May. It was missed for eight consecutive days after that before being met again on 10 May.
On 12 May, 87,063 tests were logged for 61,741 people (this figure is lower as some people need more than one test).
Now the government is working towards a fresh target to get to 200,000 tests a day by the end of May, but this figure seems to refer to testing "capacity", not the actual number of tests carried out.
Why is testing important?Why is testing important?
People are tested to diagnose them individually, but it can also be used to understand how far the virus has spread in the population.People are tested to diagnose them individually, but it can also be used to understand how far the virus has spread in the population.
For this second reason, a total of 20,000 households in England will be tested every month for a year - for active coronavirus infections and for antibodies indicating a past infection. Tests help people, including NHS workers, know whether they are safe to go to work, but wide testing can also let the health service plan for extra demand, and inform government decisions around social distancing and lockdowns.
It also helps people, including NHS workers, know whether they are safe to go to work. It can enable the health service plan for extra demand, and inform government decisions around social distancing and lockdowns. For this reason, an initial 20,000 households in England will be tested every month for a year - for active coronavirus infections and for antibodies indicating a past infection.
Has the UK been too slow in testing for coronavirus?Has the UK been too slow in testing for coronavirus?
The UK did not start with the resources to do mass testing, unlike some other countries. It also took several weeks to expand from an initial eight public health laboratories to a wider network of private and university labs. The UK significantly increased its testing capacity throughout April, but lagged behind many other nations. Germany, for example, was regularly averaging 100,000 tests a day, by the start of April.
The UK did not start with the resources to do mass testing, unlike some other countries.
But it also took several weeks to expand from an initial eight public health laboratories to a wider network of private and university labs.
Unlike the UK, countries like Germany and South Korea rapidly stockpiled kits and made the test available to a larger number of labs.Unlike the UK, countries like Germany and South Korea rapidly stockpiled kits and made the test available to a larger number of labs.
As of 29 April, the UK had carried out 8.83 tests per 1,000 people, whereas Italy had done 31.6 per 1,000, Germany 30.4 (as at 26 April) and South Korea 11.98, according to data collated by online scientific publication Our World in Data from official sources.
What about antibody tests?
An antibody test shows whether someone has already had the virus.
They work by looking for signs of immunity, by using a drop of blood on a device that works a bit like a pregnancy test.
No home antibody test has yet proved to be reliable enough to be used.
A more reliable antibody test is in use at the government's Porton Down laboratory, but it is currently being reserved to estimate population-level immunity - not to give individuals information about their infection status.
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