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After Lost Months, Britain Vows to Catch Up on Virus Testing | After Lost Months, Britain Vows to Catch Up on Virus Testing |
(32 minutes later) | |
LONDON — When Prime Minister Boris Johnson spoke to the British people from isolation on Wednesday, still suffering his own bout of the coronavirus, he said the key to overcoming the pandemic was more testing. “This is how we will unlock the coronavirus puzzle,” he said in a shaky, hand-held video. | LONDON — When Prime Minister Boris Johnson spoke to the British people from isolation on Wednesday, still suffering his own bout of the coronavirus, he said the key to overcoming the pandemic was more testing. “This is how we will unlock the coronavirus puzzle,” he said in a shaky, hand-held video. |
In fact, the British government came very late to the recognition that testing for the virus is a key part of fighting it, by helping to slow transmission. That failure has set off an outcry in the country. The government’s tardiness has left Britain with an undersupplied and poorly coordinated testing program that has reached only a fraction of the people tested in countries like Germany or South Korea. | In fact, the British government came very late to the recognition that testing for the virus is a key part of fighting it, by helping to slow transmission. That failure has set off an outcry in the country. The government’s tardiness has left Britain with an undersupplied and poorly coordinated testing program that has reached only a fraction of the people tested in countries like Germany or South Korea. |
The shortfall has frustrated doctors and nurses, who often have not had access themselves to tests despite potential exposure to the virus and who cannot quickly determine if patients have it. It has angered public-health experts, who say Britain is squandering valuable time during the lockdown that it could be using to get a better fix on the spread of the virus in the population. | The shortfall has frustrated doctors and nurses, who often have not had access themselves to tests despite potential exposure to the virus and who cannot quickly determine if patients have it. It has angered public-health experts, who say Britain is squandering valuable time during the lockdown that it could be using to get a better fix on the spread of the virus in the population. |
Front-line doctors and nurses in the United States, where testing is now being ramped up, complained for weeks of similar deficiencies. | Front-line doctors and nurses in the United States, where testing is now being ramped up, complained for weeks of similar deficiencies. |
In Britain, the testing gap has generated a flood of outraged headlines, even in newspapers normally cozy with Mr. Johnson’s Conservative government. “Virus testing plans in chaos,” said The Times of London. “Questions without answers,” declared The Daily Telegraph. “500,000 NHS Staff,” said The Daily Mail. “Only 2,000 Tested.” | In Britain, the testing gap has generated a flood of outraged headlines, even in newspapers normally cozy with Mr. Johnson’s Conservative government. “Virus testing plans in chaos,” said The Times of London. “Questions without answers,” declared The Daily Telegraph. “500,000 NHS Staff,” said The Daily Mail. “Only 2,000 Tested.” |
Under intense pressure, the health secretary, Matt Hancock, rolled out an ambitious plan on Thursday to rapidly expand testing, especially among health workers. Mr. Hancock, who himself had just emerged from isolation after contracting the virus, vowed that Britain would conduct 100,000 tests a day by the end of April, a tenfold increase over today. | Under intense pressure, the health secretary, Matt Hancock, rolled out an ambitious plan on Thursday to rapidly expand testing, especially among health workers. Mr. Hancock, who himself had just emerged from isolation after contracting the virus, vowed that Britain would conduct 100,000 tests a day by the end of April, a tenfold increase over today. |
“Our ultimate goal is that anyone who needs a test shall have one,” he said at a briefing at 10 Downing Street. | “Our ultimate goal is that anyone who needs a test shall have one,” he said at a briefing at 10 Downing Street. |
Britain has conducted 163,194 coronavirus tests since the outbreak began, the vast majority on patients who are admitted to the hospital with symptoms of the disease. Germany has conducted more than 900,000 tests and is carrying out more than 50,000 a day — a disparity that many in Britain find inexplicable, given their country’s advanced research and medical industries. | Britain has conducted 163,194 coronavirus tests since the outbreak began, the vast majority on patients who are admitted to the hospital with symptoms of the disease. Germany has conducted more than 900,000 tests and is carrying out more than 50,000 a day — a disparity that many in Britain find inexplicable, given their country’s advanced research and medical industries. |
Mr. Hancock fell back on a familiar defense — that Britain lacks a robust diagnostic industry like that in Germany. He said the government was grappling with a worldwide shortage in the swabs and chemical agents used in tests. | Mr. Hancock fell back on a familiar defense — that Britain lacks a robust diagnostic industry like that in Germany. He said the government was grappling with a worldwide shortage in the swabs and chemical agents used in tests. |
But he said the government was now collaborating with an array of private companies to supply tests — a strategy that some have likened to the flotilla of boats that helped evacuate Allied troops from Dunkirk during World War II. | But he said the government was now collaborating with an array of private companies to supply tests — a strategy that some have likened to the flotilla of boats that helped evacuate Allied troops from Dunkirk during World War II. |
Britain’s sluggish start in testing, several experts said, is rooted in the government’s overly relaxed early response to the virus. In meetings from late January to early March, the government’s scientific advisory group underestimated both the lethality of the virus and how fast it was spreading, according to published minutes from several of those meetings. | Britain’s sluggish start in testing, several experts said, is rooted in the government’s overly relaxed early response to the virus. In meetings from late January to early March, the government’s scientific advisory group underestimated both the lethality of the virus and how fast it was spreading, according to published minutes from several of those meetings. |
Those miscalculations led the government to briefly consider a laissez-faire strategy in which the virus would be allowed to spread through the population with minimal checks, infecting a large percentage of people and building up their natural immunity. Such a “herd immunity,” experts said, would make the country more resilient to a second outbreak of the virus in the fall or winter. | Those miscalculations led the government to briefly consider a laissez-faire strategy in which the virus would be allowed to spread through the population with minimal checks, infecting a large percentage of people and building up their natural immunity. Such a “herd immunity,” experts said, would make the country more resilient to a second outbreak of the virus in the fall or winter. |
In such a scenario, intensive testing and contract tracing — of the kind used in South Korea, Singapore and Germany — was deemed not worthwhile. And lacking the resources to rapidly mount a broad-scale testing program, the government decided to limit testing to people admitted to hospitals. | In such a scenario, intensive testing and contract tracing — of the kind used in South Korea, Singapore and Germany — was deemed not worthwhile. And lacking the resources to rapidly mount a broad-scale testing program, the government decided to limit testing to people admitted to hospitals. |
“Their thinking was, ‘Mass testing at that scale is not possible, it’s not feasible and what’s the point because the virus is already everywhere,’” said Devi Sridhar, director of the global health governance program at Edinburgh University. The government, she said, treated coronavirus like the ordinary flu. | “Their thinking was, ‘Mass testing at that scale is not possible, it’s not feasible and what’s the point because the virus is already everywhere,’” said Devi Sridhar, director of the global health governance program at Edinburgh University. The government, she said, treated coronavirus like the ordinary flu. |
Bureaucracy played a part, too. Unlike South Korea, where the government gathered private companies in January to encourage the speedy production of tests, Britain left testing in the hands of its main health agency, Public Health England. It kept tight control over the standards for tests and discouraged private clinics, labs or companies from developing their own tests. | Bureaucracy played a part, too. Unlike South Korea, where the government gathered private companies in January to encourage the speedy production of tests, Britain left testing in the hands of its main health agency, Public Health England. It kept tight control over the standards for tests and discouraged private clinics, labs or companies from developing their own tests. |
“We could have gone to this industry and said to them, ‘We’re going to need testing kits, we’re going to need swabs, we’re going to need a shopping list of items,’” said Bharat Pankania, an expert in infectious disease at the University of Exeter Medical School. “If you never put that call out, you won’t get it.” | “We could have gone to this industry and said to them, ‘We’re going to need testing kits, we’re going to need swabs, we’re going to need a shopping list of items,’” said Bharat Pankania, an expert in infectious disease at the University of Exeter Medical School. “If you never put that call out, you won’t get it.” |
In mid-March, the government abruptly shifted course to a more aggressive strategy of trying to suppress the virus. That was prompted by a stark new report from Imperial College London which used data from Italy to project much higher rates for both hospitalizations and deaths. Letting the virus spread completely unchecked, it warned, would crush the health system and could lead to 510,000 deaths. | In mid-March, the government abruptly shifted course to a more aggressive strategy of trying to suppress the virus. That was prompted by a stark new report from Imperial College London which used data from Italy to project much higher rates for both hospitalizations and deaths. Letting the virus spread completely unchecked, it warned, would crush the health system and could lead to 510,000 deaths. |
(Dire projections from that same study, American officials said, helped persuade President Trump to make an about-turn, from playing down the risks to Americans to embracing more stringent public health measures.) | (Dire projections from that same study, American officials said, helped persuade President Trump to make an about-turn, from playing down the risks to Americans to embracing more stringent public health measures.) |
But the government had lost precious time. “They made the unscientific decision not to test,” Dr. Pankania said. “Having made that critical decision, they didn’t put into process the things you need to do to test en masse.” | But the government had lost precious time. “They made the unscientific decision not to test,” Dr. Pankania said. “Having made that critical decision, they didn’t put into process the things you need to do to test en masse.” |
Updated June 5, 2020 | |
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
Now the government is racing to catch up. It has expanded testing among health workers and is setting up drive-through testing sites in the parking lots of large stores. A laboratory to process tests is opening soon in the town of Milton Keynes, with others to follow soon in Cheshire and in Glasgow, Scotland. | Now the government is racing to catch up. It has expanded testing among health workers and is setting up drive-through testing sites in the parking lots of large stores. A laboratory to process tests is opening soon in the town of Milton Keynes, with others to follow soon in Cheshire and in Glasgow, Scotland. |
Mr. Hancock said Thursday that 5,000 employees of the National Health Service had been tested — an improvement over Wednesday, but still just one percent of the total work force. He said that 5.7 percent of the doctors are out, either because they are sick or fear they are infected with the virus. | Mr. Hancock said Thursday that 5,000 employees of the National Health Service had been tested — an improvement over Wednesday, but still just one percent of the total work force. He said that 5.7 percent of the doctors are out, either because they are sick or fear they are infected with the virus. |
There are other signs of hope. Much as some American companies are developing new kinds of testing kits, a small technology company in Cambridge has adapted a machine used to test for H.I.V. to test for the coronavirus. The machine delivers results in 90 minutes rather than 24 hours, which is wait for most tests. It has been successfully tested at a hospital in Cambridge and could be mass-produced to test doctors, nurses and other health workers. | There are other signs of hope. Much as some American companies are developing new kinds of testing kits, a small technology company in Cambridge has adapted a machine used to test for H.I.V. to test for the coronavirus. The machine delivers results in 90 minutes rather than 24 hours, which is wait for most tests. It has been successfully tested at a hospital in Cambridge and could be mass-produced to test doctors, nurses and other health workers. |
But there is also plenty of finger-pointing within the British health system. Paul Cosford, the emeritus medical director at Public Health England, told the BBC on Thursday that it was the job of another organization, the Office for Life Sciences, to bring in other organizations, charities and the private sector. | But there is also plenty of finger-pointing within the British health system. Paul Cosford, the emeritus medical director at Public Health England, told the BBC on Thursday that it was the job of another organization, the Office for Life Sciences, to bring in other organizations, charities and the private sector. |
As the political heat has intensified, so has the confusion. On Wednesday, as Mr. Johnson was issuing his video from isolation, the deputy chief medical officer, Jonathan Van Tam, told ITV that testing was a “side issue” when it comes to reducing fatalities. His argument was echoed by a government health minister, Nadine Dorries, who has herself recovered after being infected by the virus. | As the political heat has intensified, so has the confusion. On Wednesday, as Mr. Johnson was issuing his video from isolation, the deputy chief medical officer, Jonathan Van Tam, told ITV that testing was a “side issue” when it comes to reducing fatalities. His argument was echoed by a government health minister, Nadine Dorries, who has herself recovered after being infected by the virus. |
“Testing is not a cure, it won’t cut the number of deaths, it won’t make people feel better or stop them catching #coronavirus it will only tell you if you have or have had it,” she wrote on Twitter. She called it “media hype,” adding, “There is as yet, no treatment, no cure, no vaccine and no amount of tests will alter that fact.” | “Testing is not a cure, it won’t cut the number of deaths, it won’t make people feel better or stop them catching #coronavirus it will only tell you if you have or have had it,” she wrote on Twitter. She called it “media hype,” adding, “There is as yet, no treatment, no cure, no vaccine and no amount of tests will alter that fact.” |
Medical experts lamented the mixed messages from health officials. | Medical experts lamented the mixed messages from health officials. |
To lift the lockdown, they said, Britain would have to conduct further testing and pursue contact tracing of those who may have been exposed to the virus and if necessary isolate them. They pointed out that people would likely have to undergo repeated tests to make sure they are free of infection. Otherwise, the country will face another wave of contagion. | To lift the lockdown, they said, Britain would have to conduct further testing and pursue contact tracing of those who may have been exposed to the virus and if necessary isolate them. They pointed out that people would likely have to undergo repeated tests to make sure they are free of infection. Otherwise, the country will face another wave of contagion. |
“We need to have a longer-term strategy,” Dr. Sridhar said. “We’re late, but there’s no other way out.” | “We need to have a longer-term strategy,” Dr. Sridhar said. “We’re late, but there’s no other way out.” |