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U.K. Coronavirus Testers Pay Price for a Day of Triumph U.K. Coronavirus Testers Pay Price for a Day of Triumph
(about 16 hours later)
LONDON — On May 1, a visibly relieved Matt Hancock announced that the British government had exceeded its target of 100,000 coronavirus tests a day. As health secretary, Mr. Hancock had set the goal after enduring intense criticism for the country’s lagging coronavirus testing program.LONDON — On May 1, a visibly relieved Matt Hancock announced that the British government had exceeded its target of 100,000 coronavirus tests a day. As health secretary, Mr. Hancock had set the goal after enduring intense criticism for the country’s lagging coronavirus testing program.
He called the milestone “an incredible achievement.”He called the milestone “an incredible achievement.”
But leaked documents and interviews with doctors, lab directors and other experts show that the push to hit the April 30 deadline — and arguably salvage Mr. Hancock’s career — placed a huge strain on public laboratories and exposed other problems that are now slowing efforts to further expand coronavirus testing.But leaked documents and interviews with doctors, lab directors and other experts show that the push to hit the April 30 deadline — and arguably salvage Mr. Hancock’s career — placed a huge strain on public laboratories and exposed other problems that are now slowing efforts to further expand coronavirus testing.
Days before the deadline, some hospitals in England were given 48 hours to rapidly expand testing to thousands of health care workers and patients, even though they were not exhibiting any symptoms of the virus, the documents show.Days before the deadline, some hospitals in England were given 48 hours to rapidly expand testing to thousands of health care workers and patients, even though they were not exhibiting any symptoms of the virus, the documents show.
At the same time, public labs across the country raced through limited supplies of the chemical reagents needed to carry out a flood of tests after the government promised to replenish their supplies. Two weeks later, some labs still haven’t received the stocks they need, forcing some to reduce the number of new tests they can process, several lab managers said.At the same time, public labs across the country raced through limited supplies of the chemical reagents needed to carry out a flood of tests after the government promised to replenish their supplies. Two weeks later, some labs still haven’t received the stocks they need, forcing some to reduce the number of new tests they can process, several lab managers said.
“It was clear that the reason was for meeting the 100,000 target,” said Dr. Tom Gardiner, a junior doctor at St Mary’s Hospital in London, which received a call to urgently ramp up testing. “It was two days before the deadline, only lasted two days, and we haven’t heard it before or since,” he said.“It was clear that the reason was for meeting the 100,000 target,” said Dr. Tom Gardiner, a junior doctor at St Mary’s Hospital in London, which received a call to urgently ramp up testing. “It was two days before the deadline, only lasted two days, and we haven’t heard it before or since,” he said.
Britain has recorded the most coronavirus deaths of any country in Europe, and Prime Minister Boris Johnson and his Conservative government have come under mounting criticism for an often-inconsistent response to the pandemic, especially on testing.Britain has recorded the most coronavirus deaths of any country in Europe, and Prime Minister Boris Johnson and his Conservative government have come under mounting criticism for an often-inconsistent response to the pandemic, especially on testing.
The government had a slow start in rolling out mass testing, made an ill-fated initial decision to only process tests at one central laboratory and made an embarrassing purchase of millions of unproven antibody tests from China, after failing to ramp up domestic test production.The government had a slow start in rolling out mass testing, made an ill-fated initial decision to only process tests at one central laboratory and made an embarrassing purchase of millions of unproven antibody tests from China, after failing to ramp up domestic test production.
Even the country’s statistics regulator criticized the government’s testing target this week, calling for more “trustworthiness” around how it presents its data.Even the country’s statistics regulator criticized the government’s testing target this week, calling for more “trustworthiness” around how it presents its data.
Mr. Hancock set the 100,000-test target at the beginning of last month, in response to growing pressure. Now Mr. Johnson has promised to increase the daily capacity for testing to 200,000 — except the system still hasn’t recovered from the frantic push to reach the initial goal.Mr. Hancock set the 100,000-test target at the beginning of last month, in response to growing pressure. Now Mr. Johnson has promised to increase the daily capacity for testing to 200,000 — except the system still hasn’t recovered from the frantic push to reach the initial goal.
In the two weeks since April 30, the government’s number of daily tests initially slipped well below 100,000, where it has remained for every day but three. A major problem is that Britain has far fewer domestic producers of reagents than the United States, Germany and China, and huge global demand has made supplies scarce.In the two weeks since April 30, the government’s number of daily tests initially slipped well below 100,000, where it has remained for every day but three. A major problem is that Britain has far fewer domestic producers of reagents than the United States, Germany and China, and huge global demand has made supplies scarce.
“Since the 100,000 test target was passed, there appears to be a decline in the labs’ chemical reagents in terms of what they’re getting from the government,” said Allan Wilson, head of the Institute of Biomedical Sciences, which represents public lab workers. “It’s all hand-to-mouth, there’s no secure supply chain.”“Since the 100,000 test target was passed, there appears to be a decline in the labs’ chemical reagents in terms of what they’re getting from the government,” said Allan Wilson, head of the Institute of Biomedical Sciences, which represents public lab workers. “It’s all hand-to-mouth, there’s no secure supply chain.”
Mr. Wilson said the government needed to develop a coherent testing strategy, rather than set arbitrary targets that could be counterproductive when the country’s supply chain lacked necessary amounts not just of reagents but even of the cotton swabs needed for testing.Mr. Wilson said the government needed to develop a coherent testing strategy, rather than set arbitrary targets that could be counterproductive when the country’s supply chain lacked necessary amounts not just of reagents but even of the cotton swabs needed for testing.
“When we’re chronically short of tests and supplies, the government should be prioritizing those most in need instead of focusing on hitting a target,” said Bill Esterson, a Labour Party lawmaker who has been working closely with the country’s chemical industry.“When we’re chronically short of tests and supplies, the government should be prioritizing those most in need instead of focusing on hitting a target,” said Bill Esterson, a Labour Party lawmaker who has been working closely with the country’s chemical industry.
A spokesman from the Department of Health and Social Care insisted that all labs had adequate supplies of reagents and said it was working “tirelessly” to scale up capacity.A spokesman from the Department of Health and Social Care insisted that all labs had adequate supplies of reagents and said it was working “tirelessly” to scale up capacity.
“The scale and speed at which we have increased our testing capacity and rolled out mass testing is unprecedented and a real success,” the spokesman said.“The scale and speed at which we have increased our testing capacity and rolled out mass testing is unprecedented and a real success,” the spokesman said.
From the moment Mr. Hancock announced that the government had surpassed the April 30 goal — reaching 122,347 tests that day — he was accused of manipulating the numbers. It turned out that the government had counted more than 40,000 home testing kits and tests that had been sent to satellite health centers but not necessarily returned.From the moment Mr. Hancock announced that the government had surpassed the April 30 goal — reaching 122,347 tests that day — he was accused of manipulating the numbers. It turned out that the government had counted more than 40,000 home testing kits and tests that had been sent to satellite health centers but not necessarily returned.
More significantly, the government vastly expanded eligibility for testing in the week before the deadline. Ordinarily, expanding eligibility would be admirable, but the government did so even as it lacked adequate testing resources to keep up with the demand, or to process all the test results.More significantly, the government vastly expanded eligibility for testing in the week before the deadline. Ordinarily, expanding eligibility would be admirable, but the government did so even as it lacked adequate testing resources to keep up with the demand, or to process all the test results.
On April 28, just two days before the government’s deadline, only 52,429 daily tests had been carried out, barely half the target.On April 28, just two days before the government’s deadline, only 52,429 daily tests had been carried out, barely half the target.
That same evening, the hospital staff at Imperial College Healthcare N.H.S. Trust — a network made up of five major hospitals in north and west London — had received a frantic email calling for “at least” 1,500 staff to be tested over the next 48 hours, even if they had no symptoms.That same evening, the hospital staff at Imperial College Healthcare N.H.S. Trust — a network made up of five major hospitals in north and west London — had received a frantic email calling for “at least” 1,500 staff to be tested over the next 48 hours, even if they had no symptoms.
This was far more tests than the government had previously asked hospitals to conduct as part of a pilot study to understand coronavirus prevalence in hospitals, documents show. It also came with a new deadline of April 30, which coincided with the government’s own.This was far more tests than the government had previously asked hospitals to conduct as part of a pilot study to understand coronavirus prevalence in hospitals, documents show. It also came with a new deadline of April 30, which coincided with the government’s own.
“It’s clear someone has said ‘We need to meet this target in two days’ time,’” said Dr. Gardiner. “The fastest way is not to send round test kits, but to go to a site where lots of people are still working. That’s obviously a hospital.”“It’s clear someone has said ‘We need to meet this target in two days’ time,’” said Dr. Gardiner. “The fastest way is not to send round test kits, but to go to a site where lots of people are still working. That’s obviously a hospital.”
Staff members were blindsided, but the hospitals quickly responded, testing more than 2,000 workers by the following day, internal emails show. The day after that, the government hit its target.Staff members were blindsided, but the hospitals quickly responded, testing more than 2,000 workers by the following day, internal emails show. The day after that, the government hit its target.
But problems quickly emerged at hospital labs across the country. The chemical reagent stocks the government had promised to replenish were not delivered in their weekly allocation. Some received significantly less than they had asked for while others received none, several lab managers said.But problems quickly emerged at hospital labs across the country. The chemical reagent stocks the government had promised to replenish were not delivered in their weekly allocation. Some received significantly less than they had asked for while others received none, several lab managers said.
Updated June 22, 2020 Updated June 24, 2020
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
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.
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.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.
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.
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.
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.)
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.
One senior lab manager, who helped coordinate the rush testing at the Imperial College network, said they were initially asked to carry out up to 800 tests over 48 hours, but that was ramped up to 2,600. To do this meant labs had to risk exhausting their reagents rather than keeping supplies in hand for the following week’s tests, said the manager, who spoke on condition of anonymity because the N.H.S. forbids speaking publicly without permission.One senior lab manager, who helped coordinate the rush testing at the Imperial College network, said they were initially asked to carry out up to 800 tests over 48 hours, but that was ramped up to 2,600. To do this meant labs had to risk exhausting their reagents rather than keeping supplies in hand for the following week’s tests, said the manager, who spoke on condition of anonymity because the N.H.S. forbids speaking publicly without permission.
The next week, the government provided the manager’s labs with 15 percent fewer test kits than needed — but other labs had fared far worse, the manager said, with reagent stocks at several London hospitals “semi-decimated.”The next week, the government provided the manager’s labs with 15 percent fewer test kits than needed — but other labs had fared far worse, the manager said, with reagent stocks at several London hospitals “semi-decimated.”
In one case, the manager donated the lab’s entire remaining stock of 196 test kits to South West Pathology, a lab network where the managers said one hospital had run out of reagents entirely after ramping up their testing before the government deadline.In one case, the manager donated the lab’s entire remaining stock of 196 test kits to South West Pathology, a lab network where the managers said one hospital had run out of reagents entirely after ramping up their testing before the government deadline.
Last week, the British news outlet The Independent reported on a leaked email from South West Pathology that said one of its London hospitals had been forced to restrict testing to symptomatic patients and staff, because of a shortage of chemical reagents — on the same day that Boris Johnson announced the new 200,000 test target.Last week, the British news outlet The Independent reported on a leaked email from South West Pathology that said one of its London hospitals had been forced to restrict testing to symptomatic patients and staff, because of a shortage of chemical reagents — on the same day that Boris Johnson announced the new 200,000 test target.
South West Pathology said in a statement that it was continuing to offer a “comprehensive” testing service for all symptomatic patients and workers at all its hospitals.South West Pathology said in a statement that it was continuing to offer a “comprehensive” testing service for all symptomatic patients and workers at all its hospitals.
Mr. Wilson, president of the Institute of Biomedical Sciences, said he had heard anecdotal evidence about reagent shortages “across the country” since the government passed its 100,000 target. Last week, one lab in the Midlands only received a fifth of the reagents it was expecting to get from the government, he said.Mr. Wilson, president of the Institute of Biomedical Sciences, said he had heard anecdotal evidence about reagent shortages “across the country” since the government passed its 100,000 target. Last week, one lab in the Midlands only received a fifth of the reagents it was expecting to get from the government, he said.
Further north, a network of labs held an emergency meeting on Monday, because they had not received a large enough allocation of reagents to carry out the tests asked of them. One senior lab manager said that her own lab had only received 300 kits, compared with 1,200 at peak supply, and that their biggest lab did not receive any stocks.Further north, a network of labs held an emergency meeting on Monday, because they had not received a large enough allocation of reagents to carry out the tests asked of them. One senior lab manager said that her own lab had only received 300 kits, compared with 1,200 at peak supply, and that their biggest lab did not receive any stocks.
“It’s the biggest reagent shortage by a significant mile that we’ve had since the outbreak, and it’s at least partly due to the 100,000 test target,” said the manager in the north, speaking on condition of anonymity because she did not have permission to discuss the matter publicly.“It’s the biggest reagent shortage by a significant mile that we’ve had since the outbreak, and it’s at least partly due to the 100,000 test target,” said the manager in the north, speaking on condition of anonymity because she did not have permission to discuss the matter publicly.
N.H.S. England said that its labs had successfully expanded daily testing capacity and that all labs worked together to share, “where necessary,” the supplies needed to process coronavirus tests.N.H.S. England said that its labs had successfully expanded daily testing capacity and that all labs worked together to share, “where necessary,” the supplies needed to process coronavirus tests.
A leaked briefing document shows that N.H.S. labs were running at around 75 percent capacity over three days last week — while central labs run by Public Health England, an arm of the government, were running at around 65 percent capacity.A leaked briefing document shows that N.H.S. labs were running at around 75 percent capacity over three days last week — while central labs run by Public Health England, an arm of the government, were running at around 65 percent capacity.
The biggest fear for health care workers is that testing to meet a target could lead to shortages of supplies which leave the sickest and most vulnerable without a test when they need it.The biggest fear for health care workers is that testing to meet a target could lead to shortages of supplies which leave the sickest and most vulnerable without a test when they need it.
“It’s dangerously arbitrary,” said Dr. Gardiner, who added: “We’ve met this one target and it’s given the perception to the public that we’re doing enough on testing, when clearly we are not.”“It’s dangerously arbitrary,” said Dr. Gardiner, who added: “We’ve met this one target and it’s given the perception to the public that we’re doing enough on testing, when clearly we are not.”