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Less Moonshot, ‘more like Apollo 13’: Doubts raised as leaked doc reveals plans for 10 million tests

Written by on 10 September 2020

Leaked documents reportedly show the government plans to carry out up to 10 million coronavirus tests a day by early next year, but critics have branded the proposals “waste on a cosmic scale”.

The mass testing programme would cost GBP100bn – almost as much as the government spends on the NHS each year (GBP130bn) – according to a briefing memo seen by medical journal The BMJ.

A separate document revealed there were plans to grow the UK’s testing capacity from the current 350,000 a day to up to 10 million a day by early 2021.

Operation ‘moonshot’ – PM sets out plan for testing ‘millions’ of people a day

On Wednesday, Prime Minister Boris Johnson announced ambitious plans for millions of people to be tested for coronavirus every day, in what he characterised as the “Moonshot approach”.

These documents provide more detail on what the government hopes to achieve, including plans for private companies GSK, AstraZeneca, Serco and G4S to help carry out the proposals.

But some scientists have already expressed doubts, while a document published by the government’s scientific advisory group (SAGE) last week warned mass testing could lead to an increased number of false positive results.

Anthony Costello, a former World Health Organisation director and UCL professor, wrote on Twitter: “The PMs Moonshot nonsense (no science, feasibility, evidence) has been earmarked for GBP100bn, almost the entire NHS budget, w contracts for Astra, Serco and G4S.

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“This is waste/corruption on a cosmic scale.”

Others pointed out current problems with the existing test and trace programme, which has raised concern in recent days after people complained of having to travel hundreds of miles from home to take a test.

“This plan transmits unbounded optimism, disregarding the enormous problems with the existing testing and tracing programmes,” Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, told The BMJ.

“It focuses on only one part of the problem, testing, and says nothing about what will happen to those found positive, a particular concern given the low proportion of those who do adhere to advice to isolate – in part because of the lack of support they are offered.”

He added: “On the basis of what is presented here, this looks less like Apollo 11, which took Neil Armstrong to the moon successfully, and more like Apollo 13.”

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Professor Jose Vazquez-Boland, chairman of infectious diseases, University of Edinburgh, was more optimistic about the plans.

“The focus of testing currently remains on confirmation of suspected cases (people with symptoms), thus missing the point that most community transmission comes from those who are asymptomatic,” he said.

“Only a mass screening programme, such as this alternative plan announced by the prime minister, which involves the regular testing of all the population for asymptomatic transmitters, can keep COVID-19 under control and eventually lead to its eradication.”

In a document published on Friday, SAGE said the cheaper and faster tests needed for mass testing were less likely to be able to correctly identify positive and negatives than the tests currently used by NHS Test and Trace.

Nurses help NHS workers as they self swab
Image:
Nurses help NHS workers as they self swab

It said that in a population with low infections, twice-weekly tests with 99% specificity would lead to 41% of the population receiving a false positive over six months.

“In such circumstances, rapid follow-up confirmatory testing will be needed to determine whether individuals should continue to self-isolate – it is important to rapidly isolate infectious individuals, but efforts will be needed to quickly release false positives,” it said.

But the committee did say using testing as a point-of-entry requirements for particular settings, such as sporting events, could help these activities resume with a reduced risk of transmission, but would “require superb organisation and logistics with rapid, highly-sensitive tests”.

Under the plans, the Whitehall briefing memo says testing will be rolled out in workplaces, football stadiums, entertainment venues and also at GP surgeries, pharmacies, schools and other local sites.

Coronavirus infections are rising among young people - these charts show where

Coronavirus infections are rising among young people – these charts show where

People will be given digital immunity passports that would allow those who test negative to take part in more normal activities.

Those in high-risk occupations or who are more vulnerable – such as hospital staff, ethnic minority groups and teachers – would be prioritised for regular testing.

The government is banking on technology that “currently does not exist”, the briefing memo says, including a rapid 20-minute saliva test being piloted in Salford, Greater Manchester.

Dr David Strain, clinical senior lecturer at the University of Exeter and chairman of the BMA’s medical academic staff committee, said this means the mass testing strategy is “fundamentally flawed”.

“The prime minister’s suggestion that this will be as simple as ‘getting a pregnancy test’ that will give results within 15 minutes is unlikely, if not impossible, in the timescale he was suggesting to get the country back on track,” he said.