Thu 1 October 2020

Stephen Colegrave reports on why two NHS doctors have written to Boris Johnson with their recommendation that only mass testing can now prevent a significant number of COVID-19 deaths in the UK.

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Only mass testing for Coronavirus can prevent 70% of the deaths related to it at this stage of the UK’s outbreak of COVID-19, two NHS doctors believe.

Nick Morris and Sanjeev Silva – who are not epidemiologists but senior consultants in the fields of obstetrics and gynaecology, and ENT/ head and neck surgery respectively – have sent a letter to Conservative MP Jeremy Hunt, chair of Parliament’s Health and Social Care Committee, and to Boris Johnson, which sets out a protocol for mass testing and locking down areas most at risk of infection based on this testing, as well as information about the types of testing required, where to obtain them and the cost – which they put at £6 billion.

Byline Times understands that Hunt – who raised concerns about the Government’s initial handling of the Coronavirus crisis – was supportive and has passed the letter to the Department of Health and Social Care.

There is strong evidence to back the doctors’ case.

Mass testing in South Korea and Singapore and in parts of Europe seems to have been effective in slowing down the spread of the Coronavirus. Germany has been testing at least four times as many people per population as the UK and, as a result, has the lowest morbidity per capita of cases recorded in Europe to date.

Dr Morris said that he is in daily contact with a colleague in Italy’s worst-hit region, Lombardy, and that “testing is the vaccine until there is a vaccine”.

“Testing once verified will allow the NHS and general workforce to be maximised as people who are immune or free of virus can return to normal life and the those effected isolated – it’s not complicated it’s easy,” he said.

The Prime Minister has suggested that new tests will be ready in the coming days, but Dr Silva is convinced that they are available and ready now. With the help of a colleague in Bejiing, who has a very good working knowledge of molecular biology, he has analysed many tests from hundreds of companies.

“These tech companies now have the ability to airfreight millions of test kits to the UK immediately,” he said. “We need the political will to set up testing centres right across the country imminently.”

The IgG test, for instance, which Johnson has referred to previously, is already available and appears to be perfect for mass testing. Performed as a finger-prick blood test, it provides a quick result within 15 minutes. Its accuracy can then be improved by testing positive samples with the RT PCR Test, a protein test taken by a throat swab or blood sample. This test takes two hours for the results to be obtained and requires laboratory equipment and skilled staff.

Dr Silva has found 21 antibody test kit companies in China and the antibody product he recommends, which is available in large quantities, has Chinese FDA registration, with reliable and reproducible results that should get immediate UK approval. There are also 126 PCR test companies with plenty of stock.

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In their suggested protocol to implement mass testing to prevent 70% of COVID-19 deaths from occurring, the doctors prioritise the immediate testing of all NHS frontline staff – about 500,000 people – with the finger-prick IgG test.

Anyone who tests positive should then be screened using the PCR test – the result of which will either be positive, meaning that the person is infectious and will need to self-isolate, or negative meaning that the person is immune. Such testing would prevent the spread of the virus before individuals start to show symptoms, and significantly increase the capacity of the NHS workforce as it would prevent unnecessary self-isolation.

The protocol goes on to recommend mass testing nationally to identify which of the following three groups the population falls into: ‘not-infected’, who can continue social distancing measures or go to work as a frontline essential worker; ‘infected’, who need to self-isolate or receive medical care if their condition warrants it; and ‘previously infected’, who can safely go back to work.

At a population level, this data would also be important as it would help to identify infection hotspots that could be locked down and also to forecast likely levels of demand for healthcare. Both of these factors are crucial for successful management of this pandemic, according to Dr Silva and Dr Morris.

Mass testing has to be a priority and, considering that hundreds of billions of pounds has been found to support workers and businesses, the £6 billion required to pay for this as suggested by Dr Silva and Dr Morris must be found. We must also not accept any more delays in acquiring millions of IgG tests. The UK cannot delay any longer on these measures – the saving of thousands of lives depends on it.

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