Lockdown lifts when we& #39;re confident we can contain Covid. This can only be achieved through mass test and trace. What does this look like in practice and how far is UK from implementing it? A thread on my paper for @InstituteGC written w/ @DanielSleat @BJMCooney @InsallLizzie

Firstly, it& #39;s the UK. You can& #39;t have a plan without a mnemonic.

𝗦creen. 𝗧race. 𝗜solate/Immunity. 𝗥epeat.

Well hello 𝗦𝗧𝗜𝗥.

Now, those four areas have a few sticky issues under them: accuracy,supply,scale,... and some whopper ethical and privacy questions. Let& #39;s discuss.

Accuracy: Can you 𝘳𝘦𝘢𝘭𝘭𝘺 reliably screen on tests that are only 70% accurate? Below is @paulmromer excellent modelling on that.
Blue triangles = uninfected.
Red = infectious.
Purple squares = recovered and immune.

The result? Eventually, false negatives are caught.

“But…" I hear you cry, "didn’t Oxford slam Romer!!?” ( https://www.inet.ox.ac.uk/files/stratified_periodic_testing_2_p.pdf).">https://www.inet.ox.ac.uk/files/str...

They did (politely) but not on
a) on the need for mass testing and they agreed b) you can use tests with lower accuracy (https://abs.twimg.com/emoji/v2/... draggable="false" alt="📷" title="Camera" aria-label="Emoji: Camera">= delightful footnote.)

Romer& #39;s blog says more: https://paulromer.net/ ">https://paulromer.net/">...

Supply: Where do we get our hands on these less-than-accurate tests?

https://abs.twimg.com/emoji/v2/... draggable="false" alt="👩‍🔬" title="Woman scientist" aria-label="Emoji: Woman scientist">Antigen: Procure promising non-lab rapid tests being used elsewhere AND let& #39;s use ALL available labs
https://abs.twimg.com/emoji/v2/... draggable="false" alt="💉" title="Syringe" aria-label="Emoji: Syringe">Antibody. These exist in the millions and we could get some now (Google UK-based BioPanda for example)

"Boss" as my scouse nan would say. We& #39;ve got the tests. Now what? We need to 𝘀𝗰𝗮𝗹𝗲 them.

The government must lay ground for community testing now. Responsibility should broaden beyond NHS Acute Trusts to local authorities and private sector. This isn& #39;t happening... yet.

We need to boost production too. Dunkirk, a famous film, had little boats. Sir Paul Nurse called for the same in Covid. How can we better coordinate all small suppliers, spaces to make tests? Arise a new MINISTRY FOR TESTING overseeing everything.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🛡️" title="Shield" aria-label="Emoji: Shield">SHIELDINGhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🛡️" title="Shield" aria-label="Emoji: Shield"> There are a few groups we need to protect through targeted lockdown. We should prepare now by making sure they have food, support, company and info. Do these people need to be tested? Only if they& #39;re coming into contact with others. This means more testing capacity.

Let& #39;s quickly turn our head to the ethical question of immunity certificates. Wouldn& #39;t this create a perverse incentive for folk to get the disease in order to return to work?

No. We& #39;d make it a tool to remove people from mass testing pool - not to determine if they can work.

Then the privacy question of tracing app (https://abs.twimg.com/emoji/v2/... draggable="false" alt="📷" title="Camera" aria-label="Emoji: Camera">=https://abs.twimg.com/emoji/v2/... draggable="false" alt="🇸🇬" title="Flag of Singapore" aria-label="Emoji: Flag of Singapore">). It& #39;d be voluntary but we& #39;d incentivise downloading through free socially-distanced hugs and freedom to work. Critically, we also call for complementary offline tracing built into community testing. https://abs.twimg.com/emoji/v2/... draggable="false" alt="👏" title="Clapping hands sign" aria-label="Emoji: Clapping hands sign">Prephttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👏" title="Clapping hands sign" aria-label="Emoji: Clapping hands sign">shouldhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👏" title="Clapping hands sign" aria-label="Emoji: Clapping hands sign"> starthttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👏" title="Clapping hands sign" aria-label="Emoji: Clapping hands sign"> nowhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👏" title="Clapping hands sign" aria-label="Emoji: Clapping hands sign">

This is a flavour of what& #39;s in our paper. Loads of questions, some suggestions of answer, a crucial debate about mass testing.

We all agree we need it... how do we do it?

Read the paper here: https://institute.global/tony-blair/path-mass-testing">https://institute.global/tony-blai...