If I were health secretary I would have a weekly report by NHS Trust on the percentage of ‘COVID’ ITU admissions that have ground glass changes on chest CT (which are characteristic of COVID but may not be seen in absolutely every case). 1/14

Ditto for hospital admissions. The data on admissions, ITU admissions and deaths can deceive without corroborative evidence such as this. 2/14

5% of tests from each region would be sent for testing in a laboratory with a low positive percentage rate as a quality control measure. 3/14

Cases would be defined by symptoms except in exceptional circumstances. An asymptomatic positive result would not count as a case. They never should have been. 4/14

Where a patient had direct contact with a definite case and was asymptomatic. Their positive result would be retested from scratch with a different test kit and only confirmed as positive if this test too was positive. 5/14

Regardless of symptoms no cases would be diagnosed in a child without a second corroborative positive test. 6/14

Screening of asymptomatic students and children would be banned.(As would restricting the freedoms of the asymptomatic - although that’s probably already illegal). Door to door testing and testing stalls on the street would be banned. 7/14

Any testing of the already deceased by nurses or mortuary staff would be banned. Only testing of multiple organs at post mortem by a pathologist would be allowed. 8/14

Screening of care homes and staff would stop. There would be plenty of tests available to test residents + staff if there is an outbreak of an infectious respiratory infection. If another virus was present that could account for the outbreak then COVID would require confirmation.

Hospital screening of admissions would cease. Testing on admissions would continue for those with cough, low oxygen saturations (without heart problems), ground glass chest CT changes, fever or loss of smell. 10/14

A positive test taken on an inpatient with symptoms, later during their stay, will only be diagnosed as a case with a corroborative test, taken from scratch and tested at a different lab or in the presence of ground glass chest CT findings. 11/14

In areas with minimal cases, there would be a post mortem audit of a proportion of deaths to confirm the diagnosis.12/14

Loss of smell would be used as a gateway to testing in the community. Sensitive testing is only needed during the exponential growth thereafter specificity is needed to correctly diagnose *an outbreak*. Having diagnosed an outbreak switch to sensitive testing of contacts. 13/14

Screening would start for all of those involved in the testing “chain of evidence” from delivery men to lab receptionists. Any + asymptomatics would be stopped from processing tests. (But I would not count as a case or be isolated). 14/14