WHAT'S HAPPENING WITH TESTING? (thread)

The government set the 31st October to reach its 500,000 tests a day target

Has it reached it?

It says it's about to do so on capacity. But for a host of reasons, that's not the whole story.

Read on.

As of tonight, this is where are on testing

Testing capacity: 480,961

So very near the 500k target

tests processed: 347,626

A long way of the 500k target

The difference?

The govt defines capacity as: “Projected lab capacity is an estimate of each lab’s constrained capacity each day based on the staff, chemical reagents and other resources it has available.”

Processed tests are the number of tests actually conducted and analysed.

The big leap in capacity has been in Pillar 1- NHS and PHE testing. Note it has suddenly doubled in the last five days. But the max number of tests processed hasn't increased much. We nearly hit 347,000 on 23rd October and we're just above that number now.

...So we can't know for sure how much of this capacity which has suddenly materialised into Pillar 1 (after government says, extra investment) will actually translate into sustained daily increases in tests *processed*.

Doubtless it will but up to 500,000? Given capacity has consistently outstripped tests processed, that seems unlikely.

As one scientist who works in an NHS lab told me on the capacity calculation process that each lab undertakes:

"..."what can you is sit down and calculate what you can do in a perfect situation. But we know it's not deliverable. These are very delicate piece of machinery. They have a tendency to break. They need to be maintained. And again, looked after it again, there has to be the..."

"...availability of the reactions or the chemicals. They have to have enough swabs. You have to have enough staff. It's very much what can be done on a perfect day. You can in a perfect synchronised situation [but usually] it doesn't work."

And then there's numbers of people...

We know that 500,000 is not going to be 500,000 people. Nor will the 350,000 processed figure. As someone else who has worked in these sorts of laboratories tells me:

"When you when you run a laboratory, you've got all sorts of clinical protocols about accuracy and efficacy...

"...of tests where you take control samples. So you're not literally processing five hundred thousand people's tests. You might be doing a number of tests on the same sample."

And of course there will be people who are routinely tested so that eats into the weekly slack.

I've also been told by one union rep and scientist, that he's heard reports of scientists running laboratories feeling pressured to give very optimistic assessments of their capacity. Government says this process is audited independently. But without actually...

...having the proof of the pudding, of actually reaching 500,000 tests processed, we simply can't be sure whether that capacity could be filled on one day, much less over a sustained period.

And there's turnaround time. This has definitely improved but there's still much to do. I spoke to one care provider this week who told me that only a few weeks ago it still wasn't uncommon for them to be waiting a five days to a week for results. Sometimes they'd...

...be doing the second round of testing on their staff before even receiving the results back. That does seem to have improved- with results now coming back within 2-3 days. But that's still too long for some settings, especially care homes and especially for care home visitation

Bear in mind care home staff are currently being tested once a week. That really isn't enough, especially with turnaround of 48hrs or more. Care providers would like to be doing it 2-3 times a week. With 1.6 million working in social care alone, we're a long way from that.

One care provider I spoke to this week is thus buying in their own testing capacity, to try and enable visitation and more frequent staff testing.

It's needed. In this group alone, the CEO made clear to me that covid is v much embedded back in the social care system now.

CEO told me: "it does feel that we're on the brink of getting back into something that's going to be at least as heavy as it was in the spring and conflated with what goes on with winter illnesses and the pressure on the NHS it could be worse."

And at least care homes have routine testing. Large parts of the social care sector does not. Domiciliary care or extra care housing, which is assisted living. As the CEO explained to me: "you're in, say, a building called an extra care unit, which might have 60 residents..."

"...and it might have 60 staff, because it isn't a registered care home, even though it might look after people with dementia - in one of our extra care units our oldest resident is one hundred and four years of age, and because of the building, they're not entitled to testing."

"And this has just got to be wrong. So, you know, for our team, we've got 4000 front line care workers. A thousand are being tested on a weekly basis, and three thousand of them aren't being tested at all."

Clearly, this is a big problem

So moral of this story is this: what matters most in testing is that it’s fast, it’s on lots of individual people and that it can be sustained.

Though testing capacity and processing ability has increased enormously, it seems unlikely that right now the UK could...

...actually conduct and process 500,000 tests quickly and over a sustained period. We also need it to expand much more than 500,000 to protect social care.

A DHSC spokesperson said: “Our first priority remains the prevention of infections in care homes and regular testing for staff/residents has seen over 12 million tests take place so far, with 120,000 more issued each day. We are working tirelessly to improve test turnaround...

“...Times and latest data shows result turnaround times for care homes are improving. With more than 30 million tests now processed since the programme was launched, and more than 1.4 million people reached by our contact tracers, NHS Test and Trace is helping to protect lives.."

, and keep our schools and workplaces open.”

More on Newsnight right now.

Worth noting that even on the government's newest version of the covid dashboard, it cites virus tests processed, not capacity, which might give some indication of which matters more...

Keen to speak to scientists/employees working in labs about their experiences of pillars one and two and recent expansions in capacity. As ever, DMs open and in confidence.