The UK did not learn the lesson from South Korea, and now Germany, that mass testing is the best route to managing the spread of the coronavirus – or rather, it learnt it too late. It is thought that one of the reasons for Germany’s comparatively low death rate in comparison to that of Italy and Spain is its mass testing regimen – about 500,000 a week currently. The UK now tests 6,000 people daily, a figure which it expects to increase to 10,000 a day by the end of March and 25,000 by the end of April. What it means is that people who think they have mild symptoms of what might be Covid-19 are asked to self-isolate for seven days, and if they live with others then the entire household has to self-isolate for fourteen days in case anyone else develops symptoms; they will not be tested unless they have to be hospitalised with more severe symptoms.
Apart from identifying who has the virus so they can be treated and their contacts identified, the other main reason for widespread testing is to understand the spread of the infection – something which is called surveillance testing. If that isn’t done, (among other things) many people with colds or symptoms similar to those of the coronavirus, may be isolating themselves quite unnecessarily. Director General of the World Health Organisation Tedros Adhanom Ghebreyesus was reported as saying he had a simple message for all countries, “Test, test, test,” and was then quoted as going on to observe, “We cannot stop this pandemic if we do not know who is infected.”
That seems an obvious point to all reasonable people, but some of the governments of the world, including ours have not, it appears, been so persuaded, or if they have their reaction has been belated. Britain is now trying to catch up by also introducing a different kind of test, which if it proves accurate could be a game-changer in terms of managing the spread of the virus. This is a 15-minute test to determine whether people have had the virus, and are therefore thought to be immune. It does not test whether people have the coronavirus currently. What it will mean is that there could be some relaxation of social distancing requirements sooner than otherwise expected, and most important, it would give a much more informed picture of the pattern of the virus and how it spreads, allowing for greater management of the epidemic.
The British government has bought 3.5 million of these test kits, which use a drop of blood from a pin-prick, like that used by diabetes sufferers, to produce a result in 15 minutes. While officials are still waiting for confirmation of their accuracy, if they are brought into the country – in days, rather than weeks, it has been claimed – the workers of the NHS will be given priority. After that, they will be available to the general public online from Amazon or through their local pharmacy.
If these tests are valid, and presumably the British government has reason to expect they will be confirmed as such, then they would not be available in this country for a considerable while, if they are ever available at all. In the meantime what we have to rely on are the 700 test kits which the authorities obtained courtesy of PAHO/WHO. Minister of Public Health Volda Lawrence has said that “There is an adequate supply of testing kits and [Personal Protective Equipment] for our medical personnel.” Dr William Adu-Krow, the PAHO/WHO representative in Guyana was less sanguine, saying he believed that people should be tested, but there were not enough test kits available to do so, and that this was a problem even in first world countries.
Deputy Chief Medical Officer Karen Gordon-Boyle for her part has said that persons will not be tested unless they are exhibiting Covid-19 symptoms or have been in contact with people who have tested positive for the virus or have recently travelled from a country which is known to have cases of the coronavirus. The problem is that some people who contract the infection are asymptomatic but can still transmit it to others, while others may have symptoms so mild they may just dismiss them as inconsequential. Only testing those who have obvious symptoms is not going to help manage the spread of the virus effectively, because the authorities still will not know the extent of it. As it is, they risk being overwhelmed. They desperately need far more testing kits, and while Dr Adu-Krow has said there are plans to make more kits available for the country, one presumes this is not going to happen immediately.
Since so far only five cases have been identified, there is a little time before we are exposed to the next more dangerous phase of the coronavirus’s unwelcome visitation. Why, for example, have they not gone into Good Hope with, say, 300 of the kits and done mass testing there? This is the place where patient zero’s family lives. There is also the matter of the health workers and their families and their contacts in the Georgetown Hospital. Were they all tested, or only a limited number of those who had immediate contact with the patient who died?
If testing can be done on a much larger scale as soon as possible, it would reduce the impact of the crisis which will otherwise come when there are too many cases for the health system to manage. As it is, there are only 12 ventilators in the public health system, which is not a consoling thought for anyone with an existing health issue, and who is likely to become seriously ill if they contracted the virus. While there are plans to obtain more ventilators, again, who knows how long that would take.
