UK Mass Testing Unevaluated, Under-Designed, and Costly: BMJ

UK Mass Testing Unevaluated, Under-Designed, and Costly: BMJ
A British Army soldier hands a member of the public a swab and provides information on its use inside Anfield Stadium, in Liverpool, on Nov. 10, 2020 (Oli Scarff/AFP via Getty Images)
Lily Zhou
Weekly medical journal the BMJ on Monday published an editorial calling the UK's CCP virus mass testing programme "an unevaluated, under-designed, and costly mess."

Several medical scientists also voiced their concerns about the tests on the same day.

Britain launched its mass testing pilot in Liverpool on Nov. 6. Everyone without any COVID-19 symptoms are invited to be tested in order to identify asymptomatic carriers of the CCP (Chinese Communist Party) virus, commonly known as novel coronavirus.
Two types of tests are used in the scheme, a PCR test which requires lab processing, and the Innova lateral flow test, which yields a result within an hour. By Monday afternoon, 119,054 people from Liverpool and some neighbouring areas had been tested, some of whom were tested using both methods, and 588 positive lateral flow tests had been recorded.
The mass testing of asymptomatic people, due to be rolled out to 67 other areas in England, is a part of Prime Minister Boris Johnson's Operation Moonshot—a £100 billion ($133 billion) initiative to boost Britain's testing capacity to 10 million a day by early 2021.

Unevaluated, Under-Designed, and Costly

The BMJ editorial said that although the city council claimed that the Innova lateral flow test is very accurate with high sensitivity and specificity, the user instructions for the test stated that it should not be used on asymptomatic people.

"A preliminary evaluation from Porton Down and Oxford University throws little light on its performance in asymptomatic people or in the field," the article reads.

"The false positive rate of 0.6 [percent] means that at the current prevalence in Liverpool, for every person found truly positive, at least one other may be wrongly required to self-isolate. As prevalence drops, this will become much worse."

The article criticised the government for rushing a larger scale roll-out before the pilot in Liverpool is finished and evaluated; it also said the pilot is ethically compromised.

"The context for gaining consent has been tarnished by the enthusiasm of some local officials and politicians," it reads.

"There is no protocol for this pilot in the public domain, let alone systems specification or ethical approval. The public has had no chance to contribute, as required by the UK standards for public involvement in research."

The article went on to say that it's indefensible to spend a large sum of money on such a programme.

"Spending the equivalent of 77 [percent] of the NHS annual revenue budget on an unevaluated, underdesigned national programme leading to a regressive, insufficiently supported intervention—in many cases for the wrong people—cannot be defended," the article reads.

It concluded that the mass testing programme shouldn't continue or be used as a basis of whether people should self-isolate until it has been externally and independently scrutinised.

In another editorial published on Nov. 13, the BMJ had accused the government of suppressing science "for political and financial gain."

Building a Channel Tunnel Without Asking Civil Engineers to Look at the Plans

Several medical experts echoed the BMJ's view on mass testing, in a press briefing on Monday by the Science Media Centre.

Dr. Angela Raffle of the University of Bristol said Operation Moonshot seemed like "building a channel tunnel without asking civil engineers to look at the plans."

Raffle called it "the most unethical proposal for use of public funds or for screening" that she had ever seen, and suggested it would be a lot less wasteful to target-test rather than mass test.

Dr. Jon Deeks, a professor at Birmingham University said it would be “exceedingly dangerous” to release people who get negative results from the Innova lateral flow tests from self isolation.

“This test cannot do that and is exceedingly dangerous I think for the government to be putting out any messages at all to that effect because it will give people the wrong idea,” Deeks said.

He also questioned the sensitivity of the tests and said the user error can affect accuracy even further.

Dr. Allyson Pollock, a professor at Newcastle University, said it was really important to understand that none of these tests are tests of infectiousness.

“That is one of the myths that’s being propagated, and was being propagated in Liverpool—that you could have your test in the morning and if you were negative you could go about your business or go to funerals or go to the nursing homes, and you’ll be fine.”

She also said the programme should stop and be properly reviewed.

Government Confident New Tests Will Make a Real Difference

The Department of Health and Social Care (DHSC) defended the accuracy of the tests.

“These lateral flow tests are accurate, reliable, and successfully identify those with COVID-19 who don’t show symptoms and could pass on the virus without realising," a spokesperson said in an email to The Epoch Times.

"Our evaluation work and the ongoing pilots are helping us to understand how lateral flow tests work in the field and how we may use them to help stop the spread of the virus," DHSC also quoted Susan Hopkins, the chief medical adviser of the NHS Test and Trace programme, as saying.

“We are confident that these new tests, which have been rigorously evaluated, will make a real difference in how we protect people from this disease and help break chains of transmission,” Hopkins added.

The DHSC said all technicians carrying out tests in Liverpool had been trained.

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