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Regular testing of workers with no symptoms can all but eliminate the coronavirus, according to an “authoritative” hospital study that calls for checks on millions of office workers and pupils.
Another huge scale-up of testing to give people in reopening industries weekly or monthly tests must become a “cornerstone” of Britain’s efforts to ease the lockdown, scientists at Cambridge University say. Testing booths on street corners and more mini-test sites are among the recommendations. The team said that regular checks helped to cut infection rates among workers who felt well from one in 20 to one in 840.
Yesterday Jeremy Hunt, the Conservative former health secretary, and Labour called for weekly tests for all health staff. Matt Hancock, the health secretary, is under pressure to increase Britain’s daily capacity of 220,000 tests to allow more than two million health and care workers to get regular checks.
The government’s Scientific Advisory Group for Emergencies has identified infections spilling out of hospitals and care homes as a key reason why cases are not falling faster in Britain. It is now modelling wider checks for those in other jobs such as taxi drivers and shop workers who come into contact with large numbers of people. The group is also looking at whether people need two tests to be sure of their results.
Ministers are considering “batch testing” when samples from up to ten workers are tested at once and individual tests carried out only if someone in the sample is positive.
However, Michael Weekes, of the Cambridge Institute for Medical Research, who carried out the study, said that a huge expansion of testing was “going to be essential because to be able to detect new infections and then contact-trace those infections and isolate people, you need to know who has the infections. In order to detect mild or truly asymptomatic cases, particularly very early during those infections when people are at their most infectious, you do need a regular testing programme.”
Mr Hancock said on Wednesday that regular testing of health staff “needs to spread much further” but that because of capacity constraints “it’s better to focus the resources for repeat testing on those at high risk”.
Anywhere from a third to two thirds of those infected are thought to have no symptoms, and early in the outbreak, Addenbrooke’s Hospital in Cambridge used a research lab to introduce testing every two weeks for all staff treating Covid-19 patients and every four weeks for all other patient-facing workers.
Infection rates fell among symptomatic staff and their contacts but the biggest fall was in those who did not report feeling ill. In the second week of April, 20 out of 383 tested positive, falling to one in 840 in the third week of May, according to results that are being studied by Public Health England.
Dr Weekes said that infection control, social distancing and falling rates in the wider society had contributed, but argued: “It certainly does suggest that widespread testing is necessary throughout the NHS and more widely. I think that’s one of the key cornerstones in getting on top of this. I think if there is political will it shouldn’t be difficult to generate the capacity.”
For the study, which is awaiting peer review, the team sent pre-labelled swabs to wards to make it easier for busy workers to take tests. Dr Weekes argued that the government must “make it easy for people to get tested rather than demanding they drive somewhere miles away. So I think having street-based testing booths and mini-test centres throughout the country will be one way that it is important to go so it’s very easy for people to go and get tested.”
Mr Hunt said: “This authoritative study demonstrates that track and trace in the community alone will not be enough: until we introduce weekly testing of frontline staff in hospitals and care homes we will just not isolate Covid carriers quickly enough to get the virus under control.”
Jonathan Ashworth, the shadow health secretary, said: “Regular testing of all NHS staff must now be an urgent priority.”
Chris Hopson, chief executive of NHS Providers, which represents hospital trusts in England, said: “A clear testing strategy is now more important than ever as it is key to restarting routine services which were paused during the early weeks of the pandemic.”