Liverpool have been hard hit by the second wave of coronavirus
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The UK government has announced plans to regularly test all 500,000 people in the city of Liverpool for the coronavirus. Here’s what you need to know.
Why test an entire city?
In theory, regular mass tests could help eradicate the coronavirus in just a few weeks. The UK government said in September that it would try the approach nationwide – called Operation Moonshot – and that the Liverpool program was a pilot study. “I’m absolutely thrilled,” said Julian Peto of the London School of Hygiene & Tropical Medicine, one of the signatories to an April letter seeking universal tests in a city.
Why could mass tests be better than just testing people with symptoms?
We know that most cases of the coronavirus go undetected, often because people don’t even realize they are infected. For example, they may have no, mild, or unusual symptoms, but they can still infect others. If more of the people who carry the virus can be identified and isolated, the spread of the virus will be more reduced.
Has something like this been done before?
Yes. In May, China tested all 11 million people in the city of Wuhan, where the outbreak began, to prevent the virus from recurring. The Chinese authorities clearly believe that mass tests will work as they have since been carried out in cities like Qingdao and Kashgar of 9 and 5 million people respectively. Slovakia is also experimenting with the concept – two thirds of its 5 million residents were tested last week. “China and others have shown its feasibility,” says Keith Godfrey of the University of Southampton, UK.
Will it work in Liverpool?
It should help reduce the spread of the coronavirus. How big the effect is depends on three main factors. Will enough people get in touch to test? Can the authorities put in place the infrastructure needed to test each one regularly and get their results back quickly? And will people who test positive actually self-isolate? It will also be hard to tell if it will work, as mass testing will start concurrently with a new lock in England.
So people need to be tested more than once?
Yes – unlike China, the UK government does not commit to testing the entire population of Liverpool at once, which means regular testing is required as only a small portion of the city is tested at a time. The government press release does not specify how often people are tested in Liverpool. However, this could be a problem as many people hate being swabbed for the coronavirus. Participation in other programs that require regular testing has decreased significantly. According to Godfrey, an ongoing pilot study of weekly mass testing at four schools and the University of Southampton showed a “fantastic” intake rate. However, these are more like saliva tests than nasal and throat swabs.
What if a lot of people don’t volunteer for testing?
Peto believes there needs to be a city-wide register of everyone in Liverpool – where they live and with whom. That way, authorities could get an idea of who is spreading the coronavirus, even if they aren’t tested. No plans for such registration were mentioned.
Are there enough tests?
Not from the conventional tests that detect the genetic material of the virus. Instead, the government will use so-called “lateral flow” tests, which are similar to pregnancy tests. Such tests detect viral proteins and give faster but less accurate results.
Will people who test positive self-isolation isolate as needed?
That remains to be seen. A study earlier this year found that only 1 in 5 people in the UK self-isolate after developing symptoms. The government has since made it a legal requirement to self-isolate after positive tests, with up to £ 500 in support for low-income people and fines of up to £ 10,000, but it’s not clear if that made any difference . It will also be necessary to follow up the contacts of those who test positive, but England’s existing testing and tracing scheme has been fraught with problems.
Can the program be rolled out across England if successful?
Not in the same way, says Peto. The government relies on commercial companies to run kit-form tests instead of running tests in government labs with existing equipment, and he believes companies can’t get enough of these tests out there across the country. Around 2,000 military personnel will also help with tests in Liverpool, but the army is not big enough to do this nationwide. “A different system is needed to introduce it at the national level,” says Peto.
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