Testing Times: The urgent need to decentralise COVID-19 diagnostic testing in the United Kingdom

The ASI’s latest paper, written by ASI Head of Research Matthew Lesh, makes the case for decentralising COVID-19 diagnostic testing in the United Kingdom:

  • COVID-19 is the biggest public health emergency in modern history. There have already been over 875,000 confirmed cases and 43,500 deaths worldwide. These numbers are expected to grow exponentially in the coming weeks, potentially resulting in millions of cases and hundreds of thousands of deaths. 

  • The United Kingdom is experiencing a substantial growth in cases and deaths. Over 2,350 people confirmed to have died after contracting the virus. This number is doubling approximately every 3 days, putting the UK on a similar trajectory to the worst affected regions in the world.

  • Testing is a key tool to combat infectious diseases. It allows doctors to identify the needs of patients, public health authorities to trace and isolate cases to minimise spread, and epidemiologists to track the spread of an outbreak. It is also essential for healthcare workers to return to the frontline.

  • The UK has fallen to the bottom quarter of OECD countries for COVID-19 diagnostic testing, on a per capita basis. South Korea has tested four times as many people as the UK, Germany almost three times and the United States now almost twice as many, per capita.

  • The early decision to centralise testing to a single Public Health England (PHE) laboratory has hampered the ability to increase testing in the UK. Testing has now been expanded to 12 labs operated by PHE as well as a limited number of NHS laboratories.

  • The most successful countries in testing COVID-19 – such as Germany, South Korea, and more recently, the United States of America – have decentralised testing and embraced a mixture of public, non-government and private laboratories.

  • Since March 16, the United Kingdom has just over doubled daily testing capacity. In the same time, the United States has increased daily testing by a factor of 21.

  • The private sector has shown an extensive willingness to support the Government’s efforts to tackle COVID-19, including the rapid design and manufacture of ventilators and agreeing to transfer beds and staff in independent hospitals to the NHS.

    • If the UK Government wants to meet its testing targets and save lives, it must:

    • fast-track approval for private sector laboratories to conduct COVID-19 testing; 

    • substantially expand usage of NHS and university laboratories to conduct COVID-19 testing; 

    • undertake rapid approval of private sector developed tests, including mutual recognition of tests approved by other regulatory bodies such as the FDA;

    • reduce testing red tape, including any requirements that initial positive tests must be retested centrally by PHE; and

    • explicitly call on companies to help make testing kits and develop lab capacity for COVID-19 testing, modelled on the successful call for businesses to make ventilators.