Why coronavirus mass testing must be our No 1 priority - and why we lag behind the rest of the world

The Government is fond of claiming that the UK is “one of the best-prepared countries in the world” when it comes to pandemics. It’s the stock answer it gives journalists who go to No 10 with anything faintly critical.

How then to explain the debacle over testing? Are we secretly the best in the world at this too, despite just about every other advanced economy wiping the floor with us? Germany is now testing 70,000 citizens every day, while we are hovering around the 10,000 mark.

This is not an academic point. Without large-scale testing for the coronavirus it will prove much more difficult, perhaps impossible, to effectively trace and contain the virus.

In Norway, South Korea and Singapore they deployed mass testing from the outset and have been able to avoid completely closing down their economies as a result. The same will be true for pandemic peaks two and three if, like the Spanish flu, Covid-19 hits us in waves.

There is also the issue of an exit strategy. Mass testing provides the key to that door too. You can only wind down a lockdown safely if you know those who are returning to work are free from the virus, or better still have immunity.

You can bet there are hedge fund managers the world over poring over league tables of testing capacity and shorting those economies that fail to make the grade.

So what’s the problem with testing in the UK? The immediate answers are all a bit technical. We have all the nasal swabs we need; we have a reasonable number of the polymerase chain reaction (PCR) machines that amplify the DNA of the virus (once converted from RNA); we have the chemicals needed to make the reagent the PCR machines need; and we have more than enough people to run them.

“A PCR is a bit like a bunsen burner in a modern molecular biology lab  - they are plentiful and any science grad can be trained to use one in a day,” a senior scientist told the Telegraph on Wednesday.

There is, however, a shortage of the reagent itself. While we have the chemicals needed to make it, baking them into the kits the PCR machines use is not something we can do in the UK. We have ordered lots of them but most of the rest of the world got to the big manufacturers first, so we are near the end of a very long queue.

There are then a set of issues that go further back. We once, in the days of the Cold War, had a strong regional laboratory network in Britain. Called the Public Health Laboratory service, it was set up in 1946 as a response to the threat of bacteriological warfare.

Unfortunately, the doctrine of “efficiency” has closed most of these labs over the last 20 years, leaving just one sizable one run by Public Health England in Colindale, North London. While Germany fields out its testing to public and private labs across the country in much the same way China and South Korea do, the boffins at Colindale were insisting on doing all of our testing from the outset.

Only in the last few weeks have university and private labs been added in a bid to build capacity. Yet at the current testing rate of around 10,000 a day, it would still take years to cover the entire population:

A new “superlab” currently being kitted out in Milton Keynes should boost things further - assuming they can get the reagent needed to run it. Still, without a regional network samples will have to be bused in from around the country.

So an overly centralised lab system also helps explain Britain’s testing debacle. But surely for one of the “best prepared countries in the world” there’s another question: why doesn't our national pandemic strategy envisage the need for mass testing in the first place? As the microbiologist quoted above notes, “you would think the need for that would be blindingly obvious – it should be front and centre of any pandemic planning document”.

To be fair, the strategy does mention the word “laboratory” three times in its 64 pages. In virus hotspots, it notes, “specialist laboratory services will be particularly busy”.

My guess, and it’s only a guess, is that it’s the doctrine of “efficiency” again that’s to blame. It’s a policy that prioritises the utilisation of existing resources over capital spending and pares everything to the bone. Resilience in the form of redundancy is seen as a misnomer. If you need something urgently, you spin it up to order through a just-in-time supply chain.

Unfortunately, we were just too late in placing that order this time round.

Follow Paul Nuki on Twitter @paulnuki

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