Covid: Mass testing to be rolled out to Tier 3 areas - how will it work?

Video report by ITV News Correspondent Ben Chapman


Mass coronavirus testing will be rolled out to Tier 3 areas after lockdown ends on December 2.

It follows a pilot scheme in Liverpool where fast community testing systems gave results to asymptomatic people in as little as 30 minutes without the need for a laboratory.

But with mass testing expected to be rolled out to areas with a combined population of some 23 million people, this will be a bigger challenge.

So how will it work? Here's what you need to know:

  • What is mass testing?

The scheme means inviting everyone in an area with high infection rates to test for the virus regardless of whether they are experiencing symptoms or not.

This would identify people who have the virus but are not yet showing symptoms. That way, they can isolate and restrict the spread of the virus.

Mass testing is also to take place at universities and front-line workers like hospital staff will be tested regularly as part of the scheme.

Lateral flow tests can produce results in as little as 30 minutes. Credit: PA
  • How does it work?

Two types of tests are available which both involve taking swabs inside the nose and the back of the throat,

Lateral flow tests are the rapid turnaround tests which can be processed on site without sending samples to labs. It can mean results are ready from 30 minutes to a couple of hours. This allows people to isolate quickly to reduce the spread of the virus.

Lateral flow tests are highly sensitive in identifying people with high viral loads, identifying cases that might be more infectious. In tests used in the Liverpool scheme, the specificity of the test was recorded at 99.68% with an overall false positive rate at 0.32%.

However, the most accurate test is the PCR (polymerase chain reaction) which detects viral genetic material called RNA. This test requires processing in a laboratory and can mean waiting for a few days for results.

  • How successful was it in Liverpool?

Everyone living or working in the city was offered a voluntary test in mass testing pop-up centres.

Some 2,000 military personnel assisted with the pilot delivering tests to approximately 85 sites in the city.

More than 200,000 people have been tested since the pilot began on November 6, equating to just over 40% of the city's population.

In the week ending November 27, 111,028 Liverpool residents tested with lateral flow tests and 66,166 using PCR. In addition, there were 26,476 lateral flow tests carried out by people in neighbouring areas.

40%

The percentage of Liverpool residents who took part in the testing pilot.

995

The number of asymptomatic cases identified through the Liverpool scheme.

Of these, 995 (0.7%) lateral flow tests came back with a positive test. These cases would likely not have been detected without the scheme.

There were concerns that the voluntary scheme was not taken up by the majority of the population and the local authority launched a testing 'blitz' in areas with low uptake.

However, the testing has led to infections falling from 635 per 100,000 people in mid-October to 115.1, as of November 27. Liverpool has now been moved from Tier 3 restrictions to Tier 2.

The Liverpool scheme was supported by 2,000 troops. Credit: PA
  • Are local authorities ready for the scheme?

Earlier this month, Health Secretary Matt Hancock said that nearly half (66) of all local authorities across the country took up the offer of receiving lateral flow tests for their communities, showing a willingness of local officials to scale-up testing.

But Downing Street has so far been unable to give details of how the scheme would be rolled out to 23 million people.


Government scientists believe only Tier 3 areas will be able to keep the R number below 1, Health Editor Emily Morgan says

Last week, the prime minister signalled mass testing was a way out of Tier 3 restrictions, saying it involved "everybody working together to kick Covid out".

The prime minister said the work in Liverpool "shows what can be achieved".

He said: "This is a success story which we want other parts of the country to replicate, so we’ll work with local government, with public health leaders and our fantastic, fantastic armed forces to offer community testing to Tier 3 areas as quickly as possible, opening the way for them to follow Liverpool’s example."

Mr Johnson said the allocation of tiers will be reviewed every 14 days from December 16, suggesting mass testing could make households exempt from restrictions.



He continued: "Now testing on this scale is untried, but in due course, if it works, where people test negative it may also be possible for families and communities to be released from certain restrictions even if their home area stays in Tier 3."

"Your tier is not your destiny, every area has the means of escape," the PM added.

But on Friday, the prime minister admitted that the difficulty with the scheme will not be the supply of tests but working with local authorities to roll-out the tests.

Boris Johnson said: "We’ve got tens of, perhaps hundreds of, millions of lateral flow tests coming into this country. We already have a huge stockpile.

"The difficulty is not the supply at the moment, the difficulty is actually working with local government, local communities to get them doing it.

"Liverpool already showed the way. We’re now looking at Barnsley, Doncaster and other places around the country where they want to pull together and do it."

He added: "The supply I don’t think is going to be the problem. The issue is going to be getting everybody mobilised, to understand the potential advantages of mass community testing."

But Labour MP for Wallasey Angela Eagle told LBC that a lack of clarity on the logistics of a mass roll-out of the scheme is causing concern to local authorities.

She said it was the "equivalent of dropping a box outside the front door and telling us to get on with it".

The Prime Minister’s official spokesman said details of the plan would be published next week.

"Local authorities that fall into Tier 3 will be able to apply for support from NHS Test and Trace and the armed forces to deliver a six-week, rapid community testing programme,” the spokesman said.

"That will include access to a supply of lateral flow tests, support with planning and logistics and funding and communication support."

Around 14,000 military personnel stand ready to help out in the coronavirus effort over the winter.

Personnel including specialist planners, medics and logisticians are ready to assist with the response to the outbreak, the Government said.

A university union has said that mass testing for students is 'flawed'. Credit: PA
  • Are there any concerns?

The Faculty of Public Health and the Association of Directors of Public Healthsaid in a joint statement that the roll-out would be a "massive undertaking" and warned that it would stretch the country's resources.

The two bodies also said that other priorities - such as delivery of the vaccine - may be compromised.

The statement said: "Substantial resources – human and financial – are needed to deliver lateral flow testing at scale.

"The additional logistical capacity provided to Liverpool to set up and manage testing sites alone has been enormous, and it is difficult to envisage how or even whether this could be replicated at the pace being proposed across the country.

"This threatens to be a distraction from other activities, like planning and rolling out vaccines."

It added: "There is an enormous price tag attached to this programme, and the resources and capacity needed come at a time of overwhelming and competing priorities, including making sure all those who are symptomatic get tested and self-isolate to planning and rolling out vaccines."

"Improving the existing Test and Trace Service so that people who have symptoms are rapidly tested and supported to self-isolate, and their contacts reached, must remain the top focus in relation to testing,” they said.

A university union expressed "grave concerns" over plans for mass coronavirus testing for students, warning that “flaws” in the Government’s approach are a “recipe for chaos”.

A seven-day travel window has been announced so students can spend the festive period with their families, with additional testing offered before they depart.

Students will be encouraged to take an asymptomatic test at “targeted” universities in England, while teaching will move online by December 9 so they have enough time to self-isolate if needed.

But the University and College Union (UCU) said plans appear to have been "rushed" and raised concerns around the accuracy of tests.

UCU general secretary Jo Grady said: “The flaws in Government plans for mass testing are a recipe for chaos that risk spreading the virus.

“We have grave concerns over how this programme will be carried out, particularly the risk of students being told – incorrectly – they do not have Covid, then relying on their test result to travel home and spend Christmas with vulnerable relatives.

"The risk of students receiving the wrong test result increases when testers have not been fully trained – rushing these plans makes that more likely."