Covid-19 testing: Pressure grows on government

Health Secretary Matt Hancock faced a barrage of criticism in the Commons today as he struggled to explain the lack of testing in coronavirus hotspots. The government’s community testing strategy appears to be faltering in the face of a rise in demand from parents and others  experiencing winter flu-like symptoms.

Speaker of the House of Commons Lindsay Hoyle, speaking in his capacity as a constituency MP, led the denunciations this morning. “I am receiving numerous complaints from residents unable to book a test after displaying Covid symptoms,” he said. “This is completely unacceptable and totally undermines track and trace so I have raised my concerns with Ministers to push for action to be taken as a matter of urgency.”

Naturally, the strongest criticism came from Labour’s Shadow Health Secretary, who asked an Urgent Question this afternoon to grill the Health Secretary. “When will people be able to book a test online again, or has the online booking system been deliberately disabled?” he asked. “When will ill people no longer have to travel hundreds of miles for a test that should be available on their doorstep?”

Hancock conceded that the government faces “an enormous challenge”, but emphasised that “the good news is the [testing] capacity is at record levels”. This latter point is true; the UK’s testing capacity sets a record against most, if not all European countries. The UK has also led the continent in the number of actual tests conducted in recent weeks.

The problem appears to be that the capacity isn’t being targeted to the areas that need them most. While many in less affected – and usually more rural – parts of England have had positive experiences, receiving both a test and results within 72 hours, those in areas with outbreaks, such as Bolton, are facing both shortages in the number of testing places available and extended delays in receiving their results because of backlogs in diagnostic facilities. The consequence is that while testing capacity stands at almost 400,000, fewer than 100,000 people are being tested each day.

The scale of the lag between testing capacity and the government’s ability to process tests was highlighted by documents leaked to The Sunday Times which revealed a 185,000 swab test backlog, with the British diagnostics system so stretched that tests are being sent to labs in Italy and Germany. This has reinforced criticism of Public Health England, which has been accused since the beginning of the epidemic of over-centralising the testing system and obstructing the incorporation of private and university labs.

Despite PHE’s recent efforts to organise a network of small “Lighthouse labs”, the majority of Pillar 2 (community) tests continue to flow through three mega-labs based in Milton Keynes, Cheshire and Glasgow. While these large facilities allowed the government to scale up its testing capacity quickly in the early summer, an organisational or technical error in just one of them has the potential to clog up the entire system. Their scale also makes quick fixes difficult; Hancock today said it would take weeks to solve the current problem.

Moreover, the commercial “Lighthouse labs” are themselves facing problems. They had been staffed over the summer by postgraduate students who are now returning to full time education, leading to severe staff shortages. Some have had to shut down operations entirely because of this, and it isn’t clear how quickly new diagnostic staffers can be recruited.

This chaos puts the government in a painful political position. The number of people with flu-like symptoms will naturally rise considerably as winter rolls in, putting even more pressure on an already-faltering system. As any listener of talk radio will have noted in recent days, hell hath no fury like a member of the public denied a test. And with cases expected to continue to rise, backlogs and reduced capacity will make it more difficult to locate new hotspots, which could eventually lead to the government losing control of the epidemic once again.

The British public has generally been forgiving of governmental failures throughout the pandemic, as many voters have understood that it is a novel disease for which nobody was properly prepared. But six months since the start of lockdown, there is now a broad expectation that the government should have its act together. Britons were implicitly led to believe that isolating throughout the summer would allow Whitehall to build up the capacity to protect the vulnerable. Now the government appears to be failing to meet its side of the arrangement.

Perhaps most damagingly of all, the disorganisation fits into a narrative of incompetence within Boris Johnson’s Downing Street, which could plague the Conservatives for the rest of this parliament. The Labour party plans to use incompetence as an umbrella term, under which to characterise not just the government’s handling of coronavirus, but also its dealings with the European Union.