Scientists and public health officials have warned that the government’s decision to end free mass Covid testing in England from next month despite a marked resurgence in infections and hospitalisations could hamper the UK’s ability to navigate the pandemic.
When the government announced plans to scale back testing in mid-February, infections had been on a downward trend for six weeks. However, when the “Living with Covid” strategy is implemented in full on April 1, infections are expected to be close to a record high.
The health department confirmed on Tuesday that from the start of next month access to free lateral flow tests for people without symptoms will be restricted to select groups, including patient-facing NHS staff, adult social care staff and certain care home visitors.
Free symptomatic testing using PCR swabs will only be available to hospital patients, vulnerable groups eligible for Covid antiviral treatments and those being discharged to care homes and hospices.
Some experts fear that restricting access to testing while the UK is gripped by a fast-rising wave, driven by the highly infectious Omicron BA.2 sub-variant, could leave vulnerable people at risk, disproportionately impact deprived communities and make it more difficult to respond to future variants.
“It was perfectly reasonable for the government to expect the numbers would still be heading in the right direction at this point, but then BA.2 came along and they’ve failed to react accordingly,” said Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh.
“Living with Covid does not mean ignoring Covid. We have to respond to what the virus throws at us but yet again politicians don’t want to miss self-imposed deadlines.”
Patrick Vallance, chief scientific adviser, told MPs on Wednesday that cutting testing capacity had “consequences”. He said reducing surveillance testing could “lead us to vulnerabilities” when trying to detect future variants.
Speaking at the science and technology select committee, he added that “if you massively reduce testing across the population, precautionary behaviours are likely to decrease at the same time. That will then lead to increased transmission.”
From April 1, people in England with symptoms of a respiratory infection will not be told to take a test and will instead be asked “to try to stay at home and avoid contact with other people” until their symptoms abate, according to the Department of Health and Social Care.
In Scotland, free LFTs are set to end by mid-April, and from the start of May people with symptoms will no longer be asked to test. While in Wales, free kits will be made available to those with symptoms until the end of June.
The Northern Irish government is currently reviewing testing provision but could keep free lateral flows for symptomatic individuals in place till summer.
During the first Omicron wave, UK-wide community PCR testing capacity reached more than 800,000 tests a day at the start of the year and the supply of lateral flow tests was increased to more than 300mn lateral flow kits a month.
Jenny Harries, chief executive of the UK Health Security Agency, said on Tuesday the government was focusing testing provision on “those at higher risk of serious outcomes from the virus, while encouraging people to keep following simple steps to help keep themselves and others safe”.
Speaking in the House of Commons on Tuesday, Maggie Throup, vaccines minister, rejected calls to delay the end of free testing. “We have moved on, we have broken the chain of transmission with the vaccination programme,” argued Throup.
However, Iain Buchan, professor of public health at Liverpool university, who led the first UK trial of lateral flow testing in October 2020, called the move “mistimed”.
In the week ending March 19, nearly 4.3mn people were infected with Covid across the UK, according to the Office for National Statistics, just shy of the record-high levels reached in January during the first Omicron surge.
“The most important discipline in public health is to be able to ramp up very quickly to a threat and wind down very gradually and cautiously,” said Buchan. He added he was “concerned” about unequal access to lateral flow tests once free testing ends.
“We’re nearing the peak of BA.2 in some areas and there’s a need to be alert to the higher consequences of spread in deprived areas,” said Buchan, pointing to longer hospital waiting lists and greater staffing pressures.
Speaking last week, Kate Ardern, public health director for Wigan, told the Financial Times that by ending free testing the government was relying on people’s sense of personal responsibility.
However, she added: “Some people have more agency and resources to exercise that personal responsibility and follow public health advice and that’s what’s worrying.”
With the cost of living rising, some would find it difficult to afford LFTs, which could be up to £30 a box, Ardern suggested.
But, Chris Molloy, former chair of the UK Rapid Antigen Test Consortium, a coalition of diagnostic experts and manufacturers, insisted that testing would remain a “relatively affordable” public health measure.
“I hope that the nation, having been trained over two years to use these techniques, realises they’re worthwhile not just because they are free, but because they are the right thing to do,” said Molloy.
Lateral flow tests are available at most major supermarkets and pharmacies costing a minimum of £2 per test.
Molloy added that health authorities will have “sufficient visibility of the pandemic” despite less testing data. “We’re turning the floodlights off, but the night-lights are still on.”
Javid said in a written ministerial statement on Tuesday that UKHSA would “retain the ability to enable a rapid testing response should it be needed, such as because of a new variant of concern”.
Still some fear the country could be ill-equipped in the event of a new variant arising. Thomas House, professor of mathematical sciences at Manchester university, said: “It’s a near certainty that a new variant will emerge by the end of the year and it will be a struggle to wind back up testing as quickly as needed.
“We saw from Omicron just how quickly we need to respond.”
Source: Financial Times