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UK virologists criticise handling of Covid testing contracts

Exclusive: experts say decisions apparently being made on ideological grounds


https://www.theguardian.com/world/2020/aug/03/uk-virologists-criticise-handling-coronavirus-testing-contracts


Coronavirus: UK virologists criticise handling of Covid testing contracts

Exclusive: experts say decisions apparently being made on ideological grounds


The virologists say they have been sidelined from discussions such as those about testing. Photograph: Ben Stansall/AFP/Getty Images


Sarah Boseley Health editorPublished on Tue 4 Aug 2020 09.43 BST

A group of Britain’s leading virus experts say mistakes are being made in the handling of the Covid pandemic, with testing contracts awarded on apparently ideological grounds to private sector companies rather than based on expertise.

In a letter to England’s chief medical officer and the chief scientific adviser, nearly 70 clinical virologists say they have been sidelined by the government and excluded from discussions on how to respond to the pandemic.

New 90-minute tests announced with fanfare by ministers on Monday were the latest example of how virologists were being bypassed, they say. They have been using rapid tests such as these already – but say they have no knowledge of or information on the DnaNudge or LamPORE tests that the government is contracting to buy.

The UK Clinical Virology Network wrote to Prof Chris Whitty, the chief medical officer for England, and Sir Patrick Vallance, the chief scientific adviser, on 10 July but say they have had no response. The experts in testing for viruses such as Covid-19 mostly work in 40 NHS and Public Health England (PHE) laboratories across the country.

They were writing, they said in their letter, “to express our concern over lack of engagement by policymakers with clinical virology expertise in the UK in the management of the Covid-19 (Sars-CoV-2 pandemic)”. The letter adds: “Our skills have been underused and underrepresented (albeit to differing extents within the devolved nations of the UK), resulting in lost opportunities to establish a coordinated robust and durable testing framework for Sars-CoV-2.”

Deenan Pillay, a professor of virology at University College London, is one of the signatories. “There’s always new tests being developed. And it’s almost as if they’re being pushed as a sort of magic bullet … it’s almost like getting stuff out to actually reassure the public rather than the more boring but really hard work of doing proper contact tracing,” he told the Guardian.

He and others think the government is convinced that only the private sector can rise to the pandemic challenges. But, he said, a series of mistakes and problems had arisen from failing to consult with clinical virologists.

In March the government rushed into buying antibody tests that were then found not to work well enough.

In the same month, it set up drive-through testing centres and so-called Lighthouse labs – privately and publicly operated – to increase the number of swabs taken and processed, but did not have the systems to feed the data into the NHS and public health authorities around the country, where it is needed.

“If you’re going to build a Lighthouse lab or a new lab somewhere, to have it under control of an NHS laboratory would be the obvious thing,” said Pillay. “It was the first thing I said when Deloitte phoned me and asked me for advice on setting up Lighthouse labs. “I said, well, the most important thing is not just the test – it is the data. How are you going to get it [to] assimilate into NHS data systems? And again, that was overlooked. I think we now realise that was a major error.”

The only clinical virologist on the Scientific Advisory Group for Emergencies (Sage) is from the main PHE reference laboratory, he said. Prof Will Irving at the University of Nottingham, another signatory, pointed to centralised control of the response when Lighthouse labs were set up. “We never quite reached capacity. We could have done more testing,” he said of the Nottingham laboratory.

“When I first saw the email that … the army were going to come up to the university the next day and collect whatever machines we could give them to go down to the Milton Keynes Lighthouse [lab], my first reaction was – that’s a really good idea. You put all these capabilities in a very large warehouse, and you work it 24 hours a day. You can do a huge amount of testing.

“But just like whoever first thought of that, I hadn’t thought it through. And in fact, the actual testing in the laboratory – of taking the sample and determining whether or not it’s got virus in it – is far and away the easiest part of the whole process,” he said.

Diagnostic laboratories such as his had rigorous processes for getting the results where they should be, so patients could be treated, contacts traced and local public health officials notified of what was happening in their area.

Instead, it emerged that some Lighthouse labs sent home volunteers because there were too few samples to process, while some patients got wrong or delayed results. “We heard stories about thousands of samples being sent to the United States for testing which is just plain ridiculous,” he said. “And it just seems there is a rush to do everything privately.”

The virologists still hope they can help, advising that private testing centres and labs should be at least partnered with an NHS or PHE diagnostic laboratory. “It is not too late to effect change. The Covid-19 pandemic response will need to evolve through the coming winter and beyond … We ask that you reach out to the clinical and academic virologists in all countries of the UK,” the letter says.

A government spokesperson said: “We have made significant strides in our approach to tackling coronavirus and have been guided by the latest scientific advice throughout … At every stage, the government’s response has been informed by the advice of experts from SAGE and its sub-committees. Our approach is kept under constant review as new international and domestic evidence emerges.”

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