Without lateral flow tests government policy is in jeopardy

Editorial: The booster campaign needs more time to rebuild the wall of coronavirus protection

(Brian Adcock)

It is almost a cruel hoax that is being perpetrated on the people of England. Whereas in Northern Ireland, Wales and Scotland there are restrictions on new year and Hogmanay festivities, and they have already had their disappointments, in England the apparently magnanimous UK government has said the parties can go ahead, virtually unhindered. Boris Johnson may even have saved his premiership by following the instincts of his rebellious backbenchers in sweeping away the puritan doubts of his advisers, and restoring Merrie England in the face of a pandemic: trebles all round. 

“Enjoy yourselves … but be cautious” is the message from his health minister, Gillian Keegan, doing the broadcast rounds. The key to that, though, is to take a lateral flow test (LFT) before venturing out or greeting guests for a home celebration. All very practical and sensible – except of course that there is a shortage of lateral flow tests, and has been for a while. The independent pharmacists describe the situation as “patchy”.

Visits to the NHS website are met with a message that postal deliveries are not possible. Parallel problems have arisen with the more accurate and involved PCR tests. Given the timings, it will now be impossible for many would-be revellers to swab themselves before they try to remember the words to “Auld Lang Syne” and they say hello to 2022. The temptation to skip the test is obvious; but so are the grim consequences.

The dire situation with the tests also threatens the ability of people to return to work after an infection. The condition for coming out of self-isolation is for two negative LFT tests taken 24 hours apart. Without these, it is impossible for anyone to tell if they are still infectious, even if they feel well. A further reduction in quarantine times to five days – which would help more people return to work and normal family life – while there is such a shortage of tests looks impossible. In England, despite the formal stance of lightened restrictions, the shortage of LFTs means that self-imposed lockdowns for many will feel as complete as at any other time during the past 21 months of crisis. The test shortages also distort the Covid statistical system and detecting the rise of Omicron in relation to the Delta coronavirus variant.

Therefore, much of the basis of the government’s policy towards Omicron is in jeopardy, because the tests people need aren’t there, and, in fact, because the effective rate of booster vaccinations remains too low overall to gain full herd immunity (given the lag of at least seven days for the booster jab to be properly effective), the successful booster campaign needs more time to rebuild the wall of coronavirus protection. It seems quite certain that the spread of the virus will be greater than if the tests were available freely. Even if Omicron doesn’t overwhelm the NHS, the inevitable spikes in hospitalisations will add to the challenges facing the health service, and make treating non-Covid cases harder.

While parliament is in recess, the prime minister invisible until now, and with the seasonal distractions, it’s worth noting that there has been little attempt by the authorities to explain exactly why the LFT shortage has arisen. The UK Health Security Agency blames “supply-side difficulties”, which is merely a restatement of the problem. It is said that there is no shortage of stock, but just of logistical capability, which, again, is no use to anyone (and sounds like a disturbing echo of the excuses offered last year for the severe shortages of personal protective equipment).

The Royal Mail, other delivery services and the pharmacies have done an admirable job in supplying these invaluable kits over many months. Why are they now being blamed by some for the problem? Why does there seem to have been little attempt to boost their supply? Is it poor planning by the UKHSA over many weeks as the limited plan B restrictions (which implied more lateral flow testing) were being contemplated? Perhaps the contracts with suppliers based in China were faulty. Some Tory MPs are claiming there is a global shortage of LFTs.

There may be many factors at work, but the public has a right to know what has gone wrong and why. With a relatively long shelf life, it should have been possible to stockpile many more lateral flow tests, and indeed PCR tests as the Omicron variant emerged a month ago, and case numbers were forecast to ramp up. It wasn’t done. Why?