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The UK's coronavirus testing bottleneck: what's wrong and what's important right now

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Geneticist Professor Alex Blakemore – Brunel University London's Head of Life Sciences – gave expert opinion this week to the UK media about the country's coronavirus testing bottleneck and the shortage of reagents: the chemical and biological ingredients needed to make tests to diagnose whether or not someone is ill with COVID-19. 

The Times 

Prof Blakemore was quoted in The Times's article 'Delay and dithering mean targets for coronavirus testing are way off' (1 April 2020). The journalists sought to understand decisions that had been taken by prime minister Boris Johnson, his advisors and public health officials, which had resulted in coronavirus testing rates much lower than planned. 

Prof Blakemore explained how countries worldwide were all in competition: "Everyone in the world wants those same reagents and the suppliers can only supply a limited amount," with stock levels low despite manufacturers increasing production levels. 

With new tests in development that would use different reagents, Prof Blakemore hazarded that these need to first be assessed and accredited by Public Health England, otherwise it will be difficult to interpret test results. "You've got to decide which tests are valid and which aren't. You've got to train people to use those tests specifically and you've got to validate the laboratories." 

LBC 

Prof Blakemore was interviewed live by Shelagh Fogarty on the national radio station LBC yesterday, and was asked to explain why the reagents are hard to come by. 

She stressed that reagents have to be validated to ensure the tests produce the right results. "I could make a lysis buffer in my own lab, but it might not be breaking cells open properly, and therefore the test might not be working properly," she said. If the cells weren't opened during the test, "somebody could be told they're not infected, when they actually are – they might go out and infect other people". This would be especially bad if it was a healthcare professional working with vulnerable people. 

This issue has been faced by some countries: in the United States, batches of test kits have had to be replaced because the reagents were not well controlled for quality, she explained. 

Shelagh wondered whether the testing bottleneck could be blamed on what she described as the 'system mentality' of the NHS, the UK's National Health Service. But Prof Blakemore felt strongly that the NHS is not at fault. "The NHS is doing level best to deal with the situation that the government might have taken a better hold on earlier. It's a failure higher up in government, in our response, in the timeliness of our planning." 

But could the bottleneck be eased by relaxing the rules on developing new tests, Sheelagh wondered. "It could be, but then we'd have less confidence in the results," Prof Blakemore warned. She spoke about a new point-of-care coronavirus test being developed by Brunel, in conjunction with the Universities of Lancaster and Surrey, which would get rid of a lot of the problems by performing tests at a patient's bedside within 30 minutes, rather than having a swab having to be sent to a validated lab. Such tests are "only just getting notice from government and Public Health England to complete and develop their quality controls", to test on known positive and negative samples to assess the test's reliability.

talkRADIO 

Yesterday afternoon, Prof Blakemore spoke live with talkRADIO's Dan Wootton, who contrasted the UK's testing plan with that of South Korea, whose leadership have pointed to their 'almost over-the-top' testing capacity as the main reason to 'flatten the curve': slowing the spread of coronavirus among their population. 

Prof Blakemore gave a personal illustration of why South Korea's approach was so useful. She recently had a heavy cold-like illness which may or may not have been COVID-19. But did she have it? Can she now look after her grandchildren, freeing their parents to work? "If I'd been able to have the RNA-based test for the virus when I was ill, I would know," she said, adding that, now she had recovered, she would need an antibody test to work out whether her blood showed signs of having fought the virus. And with between a fifth and a quarter of hospital doctors now in isolation, not knowing whether their illnesses are COVID-19, or whether they've already fought the virus, NHS staffing levels are low – in itself a danger to the rest of the country. 

Dan quoted Bill Gates as saying that the number-one priority should be testing frontline health workers – and Prof Blakemore completely agreed. "They are a very skilled set of people, and we need them to look after the rest of us. And they are at enormous risks because they're physically handling people who are infected and very ill." 

To request to speak with Professor Alex Blakemore, please contact Brunel's Media Relations team.

Reported by:

Joe Buchanunn, Media Relations
+44 (0)1895 268821
joe.buchanunn@brunel.ac.uk