Covid-19: Testing

Lord Bethell Excerpts

Thursday 14th May 2020 Lords Chamber

The Question was considered in a Virtual Proceeding via video call.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, testing is a critical part of the Government’s test and trace programme. It will enable the UK to start to come out of some elements of lockdown. We salute the efforts and innovation of our NHS, public health and private sector partners. Their hard work will bring forward the easing of important restrictions that keep people safe and protect our NHS.

[The Earl of Clancarty (CB)]

My Lords, public health specialists have been worried from the beginning of this crisis that a large-scale nationwide test, trace and isolate infrastructure was not straightaway put in place. I did not hear the word “isolate” in the Minister’s reply. Will the Government yet set this up, perhaps headed by an independent epidemiologist? To that end, will they address the concern that commercial lab test results are not reaching councils and the local NHS so that proper action can be taken to isolate and eradicate this virus across all communities before lockdown is substantially eased?

[Lord Bethell]

My Lords, I pay tribute to Public Health England, which stood up the CTAS system that provided track and trace services at the beginning of the epidemic. I pay tribute to Dido Harding, the track and trace director whose appointment was announced earlier this week. I pay tribute to Professor John Newton, who provides scientific guidance and co-ordination for the track and trace programme.

[Lord Wood of Anfield (Lab)]

My Lords, we have seen from the Covid outbreak at a nightclub in South Korea that speed is of the essence in ensuring an effective test, trace and isolate strategy. However, given the limited availability of test kits and the fact that it can take three to four days to process them, and in the light of the fact that what the Government called “operational issues” led last week to 50,000 tests being sent for analysis to the US, can we really be confident that the tests can produce sufficiently timely information to form the basis for a test, trace and isolate strategy?

[Lord Bethell]

The noble Lord is entirely right. Speed is essential and the South Korea example is a good one. More than half of our tests are turned around within 24 hours. I pay tribute to the track and trace team, who handled an extremely complex and difficult laboratory failure last weekend and used innovation to turn around 50,000 tests, the results of which were reliably given to people. However, we will continue to work on shortening the result times and getting the information back speedily so that isolation can happen in a thorough way.

[Baroness Barker (LD)]

What is the average time between a swab being taken and a patient getting the result, and what is the average time for that test result to show up in national tracking data?

[Lord Bethell]

The average times are not at my disposal, but I reassure the noble Baroness that more than half the results are turned around within 24 hours. Our target time is currently 48 hours and the vast majority of tests are done within that time. As the noble Lord, Lord Wood, rightly said, speed is of the essence, and we are working hard to compress those times.

[Baroness Rawlings (Con)]

My Lords, testing and tracking are vital in working towards the lifting of restrictions. Can the Minister therefore consider looking at encouraging people to keep a daily diary on everyone they meet, wherever they go outside their home? Should they fall ill with Covid-19, that would provide a simple, easy way to trace the source of further testing?

[Lord Bethell]

My noble friend Lady Rawlings is entirely right: we all have an important role to play. There is good evidence that personal tracing by individuals of contacts within their networks has a powerful role to play in isolating those who might have been in contact with the virus. Defeating this virus will be the responsibility of everyone in the community; we cannot rely just on digital apps and central databases.

[Lord Patel (CB)]

My Lords, what evidence do the Government use to calculate the value of R0?

[Lord Bethell]

The noble Lord will know that we have set up one of the most ambitious surveys, conducted by the ONS, to study on a weekly basis a large number of viral and serological tests. Those are used by statisticians to understand both the prevalence and the spread of the disease. Figures for that are emerging—we now have three weeks-worth of figures. They are being published regularly and I would be glad to send the noble Lord a link to the relevant data.

[Baroness Thornton (Lab)]

My question is relevant to what has been in the news today concerning antibody testing. PCR testing is the most reliable but most resource-intensive test. Will it ever be sufficiently scalable for widespread regular testing of all key workers and to track clusters of reinfection? Are the Government investigating the potential of increasing the reliability of antibody testing by double testing? Now that a range of tests is being manufactured globally, will the Government publish their assessment of their relative efficacy in testing the two relevant antibodies?

[Lord Bethell]

The noble Baroness is entirely right. PCR testing is an important guide as to who has the virus, and we have made it available to all key workers who exhibit symptoms. However, we are sceptical of whole-population surveys. Double testing might help if there is damage to serological equipment, but the challenges of serological testing are more to do with the blood, and unfortunately people do not change their blood. We are very proud of British universities, which regularly publish assessments of the various serological approaches. That work is under way and continues, and we hope to make more progress on it in the months ahead.

[Lord Hussain (LD)]

My Lords, all the evidence shows that BME communities are suffering disproportionately more from Covid-19. Many of them work on the front line as doctors, nurses, care workers, cleaners, porters and hospital security staff, who deal directly with difficult people. Can the Minister assure the House that these front-line staff will be prioritised and tested frequently for Covid-19? In asking this question, I declare an interest, as a close family member works in hospital security.

[Lord Bethell]

My Lords, I pay tribute to those BME workers on the front line. There is no doubt that their courage and bravery in the face of heightened risk is one of the things that has kept the NHS and our care service working and we owe them a huge debt. That debt will be paid by providing testing for anyone who needs it. To answer the noble Lord’s specific question, we started rolling out asymptomatic testing throughout the NHS and care service last week. The results of that will be published by the NHS shortly.

[Baroness Ritchie of Downpatrick (Non-Afl)]

My Lords, the Minister will be aware that, to be effective, testing in care homes of residents and staff needs to be done continuously. Can he confirm when this testing system will be established and then achieved?

[Lord Bethell]

Testing in care homes is absolutely a number one priority. We have massively ramped up testing: we are now running it at 30,000 tests a day. We will test 300,000 care home residents and 500,000 care home staff before mid-June. That will make a massive difference, but we will not stop there. The ongoing and regular testing of both residents and staff will be a core part of our test and trace programme.

[Lord Cormack (Con)]

My Lords, with the encouraging announcement of the ending of virtual proceedings in the other place and in the hope that we will not be too far behind, can my noble friend assure me that adequate, permanent testing facilities will be available for all who work in the Palace of Westminster and all Members of both Houses?

[Lord Bethell]

My Lords, workplace testing for not just Peers but all workers is an important part of our return-to-work strategy. We need to work with employers of all kinds and the diagnostics industry to put in solutions so that people can go back to work with confidence that they are not infectious and that the person sitting next to them is not infected.

[Baroness Finlay of Llandaff (CB)]

My Lords, what national policy control mechanisms will be used to monitor and report on false negatives and false positives as testing is rolled out to complement a contact tracing app?

[Lord Bethell]

I did not hear all the question, but I think I understand what the noble Baroness is asking. The truth is that, however strong the sensitivity of the machines, false negatives and false positives are an inevitable part of the testing process. However, PHE conducts extremely thorough validation processes so that these are kept to a minimum and we will use algorithms to ensure that rogue test results are picked up as soon as possible.