Smart testing and ‘people power’ – as well as vaccination – can get us out of this pandemic sooner

A Liverpool public health expert says the city’s mass testing pilot can use “people power” to get us out of this pandemic faster than simply waiting for vaccination.

Professor Iain Buchan, Chair in Public Health and Clinical Informatics at the University of Liverpool, says open-access, repeated testing, with negative test results enabling people to release sooner from quarantine and return to restricted activities, could help towns and cities reopen safely.

This in turn would reduce the public health and economic harms resulting from current restrictions. He believes “togetherness and technology” can crowd-source a better recovery from Covid-19.

MAST pilot is not screening

“Liverpool’s pilot of Mass Asymptomatic Serial Testing (MAST) is a pioneering public health intervention… It is not screening, but has been misrepresented as such in some external commentaries. We can protect the vulnerable by getting ourselves tested twice a week.”

Currently, everyone living or working in Liverpool is being offered a test for the virus that causes COVID-19, whether they have symptoms or not.

Since the whole-city pilot was launched on November 6 140,000 people, a third of the city’s population, have come forward to be tested.

The scheme may be rolled out to 67 sites across the country.

Freeing people from quarantine

Professor Buchan says an important idea behind mass testing is to free people sooner from unnecessary quarantine and from avoidable current restrictions to daily life.

“The aim must be to enable people to live their lives with fewer restrictions. We want to reopen towns and cities, but we must do it safety.

“We must get it right if we are to protect jobs and businesses imperilled by Covid-19 restrictions.

“We need to build a partnership of trust between the state and the public so that more people want to come forward for testing, and are properly supported if they need to isolate.”

Encourage deprived communities

Annemarie Naylor, Director of Policy and Strategy at Future Care Capital, says it’s challenging to move from the message that testing is solely for people with symptoms to one that says everyone is encouraged to get tested.

“But, those people in higher risk groups, including those living in deprived households and communities, must be encouraged, incentivised and supported to come forward

“How do we incentivise people to do the right thing if they’re struggling to make ends meet and fear losing income or, even, their livelihoods? The £500 Test and Trace Support Payment in England is, often, not enough to assuage their concerns.”

The ‘worried well’

Ms Naylor is concerned that many of those who participate in mass testing pilots come from more affluent and less ‘at risk’ households and communities

“We know that the ‘worried well’ are likely to come forward and women are, ordinarily, inclined to access healthcare services more often than men.

“But mass testing needs also to appeal to the reticent as well as to those young professionals who want to go and mix in bars and restaurant. So, local areas will need to work hard to engage with those people whom pilots might otherwise struggle to reach.”

She adds that, once the current lockdown in England ends, if we return to a system of tiers, there is the potential for confusion to rear its head again over public health messages. People are also liable to feel “it’s not fair”.

“But, as others have pointed out, there is nothing fair about Covid-19.”