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Covid-19: Test Results

Volume 807: debated on Tuesday 27 October 2020


Asked by

To ask Her Majesty’s Government what immediate changes they are making to improve the speed of test results for COVID-19.

My Lords, in the last two months we have responded to the rising demand for tests, the rising infection rates, the need to protect the front line in health and social care, the need for clinical trials for vaccine-to-medicines, outbreak control and surveillance by doubling the number of tests to 360,000. This has impacted turnaround times, which is regrettable, but we are focused on increasing capacity to raise efficiency, investing in the logistical backbone and encouraging users to the weekends, which will bring turnaround times down to the objective of next-day results.

My Lords, this morning I spoke to Allan Wilson, the president of the Institute of Biomedical Science, which represents 20,000 professional lab staff. He wrote to the department in early April to offer his free advice on how to improve the system and get a speedy testing system. Seven months later, the department responded with a letter advising him to go to the government portal for public contracts. Will the Minister now agree to meet the person who probably has the most experience of labs up and down the country? Why are the Government shunning Mr Wilson of the Institute of Biomedical Science in favour of paying £700,000 a day to management consultants?

My Lords, I am distressed to hear the anecdote that the noble Lord has just shared with us. We embrace the support and help of anyone who steps forward, particularly someone such as Mr Wilson, who clearly has an enormous amount of expertise. I would be delighted if he would write to me personally and I would be very prepared to meet him. I would also like give massive thanks to all those from all the relevant logistical, pathology, military and medical sciences who have formed an organisation practically the size of Tesco, which is what the national diagnostic system now looks like. It is only with the support of British industry, universities and business that we have been able to build this up and we are enormously grateful for that support.

My Lords, we have had continuous failure of test and trace since March. Again and again, we are missing the targets. Why? Is it the equipment, the personnel or the management structure that is causing this failure of our efforts?

I am not sure that I can answer the false premise. Actually, test and trace has enormous achievements—the isolation of 1 million people who would potentially have spread the disease is the most glaringly obvious—but we are here to talk about turnaround times and there, I completely accept that the current performance is not where it should be. I have sought to explain the reasons for that, and the enormous increase in capacity in the last 60 days. I have also sought to explain the measures we are putting in place to mitigate that. I am confident that those measures will be successful, and I am happy to report back to the House on them

My Lords, South West Water and Plymouth City Council have been co-operating in the testing of wastewater across the city to determine the strength and location of Covid outbreaks. What guidance has Public Health England given to local authorities on this, and what analysis has it done on this sort of testing?

The noble Baroness is right to cite the use of wastewater analysis. The innovations and partnerships team at test and trace has a programme to look at precisely that method. We are particularly interested in using targeted wastewater analysis at schools and in social care in order to promptly identify the presence of the disease. We are looking in particular at technologies that have already been trialled in Italy. The trials are extremely promising, but I would be happy to make that connection between South West Water and the relevant team so that their knowledge is usefully used.

My Lords, what study has been undertaken into the efficiency and accuracy of these tests; by which I mean how many false positives and false negatives there are? Furthermore, what is the long-term strategy regarding this? If, every time restrictions are relaxed, tests show that infections rise, are we then just to continue imposing lockdowns ad infinitum?

My Lords, we have a very intense and rigorous validation programme around the various tests. They look at sensitivity and false positives. We do not believe that the current machines we use have a high risk in that department, but we always keep a close look at it. I am extremely grateful to those businesses that have developed new and innovative tests that we are rolling out all the time.

My Lords, what does the Minister think about trained sniffer dogs to detect Covid-19? Does he know that the London School of Hygiene & Tropical Medicine is one of several groups that have assessed the accuracy of using sniffer dogs?

My Lords, I take my hat off to the London School of Hygiene & Tropical Medicine, which runs an extremely exciting trial. In fact, the Secretary of State is visiting this very afternoon in order to get an update on that trial. Dogs can be used as a way of screening crowds in such places as airports and high-density venues. The validation of that method has not been proven yet, but I am personally extremely hopeful and remain grateful to those involved in the pilot.

We move from dogs to the technical teething problems with the app. It seems that the NHS Test and Trace app sends out exposure warnings to people stating that they have to isolate and then a few hours later sends another alert saying that there is no issue and they do not have to isolate. That probably means it is working quite well, but it does not tell anybody where they might have been exposed, or, as I have experienced, it flashes at you that you have been near someone who has tested positive and then there is complete silence. When will we be able to trust the technology to help us as well as alarm us? Secondly, when will the care homes testing speed up? Care homes’ turnaround time for tests still seems to be stuck in three to five days on average.

My Lords, on the app, the noble Baroness alludes to two separate issues. The first is the exposure notices, which are not sent by the NHS app but by the Apple telephone device. We have put in the new version of the NHS app a way of mitigating those exposure notices. She is entirely right that the app has no idea of your geography; that is the genius of the app and its commitment to privacy. It means that we cannot tell you where you were exposed, but also that your location and privacy are protected. On social care, we are investing in a large number of trials to try to speed up mass social care testing, including bulk testing and the use of wastewater, which we discussed earlier.

My Lords, on 25 September, NHS England gave guidance specifically to implement pool testing to speed up testing times. Since then, what increase in pool testing has taken place?

My Lords, pool testing offers a huge opportunity to cover a large amount of ground very quickly, and there are some workplace testing champions for it, including Amazon. However, it has some restrictions, in particular not knowing the identity of the person who might have tested positive. That is why we are running a large number of pilots at the moment and investing heavily in trying to figure out this exciting but challenging technology. We will deploy it the moment we can find a model that works.

My Lords, there have been a lot of allegations of corruption in the tendering processes for various aspects during the pandemic. I am curious whether the Minister feels that that could have some impact on the efficiency of what is happening now. When will the Government work with the right people?

I acknowledge the presence of fraud and condemn all those involved, but I do not see the connection between fraud and inefficiency.

My Lords, I ask the Minister to convey our thanks to those rank and file workers who are trying to make this system work. I also say that, until he modifies the scheme so that we have local tracing, there will be many more sessions of Question Time that will be embarrassing for him.

I am extremely grateful to the noble Lord—I am never embarrassed—for giving me the opportunity to say a massive thanks to those tens of thousands involved. They take a huge amount of heat from the criticism targeted at test and trace, but many of them are working through the night to hit our targets, because people often take their tests during the morning or the afternoon. A lot of them work at the weekend and during holidays, when people often want their test results. It is arduous, tough, technical work and we are enormously grateful to those concerned. On local testing, we have in place 100 local test partnerships between local authorities and the national test and trace system which are proving extremely valuable, particularly in targeting hard-to-reach communities. We are putting an enormous amount of resources into them and they are proving extremely successful.

Sitting suspended.