Scouse lessons – Liverpool’s mass-testing shows promise, but must reach more people | Britain
IF YOU WANT something done on Merseyside, it helps to have Jurgen Klopp on your team. On November 5th, the manager of Liverpool FC posted a short video on social media urging people to get tested for covid-19. “Regular testing has kept the Premier League going,” he said. “Let’s do it together; let’s do it for Liverpool.”
Mr Klopp’s video was part of the “moonshot” programme’s first major trial. In September, a leak revealed the government was prepared to spend more than £100bn ($130bn) on mass testing—an approach championed by Dominic Cummings, then the prime minister’s chief adviser. Nothing like that much has been spent yet. But a day after Mr Klopp’s video was posted online, anyone living or working in Liverpool was encouraged to get tested, and to continue doing so once a week.
The pilot relies on Innova antigen tests, which pick up proteins the virus sheds. They are less sensitive than more commonly used polymerase-chain-reaction (PCR) tests which look for its genetic sequence, but can be processed on the spot rather than sent to a laboratory. A study by Oxford University and Public Health England found that when carried out by laboratory scientists they catch 79% of positive cases identified by PCR, and 58% when used by self-trained members of the public. They catch 95% of people with high viral loads, who are thought to be most likely to spread the disease.
The idea is that, since you are testing people who otherwise would not have been tested, everyone who is caught is a win. By November 18th, 702 positive cases had been identified in Liverpool. The government is now offering antigen tests to medics around the country, who will use them twice a week, and plans to employ them to enable students to return home at the end of term.
Some public-health professionals fear that people will change their behaviour on falsely receiving the all-clear, possibly even increasing transmission of the virus. While Liverpool is locked down, that is not much of a problem. “If it comes back negative, I don’t really know what I could do differently,” says Cara Sutton, a pharmacist getting tested in the south of the city. Lower sensitivity may be more of a problem when loosening existing restrictions. Trials to use tests to allow visitors into care homes will therefore start by employing both PCR and antigen tests.
The other problem Liverpool throws up is getting people to take the tests. Despite Mr Klopp’s best efforts, just over 130,000 tests have been carried out. Some 400,000 adults live in Liverpool and more work there. That level of testing will reduce the spread of the virus, but it may not have a dramatic effect on transmission.
At the moment, some people will get tested out of pure altruism, or “so granny doesn’t die”, says a scientist advising the government. But for others, it is unclear what the incentive is: test positive and you must isolate; test negative and you gain nothing besides a little peace of mind. In Slovakia, which recently tested 3.6m people, or 95% of those eligible for the scheme, a negative antigen-test result exempted the receiver from obeying stricter covid rules introduced just before the roll-out.
The Slovakian experiment, which appears to have contributed to a sharp reduction in the spread of the virus, has heartened those in government who are pushing for a similar nationwide blitz. The alternative is a roll-out of the Liverpool model to other hotspots, and greater use of tests by doctors, students and similar groups.
Mr Cummings was recently fired from government, which means that others will have to make the final call. Millions of antigen tests represent a welcome, if curious, leaving gift.■
This article appeared in the Britain section of the print edition under the headline “Scouse lessons”