Saturday, October 24, 2020

Universities expose uneven playing field on Covid testing

Universities expose uneven playing field on Covid testing

At colleges across Cambridge university, students have been divided into “Covid households” of up to 10 people, several of which are selected each week to swab the back of their throat and put their samples into a shared pot.

The pooled samples, taken from symptom-free students, are then tested together: if it comes back negative, the whole household is deemed coronavirus-clear. If positive, everyone is given an individual Covid-19 test.

The testing of the samples, which takes place at one of the UK government’s ‘lighthouse laboratories’ located on the university’s land, runs counter to current NHS guidance which states that only individuals showing coronavirus symptoms should get public tests.

One Cambridge student published an anonymous confessional on the ‘Camfess’ Facebook group last weekend, asking, “Is there anyone who feels a disgusting sense of privilege at the fact we are being tested every week without symptoms, whilst there are thousands of people in the rest of the UK unable to access anything near to this??”

But Cambridge is one of hundreds of universities that has developed bespoke strategies to test for Covid-19, amid a backdrop of public frustration over shortages and delays in the central government system.

While some institutions have struck deals with public labs, others have hired private companies or used testing facilities on site.

What has resulted is an uneven playing field in higher education, with those universities that have money and resources able to test widely, while those without have had to make do with an often overwhelmed public system.

Despite efforts by universities to suppress the virus, the growing rates of infection on student campuses — particularly in the north of England — are believed to be one of the factors behind the alarming surge in cases across the whole country in recent weeks.

“We’ve always had a two-tier system in Britain,” said Devi Sridhar, professor of global public health at Edinburgh university, referring to inequities in testing across the UK. “Early on in the pandemic it was that doctors couldn’t get tests, while rich people could get one in a private clinic.”

Referring to government advice, she said, “we’re hearing that asymptomatic testing doesn’t matter, but at the same time Eton tested all its students, Cambridge also sees it as a priority.”

The Cambridge laboratory being used by the university is one of six lighthouse laboratories — “pop-up” facilities rapidly established by the government to meet the growing demand for processing tests.

A technician at one of the government’s ‘pop-up’ lighthouse laboratories © Andrew Milligan/AFP

Cambridge defended the arrangement, saying: “We have access to a limited number of tests at the Cambridge Covid-19 testing facility, which we helped set up and staff on a voluntary basis, and which occupies a large portion of a state of the art University building.” The university added that it is contributing the majority of the costs of the testing programme.

Nevertheless, Allan Wilson, president of the Institute of Biomedical Science, noted that there is now an “unhealthy mix of private and public” in the UK’s testing system.

The Oxford University Hospital Trust, which has been analysing public swabs for the government since August, until recently had an agreement with the university of Oxford and a private school in the region to process its swabs.

The Oxford University Hospital Trust said: “Any remaining capacity has on occasion been offered to the local community, but this arrangement has now been stopped and all tests will be used in line with priorities set by government.”

Students at Cambridge university are being tested for Covid-19 even if they do not display symptoms © Andrew Couldridge/Reuters

Cambridge and Oxford universities said priority was given to patients and the public, and they were only paying for public laboratories’ excess capacity. 

Symptomatic students at the University of Liverpool are also being tested at an NHS laboratory, which the university has supported with equipment and volunteers. Symptomatic staff and students at Liverpool and John Moores universities are allocated 300 of its 1,900 tests a day.

At the University of Worcester, on the other hand, vice-chancellor David Green said it was the “right thing” that staff and students should have the same access to testing as the community. While the university’s case rate so far remains low, “the availability of speedy tests is quite a big handicap,” Prof Green said.

Worcester has one walk-in facility, only accessible by car, and while students can order tests by post it is not uncommon for track and trace to notify students a week after they have been in contact with a positive case.

“We don’t want special treatment, we want access,” added Prof Green.

While many other universities have also told students to access testing in the same way as other members of the public, a significant number have created their own in-house testing regimes.

The university of East Anglia is regularly screening all students using its own laboratory facilities, while others including Exeter university have commissioned private companies to run testing systems. 

Cardiff University is screening all asymptomatic students using its own saliva tests, a system it hopes will stop young people unknowingly spreading the virus in the community, and prevent outbreaks in halls before they begin.

“One of the questions we get is are you taking away resources from the NHS,” Andrew Westwell, professor of medicinal chemistry at the university said. “We’re not — we’re using an entirely different workflow and different reagents.”

“There’s a whole number of different approaches across the university sector, it would be nice if there was a uniform approach,” he added.

One Cambridge student described the pooled testing system as “great”, but said the same “should be happening elsewhere”. “It’s a classic case where a crisis has meant that the divide in society is worsening,” she said.

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