Tue. Jan 18th, 2022

British Health Minister Sajid Javid has acknowledged that the government will have to “limit” the supply of rapid Covid-19 tests over the next two weeks to respond to ‘unprecedented demand’ driven by the Omicron variant boom .

“The advent of the Omicron variant has caused record case numbers and unprecedented demand for both PCR and Lateral Flow Device [LFD] tests, “Javid wrote in a letter to MPs on Wednesday night. “This inevitably put pressure on the testing system, despite the impressive scaling up of supply, logistics and laboratory capacity.

“We expect to have to limit the system at certain points over the next two weeks to manage supply through the course of each day, with new portions of supply being released regularly through each day.”

The letter follows a few weeks in which the government’s discussion platforms for PCR tests, which require laboratory processing but are more accurate, and rapid LFD tests have been hampered by patchy availability.

Does the supply of lateral flow tests keep up with demand?

The rapid spread of the Omicron variant put more pressure on the test system than any previous Covid wave.

This is largely because, in England, double-grafted close contacts of a Covid case can avoid self-isolation by taking daily lateral flow tests for a week, while infected people vaccinated can leave isolation after taking an LFD on days six. took and seven.

“We can not have enough tests right now,” said Irene Petersen, professor of epidemiology and health informatics at University College London.

In his letter to MPs, Javid promised to triple the offer of 100 million LFDs per month before Omicron.

Graph showing that lateral flow now accounts for a large majority of tests in England, and a fifth of new cases

According to the latest figures quoted by Prime Minister Boris Johnson, 200 million tests will be sent directly to UK households over the next month, while 42 million will be provided by pharmacies. This equates to just over one pack of seven tests per household.

But Petersen said the government was “very vague” about how LFDs are prioritized, adding that it caused “panic” over the lack of availability on the ordering platform.

“We need to do smart testing by making sure supplies penetrate key workers who want to avoid or end their self-isolation period,” she said, reflecting calls from doctors ‘and nurses’ representatives. “Only then can we think about getting tests from as many households as possible.”

Prof Azeem Majeed, head of the department of primary care and public health at Imperial College London, said some of his patients “test their whole family every day” due to “the lack of clear guidance”.

Is there a worldwide shortage of lateral flow tests?

Sir Roger Gale, Tory MP, tweeted on Wednesday that the health secretary had informed him that the “lateral flow and PCR test block” in his Kent constituency was the result of a “world deficit”.

Two people familiar with the government procurement process told the FT that the UK was facing ‘much fiercer competition’ for lateral flow supplies compared to earlier in the pandemic as more countries now deploy the technology.

They also said the UK’s small pool of approved suppliers was limiting its options. Only four biotechnology companies have exceptional usage authority to provide fast test kits for self-use through the NHS testing and tracking program.

“No domestic suppliers can scale up, so the government has to rely on the best international manufacturers out there. . . largely from China, ”the source said.

“These companies receive claims from France, Germany, Poland, Spain, Italy. . . “Lateral flow tests are seen as the answer to Omicron around the world,” they added.

How stretched is PCR testing capability?

At a meeting on December 20, the government’s Scientific Advisory Group on Emergencies warned that “capacity constraints [for testing] can already affect case data ”.

The burden on the PCR testing service has led some experts to call for a change in government strategy.

Majeed said health authorities in England should stop asking people to take a PCR test to confirm a positive LFD result to relieve pressure on the “already cracking” system.

Between January and March this year, England’s public health body suspended confirmatory PCR tests due to high prevalence. A similar move was made by Danish health authorities earlier this month.

Professor Alan McNally, a microbiologist at the University of Birmingham, on Thursday asked a series of tweets for the health secretary “to move on to community symptomatic LFD testing” in England instead of using more time-intensive PCR tests.

“You can’t possibly run a community PCR testing program with a quarter of a million cases a day,” he said.

But a person close to England’s test program said that laboratory capacity was “only part of the chain” and the supplies of PCR test kits and reagents could also “come under pressure as test volumes increase”.

“We are not the only ones doing this and all nations – in both the private and public sectors – draw the same supply of everything from plastic points and tubes to swabs and PCR reagents,” the source said.

How will lateral flow tests affect transfer on New Year’s Eve?

Iain Buchan, a professor of public health at Liverpool University, said LFDs had “broken transmission chains” over Christmas, with people “staying home when they are positive rather than going to see grandma”.

He predicted the same benefits would come from testing on New Year’s Eve, if sufficient supplies were available. “Societal behavior around risk mitigation and testing has completely changed,” he said.

But Petersen said she expects LFD use may have been higher over Christmas due to younger groups feeling “a greater sense of responsibility towards older people in their families”.

“Lateral flow tests work when everyone lets them do it,” she said. “If you go to a big party where only 50 percent of the people did it, it will reduce distribution, but it’s less of a guarantee.”

However, John Drury, a professor of social psychology at the University of Sussex, said he was concerned about the “overpayment” that was having a negative effect.

“How many people know this? [LFDs] should be taken as late as possible otherwise they are much less effective ?, ”Drury asked. “They can help people make an informed judgment about how to deal with others, but they can provide false reassurance.”

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