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Logistical issues constrain UK’s increased virus testing capacity 


Restrictive criteria and hard-to-reach screening sites are contributing to a growing gulf between the UK‘s Covid-19 testing capacity and the number of people being tested for the virus.

National Health Service and care workers are struggling to reach testing sites, and laboratories have been working at below capacity because fewer swabs have been arriving for processing than were expected, people with knowledge of the situation said.

Donna Kinnair, chief executive of the Royal College of Nursing, said on Friday that some ill and symptomatic nurses were driving for hours to testing stations, only to be turned away because they did not have appointments. 

“We need clear direction on how to access testing,” she said.

Although daily testing capacity has increased to more than 38,000, Downing Street confirmed that just 18,665 tests had been carried out in the 24 hours to 9am on Thursday. 

“Frankly, the number of NHS staff coming forward wasn’t as high as expected,” health secretary Matt Hancock said on Friday morning. He said earlier this week that the Easter weekend had pushed down demand for testing, “as staff haven’t wanted to come forward”.

However, Chaand Nagpaul, council chair of the British Medical Association, the main doctors’ union, said the organisation’s members were “telling us that they are unable to access tests in their areas”.

The proportion of NHS staff who are self-isolating — around 8 per cent — indicates that “demand is certainly greater than current tests available,” he said.

The government has established 29 regional drive-in test centres for key workers, which operate by appointment only. Testing eligibility was extended on Friday from frontline NHS workers and social care staff to groups including the police and fire services, and prison and judiciary staff.

However, concerns remain about logistical hurdles and the narrow period of time in which people can go for tests.

To be eligible, an individual must be self-isolating with symptoms of coronavirus — or be living with a frontline worker who does — and should be in the first three days of symptoms at the time the swab is taken.

The 29 sampling sites are not in town centres or outside hospitals, but in less accessible places including the north London Ikea store, which is in the suburbs near a motorway, and Stansted airport. Those going for tests may not use public transport, nor can they be taken by someone they do not live with.

“The centres are often some distance from where staff live or work, travel is difficult if someone is unwell and there’s only a narrow window of time for tests after symptoms show,” said Sara Gorton, head of health at Unison, the union which represents many people working in the sector.

Michael Hopkins, an expert in the sociotechnical challenges of biomedical innovation at the University of Sussex, said that if the focus was on getting NHS staff back to work as quickly as possible “one would expect every hospital to have a site for swabbing staff in their car park or at another nearby location”.

Hospitals and care homes have been drawing up lists of individuals to send for testing, with some institutions allocated a quota of slots.

A letter circulated to GP practices in east London earlier this month said that, since “testing capacity is limited”, the clinical commissioning groups in seven of the city’s boroughs would be allocated one day each to book staff appointments.

One doctor at a central London hospital said the varied availability of testing meant many symptomatic staff looking to be tested were “finding it so difficult that they just give up”.

Since people working in hospitals who are not showing symptoms and not self-isolating cannot currently be screened, some analysts are concerned that asymptomatic staff could be spreading the virus to other workers and patients. 

Mr Hancock said on Friday that the government was considering extending testing to asymptomatic hospital workers. 



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