Governments are seldom good at radically changing existing systems, much less inventing new ones and then ramping up delivery of the resulting solution in a short time span. That’s why countries caught flat-footed when the coronavirus hit have paid in lives. And yet a rare bright spot in the UK’s otherwise dismal coronavirus record was announced by Health Secretary Matt Hancock on Friday, in the manner of a child with failing grades pulling off his first A.
It was pretty evident that Hancock’s job was the on the line. In early April, as Britain moved briskly up the epidemiological curve, Hancock pledged that by the end of the month the country would be testing 100,000 people a day. At the time, the government was struggling to test one-tenth that many people, while Germany was already testing 70,000 a day comfortably. There was every reason to doubt he would succeed. With death toll now above 28,000, Britain couldn’t afford a failure.
Hancock’s announcement Friday that the target had been more than reached — 122,347 tests were provided in the 24 hours up to the announcement — was a significant milestone in Britain’s coronavirus battle. Whether it is also a turning point remains to be seen.
Mass testing is essential if the government’s track and trace policy is to prove effective. It goes hand in hand with plans underway to hire 18,000 contact tracers and to convince well over half the population to download and use a new Covid-19 app being trialed this week. When potential infections are identified, and the web of contacts mapped, tests have to be available. Regular testing can also inform people when they should isolate and when it might be safe to go to work. Finally, testing will be critical in determining if a second or third wave of concentrated infections is brewing.
Of course, there were quibbles about Hancock’s numbers. It turned out that only 70,000 people had actually been tested; the total figure included kits delivered to people’s homes and those sent out to hospitals and other sites run by the country’s National Health Service that may not have been used or sent back to laboratories.
And yet, if the momentum can be sustained, the exact number is less important than the distance traveled. It was right to set an ambitious goal. The testing figures showed the ability of government, not normally the nimblest of operators, to find solutions when push comes to shove, including by partnering with the private sector. Doing so, however, required a massive course correction.
Back in mid-January, after Chinese scientists had published the full genetic code for the virus, it was a government facility — the Colindale laboratory — that developed a polymerase chain reaction (PCR) test for Covid-19. Back in 2002, the facility had also developed a test for SARS, a preceding coronavirus, and by February it seemed confidently ahead of the game on this virus too. Its diagnostic test would be conducted from 12 labs operated, like Colindale, by the state executive agency Public Health England.
The capacity announced was modest, but so they thought was demand. The UK had initially brushed off the World Health Organization’s advice to “test, test, test.” The country’s scientific advisors and government were leaning toward herd immunity — essentially just letting the virus rip until enough people had it that it burnt itself out. But that underestimated the number of infected who would need hospitalization, threatening to overwhelm the National Health Service.
As the number of cases, and deaths, shot up, Prime Minister Boris Johnson pivoted and promised the government would quickly ramp up testing. But Public Health England’s capabilities were nowhere near sufficient. Then there were problems getting enough swabs and reagents for the tests. And worries about reliability.
Ultimately, the government switched to commercial testing. Three mega-labs were set up to test samples supplemented by 50 drive-through testing centers, a home-testing service and mobile units.
The belated public-private partnership appears to have been successful. There is still a way to go, however. There are black spots around the country, places like Cornwall on the west coast where residents live more than an hour from their nearest test center. The overall testing level, as a share of population size, is still too low. There are logistical problems in getting tests to the people who need them most — especially in care homes without convenient access to testing sites. And two days after Hancock’s triumphant announcement, the government had already failed to meet the daily target.
Even so, the UK’s testing story underlines both the strengths of the British system and weaknesses that have proved fatal for so many. If Britain has suffered unduly in this crisis, it is because its response to the virus was initially so hesitant and incremental. If Johnson’s government struggled to provide the levels of testing and personal protective equipment that other countries had managed to achieve, it is partly because public bodies were too leaden and reluctant to share control.
Johnson’s long absence as he battled to recover from his own coronavirus infection didn’t help. Now that he’s back, government communications — so often cryptic and defensive as the crisis unfolded — have also improved, emulating the transparency and seriousness of communications by German Chancellor Angela Merkel and her key advisers.
Whether the UK government can apply the lessons of its recent testing success — set bold targets, be nimble in pursuing them and be transparent — will soon become clear as it rolls out the program for mass tracing and as Johnson prepares to reveal the plan for lifting lockdown restrictions in the coming week.
Another key test is whether the government can now relieve continued shortages in personal protection equipment that have endangered medical staff, forcing nearly half of doctors to source their own.
Any government can be judged on two aspects of their coronavirus response: How quickly did it act at the start to contain the virus, and how well did it learn from early mistakes and adapt? Britain started poorly and the costs for that have been tremendous. Perhaps it will now fail better.
Bloomberg
