The UK could be testing thousands for coronavirus daily – so why aren't we?

Imagine you’re a cook in the best-equipped kitchen in the world. You are surrounded by high-capacity grills, commercial-grade ovens, blast chillers. You feel ready to tackle macarons, beef wellingtons, paellas. The chef comes in, gives you the order, and you read: spaghetti with tomato sauce.

Now, with all due respect to Italian cuisine, that is not a particularly challenging meal. And as biomedical research goes, coronavirus testing is little different. There are various detection methods and kits, but all are based around nucleic acid amplification (NAAT) using quantitative polymerase chain reaction (qPCR). Almost every university will have at least one, if not multiple, RT-PCR machines, with trained staff already on the ground. According to a US government official who spoke to me on condition of anonymity, “virology laboratories in major biomedical universities should all be able to process at a minimum 100 samples per day”. Given this, there is no excuse why the UK is not testing more potential Covid-19 cases.

China’s draconian social distancing measures have been proven effective, yet their economic consequences have been severe. Meanwhile, South Korea, Taiwan, Hong Kong and Singapore have been able to contain their outbreaks with far fewer economic repercussions through a combination of measures: travel restrictions; quarantine of known and suspected cases; and increased hygiene and distancing precautions.

However, one of the key things that has enabled South Korea to excel in its response has been its extensive testing of suspected Covid-19 carriers, which in turn has allowed the country to more precisely target its control efforts and allocate precious public health resources. The country learned from previous experiences with SARS and MERS to develop a streamlined approval process for test kits – four companies were quickly given the green-light to manufacture them when Covid-19 first appeared.

Today in South Korea, 20,000 people can be tested daily, both at clinics and at drive-through centres. As of yesterday, over 270,000 tests have been done. The results? New infections are down from a peak of 909 on 29 February to 76 on 16 March. And while schools are still closed and offices still encouraging home working, high streets are beginning to bustle with activity once more.

The UK has only tested 450 individuals per million people to South Korea’s 5,000 – all while new cases are rapidly appearing. This weekend, the government announced that it will soon issue home-testing kits. It is welcome news; however, the test will detect antibodies against the Covid-19 virus, and antibodies take time to develop. A patient may only test positive 2-3 days after the onset of symptoms. South Korea is undertaking PCR testing, the only methodology that can discern infection before symptoms arise, particularly important given that Covid-19 appears to be transmissible during this so-called “window period”.

We should also take advantage of our available academic infrastructure. Designated CL-2 facilities in national research universities should be converted into Covid-19 processing centres, and local laboratories hired out to test Covid-19 samples. Importantly, Covid-19 won’t be our last epidemic. This testing network must maintain the capability and staff to swiftly process any kit sent by public health authorities as future outbreaks reach the UK. And modular testing centres should be created at airports, railway stations, ports for rapid deployment when the need arises.

We have the required expertise – we must use it. Until then, please help protect all the vulnerable members of our society: wash your hands, stay home and, if at all possible, enjoy your quarantini.

Gianmarco Raddi is a student doctor at the University of Cambridge and a visiting scientist at the Wellcome Sanger Institute and Cancer Research UK.