Britain has millions of coronavirus antibody tests, but they don’t work
Posted on April 6th, 2020
Courtesy The Times (UK)
Ministers had hoped tests would pave way for an easing of lockdown restrictions
None of the antibody tests ordered by the government is good enough to use, the new testing chief has admitted.
John Newton said that tests ordered from China were able to identify immunity accurately only in people who had been severely ill and that Britain was no longer hoping to buy millions of kits off the shelf.
Instead government scientists hope to work with companies to improve the performance of antibody tests. Professor Newton said he was optimistic” that one would come good in months.
However, Dame Deirdre Hine, the public health expert who chaired an official review that criticised failures of modelling in the 2009 swine flu pandemic, said that it was difficult to understand” why the government had not planned for more testing.
The scientist tasked with evaluating the antibody tests for the government said that it would be at least a month until one was good enough to offer to millions of people.
Sir John Bell, regius professor of medicine at the University of Oxford, wrote: Sadly, the tests we have looked at to date have not performed well. We see many false negatives (tests where no antibody is detected despite the fact we know it is there) and we also see false positives.
None of the tests we have validated would meet the criteria for a good test as agreed with the MHRA [Medicines and Healthcare products Regulatory Agency]. This is not a good result for test suppliers or for us.”
Sir John acknowledged that large-scale testing is therefore a strategy which will be crucial for getting us back to our normal lives in the coming months”. He wrote: The government will be working with suppliers both new and old to try and deliver this result so we can scale up antibody testing for the British public. This will take at least a month.”
Professor Newton, of Public Health England, was appointed to oversee testing last week as Matt Hancock, the health secretary, responded to criticism of the failure to increase checks quickly enough by promising to use private labs and hit 100,000 daily tests this month.
Professor Newton said that his priority was three mega labs” for testing NHS staff and that he did not expect university and commercial labs to be much help in hitting the target.
That’s a very clear message: we are not relying on lots of people coming forward to help us to achieve what’s required and we shouldn’t get too distracted by that,” he said. There’s a big, big ask at the moment which is quite specific [on testing NHS staff]. So a lot of these companies who are offering their capacity may not be directly related to that ask and therefore they might not be as helpful at the moment.”
The antigen test to see who has the virus will be crucial in allowing NHS staff back to work if they do not have the virus, and a separate test that tells who has recovered from infection is seen as crucial to ending the lockdown.
The government has ordered millions of antibody tests but yesterday Mr Hancock said that we still don’t have any that are good enough”.
Professor Newton said that all of the tests failed evaluations and are not good enough to be worth rolling out in very large scale”.
Some of the tests have not been total failures, but Professor Newton said: The test developed in China was validated against patients who were severely ill with a very large viral load, generating a large amount of antibodies . . . whereas we want to use the test in the context of a wider range of levels of infection including people who are quite mildly infected. So for our purposes, we need a test that performs better than some of these other tests.”
The government is still looking for commercial tests but it has accepted that rollout is months away.
Previously officials had spoken of sending millions of home test kits in days, but Professor Newton said the idea that we might have it in days was based on the fact that we might just buy the existing test, and at the moment the judgment is that that wouldn’t be the best thing to do. It would be better to try and improve the test”.
He added: The scientists in Oxford who have been evaluating them are working with manufacturers to say, ‘We’ve tested your test, and it doesn’t seem to perform quite well enough, but we think we can work with you to improve it.’ So it is a little bit uncertain but there are commercial partners able to work with us. I’m optimistic.”
Dame Deirdre, who chaired the official review into the swine flu, said: I am finding it difficult to understand why both the antigen testing and the antibody testing is taking so long to get off the ground.”
In 2010 Dame Deirdre’s report said that ministers and officials had unrealistic expectations of modelling, which could not be reliable in the early phases when there was insufficient data. Once better data was available, modelling became extremely accurate.”
She said: I think that if there is anything perhaps where the response could have been better this time it is on the whole question of testing.”
The government also risks losing an opportunity to buy 400,000 tests a week from South Korean manufacturers, because of officials’ failure to respond to the offer, it has been claimed. Ten days ago a British businessman approached health officials after a Korean investor who has connections with LG helped to persuade five manufacturers to sell their diagnostic tests to the UK. Steve Whatley, who runs a financial technology business, said: We just need a letter saying, ‘Subject to the tests being proven, then the UK will take x amounts of kits per week for x long.’ ”
At-risk doctors kept waiting
Less than a third of doctors with symptoms of Covid-19 are able to get tested for the disease, according to a survey by the Royal College of Physicians (Kat Lay writes).
It also found that one in five did not have access to the personal protective equipment they need to safely treat coronavirus patients.
Andrew Goddard, the RCP president, said the findings of the survey of 2,513 respondents, were a stark indication of the incredibly difficult situation facing our members working in the NHS”.
Matt Hancock told Sky News yesterday that 8 per cent of NHS frontline staff were self-isolating and off work. However, the RCP’s survey suggested the figure could be as high as 14 per cent.
Many of those off work are thought to be in isolation because of a member of their household with symptoms. The poll found almost nine out of ten doctors could not access Covid-19 testing for someone in those circumstances.
Professor Goddard added: The government’s current strategy to deliver testing that would support NHS staff to return to the workforce as quickly as possible clearly isn’t working.” He called for the government to publish its plan, timeline, and the challenges that it expected.