LONDON — In the global struggle with the coronavirus pandemic, the U.K. is fighting in the dark.
Top officials now accept the country has not done enough to test the population and its key medical workers to be able to see how far the virus has spread — and to stop it spreading further.
Prime Minister Boris Johnson is personally leading efforts to source the kit the country needs from around the world. His team blames a shortage of chemical components, and British experts and officials struggle to agree on what to do next.
“You cannot fight a fire blindfolded and we cannot stop this pandemic if we don’t know who is infected,” the director-general of the World Health Organization, Tedros Adhanom Ghebreyesus, said two weeks ago. “We have a simple message for all countries: test, test, test.”
While Johnson’s approval ratings have risen since the crisis hit, questions over the U.K.’s approach have grown louder in recent days as the death toll begins to soar. Politicians, academics and the British media are asking how the U.K. ended up lagging so far behind other countries, including Germany and Italy on testing rates for COVID-19.
It wasn’t always so fraught. In the early stages of the outbreak in the U.K. in February and early March, medics engaged in a rigorous process of tracing people who had been in contact with individuals confirmed to have the virus. Those involved were then tested and told to quarantine themselves at home.
As the outbreak spread, however, it became clear the government’s strategy to “contain” the disease was not going to last. On March 12, Johnson and his most senior scientific advisers made a decision: to abandon efforts to limit the outbreak and instead seek to delay the worst phase of the epidemic until the National Health Service was better able to cope.
That policy had two crucial and hugely controversial elements: first, an acceptance that at least 60% of the population would ultimately get the virus, in order for the country to acquire a degree of “herd immunity.” At the same time, officials decided it was pointless — and people involved in the plan say the U.K. didn’t have capacity in any case — to continue widespread testing in the community.
“It is no longer needed for us to identify every case,” England’s Chief Medical Officer Chris Whitty explained on March 12. “We will pivot all of the testing capacity to identifying people in hospitals who have got symptoms so that we can pick them up early.”
Last Friday, Whitty himself fell ill. He went into isolation without taking a test.
On the same day, Johnson and the Health Secretary Matt Hancock also announced they had the virus — but the two top politicians had taken tests that proved it.
That discrepancy underlines the confusion in the U.K.’s approach. It may also indicate a fundamental conflict between the argument the scientists are making — that testing everyone isn’t necessary or desirable — and the political reality for Johnson’s ministers, who need to be seen to be doing everything they can.
The policy of ditching widespread tests lasted only a week before it came under intense pressure. A new model of the outbreak sent shock waves through London, with a warning that 250,000 people could die unless ministers took radical new steps to limit public activities. The strategy of allowing “herd immunity” to build was abandoned and in its place began the phased shut down of swathes of Britain’s economy and the lockdown of its population.
Schools, pubs, bars and restaurants were closed. Public gatherings of more than two people were banned, and police were given sweeping powers to enforce the unprecedented nationwide restrictions.
But there was still no testing on a wide scale. It was only at the weekend that front-line National Health Service staff started getting tested. And a week into the lockdown, despite promises from Johnson and his ministers that tests will be scaled up, it hasn’t happened yet in a way to match some of the U.K.’s neighbors.
The U.K. has been testing about 2,000 people per million citizens, compared with about 6,000 tests per million in Germany, according to analysis from the BBC. Critics have also pointed out that the U.K. was slower than countries such as Germany to make labs available for processing tests.
“Countries like Germany and South Korea have gone a different route,” former Health Secretary Jeremy Hunt said Tuesday in a video on Twitter. “It is essential that mass community testing is part of our national strategy.”
The government now concedes Hunt’s point. Johnson is trying to play catchup, announcing a plan on March 18 to reach 25,000 tests a day by the middle of April, and “hopefully very soon up to 250,000 per day.” Ministers have yet to chart a path toward Johnson’s most ambitious goal.
“While the rate of testing is increasing, we must go further, faster,” Cabinet Office Minister Michael Gove told reporters Tuesday. A “critical constraint” on the U.K.’s ability to “rapidly increase testing capacity” is the difficulty in obtaining the chemical reagents needed to carry out the tests, he said.
Since the start of the outbreak, Johnson has promised that he and his government will rigorously follow the advice of their top scientists at all times. Being “guided by the science” has become a mantra in the U.K.’s campaign against the virus.
Yet even Whitty, the chief medical officer who advocated moving away from mass testing, has since said the U.K. should try to learn from other countries and test much more. For politicians like Johnson and Gove, who will ultimately be accountable to voters, the science is not enough on its own.
“Once this dreadful epidemic is over,” Gove said Sunday, “there will be an opportunity for all of us to look back and to learn.”
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