Operation Moonshot, the government’s ambitious plan to test the entire population for coronavirus infection, launches in Liverpool today.
Everyone living or working in Liverpool will be offered repeat tests, whether or not they have symptoms.
Liverpool is the pilot project for ministers’ big vision of weekly testing of the entire population – covering up to 10 million people across England a day. Many people support mass testing, which could allow a return to workplaces, socialising and going to the theatre and football matches without the fear of spreading infection.
Mayor Joe Anderson said the testing pilot could save lives, stop hospitals being overwhelmed and “get the city out of tier three restrictions”.
The pilot will last for approximately two weeks, the government said.
But Liverpool’s director of public health Matthew Ashton told BBC Breakfast it could last longer, saying he wants “to make sure [the pilot is] long enough for us to be able to see the impact”.
People will be offered a mix of existing swab tests and new lateral flow tests, which could provide a result in 20 minutes without the need to use a lab.
New test sites have been set up across the city, in schools, universities, work places and care homes.
Six test centres for people who do not have symptoms will be open from 12:00 GMT until 19:00, with more sites planned. There are appointments available at different testing centres for those with symptoms.
Meanwhile, a leading scientist has warned the Serco Test and Trace system has made no difference to the spread of coronavirus in the UK.
James Naismith, professor of structural biology at Oxford University, told BBC Radio 4’s Today programme the system “hasn’t been effective at all” and was only reaching a fraction of the number of people who should be contacted.
He said: “The point of the system is you need to get a large number of the contacts and break the chains of transmission at a large scale for the Track and Trace system to be effective.
“Given that you miss over half right at the start and then as you walk through the various losses through the system you are actually reaching 20% of the contacts you want to reach overall.
“Given where we are now in infections, it is not until we get proper mass testing that the system can really recover.”
About 2,000 military personnel are helping deliver the tests.
Liverpool City Council has said it is particularly keen to test health and care workers, teachers, school pupils and university staff and students, although everyone is being asked to come forward.
But in the drive to bring about a return to normal life as quickly as possible, the government appears to be endorsing technologies that have limited or questionable accuracy data.
Hope is being invested in saliva tests, but there is no good published data yet, and it is clear they will often miss low levels of the virus in people who have no symptoms. The main one to be offered to the general public in Liverpool is the Innova test, which Porton Down has approved as effective – but only using nose swabs. No data has so far been published on its effectiveness with saliva.
The test is a lateral flow device, which looks and works like a pregnancy test, and is made in China by Biotime Biotechnology for the US company Innova Medical. It is supplied in the UK and Europe by a micro-company called Tried and Tested, which has no office and operates out of a house in Wallingford, Oxfordshire.
The government has signed a contract worth £138m with Innova without a tender, as is permitted in the emergency. “The lateral flow tests were identified as strictly necessary to meet the demand to scale up the mass testing programme in the UK,” says the contract.
British companies say they are perplexed. “I’m surprised and disappointed as a UK manufacturer and having worked in the industry for some time. There are lots of people with tests available in the UK at the moment,” said Christian Stephenson, the chief development officer at the Manchester-based Medusa 19.
It has been unable to get its rapid test evaluated by the government because it works using antibodies – although it is an infection test. But it is now in a trial in Spain, which is likely to lead to orders there.
Dr Emily Adams, a senior lecturer in diagnostics for infectious disease at the Liverpool School of Tropical Medicine, said her team was trying to help with the choice of tests for the city. They evaluated rapid lateral flow tests for the international NGO Foundation for Innovative New Diagnostics (Find), which led to tests developed by SD Biosensor and Abbott being approved by the World Health Organization.
“Our data is not being used nationally, which is a shame,” she said. “In principle, I really agree with mass testing, especially in high-prevalence areas and high-risk groups.” But, she added, “the right tests need to be implemented and we need to make sure that locally that will be the case”.
Evaluation data was needed for the tests that had been chosen for Liverpool, she said. She was disappointed that England was not embracing the WHO-approved tests, as many other countries are.
If somebody tests positive with a lateral flow test, they will be offered a second, PCR test, to confirm it. PCR swab tests are the gold standard for diagnosis but have to be run on lab equipment, so are slower.
Picking up any infections that would otherwise have gone unnoticed because people have no symptoms has to be good. But there are concerns that a false negative test may lead people to assume they have no infection when they do.