Coronavirus Testing- Fixing a Fragmented Public Health System

Hasnain Khan analyses the government's policy of testing during the pandemic and fundamental changes needed in Public Health services.

The World Health Organisations Director General had a simple message for all countries, ‘Test, Test, Test’. However, we had failed to combat the demands of the pandemic with the UK having the 2nd highest death rate in the world. It is unclear the reasoning for the UK to not meet and sustain the target of 100,000 tests per day. There was no lack of cases. There were 6,201 cases recorded on the 1st May (2nd highest recorded daily toll) and no shortage of trained workers, equipment and reagents. Here, I focus on the key problems that limited the level of testing in the UK.

It took too long

The government were too slow in responding to the testing demands required in the early, critical stages of the coronavirus pandemic. Its focus on centralised testing centres, whilst supports industrial production, provides logistical complications localised testing centres would not have caused. In Yorkshire, we have two of the leading research centres, University of Sheffield and University of Leeds, in the world yet their potential was not fully capitalised. An example includes a research student at the University of Sheffield to create Artificial Intelligence to predict COVID-19 from standard blood tests two week earlier than current, existing tests. The government did not learn the lessons from Germany and South Korea in developing robust and wide-reach testing programmes. 

Lack of Co-ordination

The government showed a lack of co-ordination with the use of resources. The UK has some of the best genetic-testing laboratories in the UK, such as the University of Sheffield, University of Leeds and Sheffield Hallam University, yet trained staff were under stay-at-home orders and some facilities were closed. The NHS has consistently only used a portion of its testing capacity.

Testing- Not for all

The NHS were too restrictive on its testing criteria. Government announcement on the 28th April to expand testing to all asymptomatic NHS staff members had only included those working in care homes, not personal care assistants and unpaid carers. Domiciliary care had been forgotten, with it acting as a significant proportion of social care. A carer from Sheffield, who was unable to be tested for coronavirus until July, said she feared she may have spread the disease into care homes despite showing no symptoms. The governments language to protect those working on the frontline does not match the several cases where testing guidelines are not met. It highlights a failing in the system to co-ordinate policy into action.

Test, Track and Trace

WHO were very clear for countries to create an established Test, Track and Trace system to monitor the spread of the disease to allow swift and appropriate action. The British government failure was mostly due to a decade of public health austerity measures. Director of Public Health Sheffield, Dr Greg Fell introduced an Annual Report in 2017. It showed a correlation between austerity and for the life expectancy in Sheffield stopping, with a risk it could start to fall. Nationally, they found regions that are more vulnerable and less affluent getting a worse deal. He wants clearer guidelines for tackling poverty. With a fragmented public health system, the government resorted to private measures to deliver a coronavirus tracking system, which has allowed the disease to target those less-protected in our communities.

Ways to resolve a fragmented health service

  • Trust in our facilities- I do believe central government must take responsibility creating a track and trace system. However, we are fortunate to have some of the world-leading universities and research centres to help on the national and regional effort. We must utilise the best of Britain’s qualities to combat the pandemic. A communal effort of bringing different groups together could have supported the national effort.
  • Protect Public Heath Services- the greatest investment to resolve health inequalities and promote social justice will be towards our public health services. A funding effort would help bolster national policy work to help those vulnerable in all regions and respond effectively to fundamental disparities in health.

Hasnain is a 4th year medical student at the Univeristy of Sheffield. He is also currently the President of the Sheffield Medical Society where he runs a COVID-19 Volunteer Scheme, sending over 150 medical students to hospitals, GPs and NHS babysitting services across South Yorkshire. 

He tweets at @HazKhan07

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