(Bloomberg Opinion) — The scary thing about the U.K.’s much-publicized problems with Covid-19 testing is not that the system is encountering difficulties — those were inevitable. It’s that the government failed to anticipate them, it has not been transparent about what went wrong or convincing on the question of when the problems will be resolved.
Boris Johnson and Health Secretary Matt Hancock have been getting an earful from lawmakers from all parties as stories mounted of a meltdown in the country’s testing system. Many people with Covid symptoms have been instructed to travel hundreds of miles for tests and those were the lucky ones. Others seeking to book a test spent hours in a front a screen hitting the refresh button with no joy.
Hancock told Parliament on Tuesday that it would take “weeks” to fix the current problems. When asked on Wednesday, Johnson did not repeat that pledge. He said only that capacity would be up to 500,000 tests per day by the end of October, compared with capacity of about 375,000 currently.
In the meantime, the government will be working out its “prioritization” system for existing testing. It is ironic that a week ago Johnson spoke of Operation Moonshot — a bold stretch goal to test 10 million people a day by early 2021 — while now the government is focused on rationing a small fraction of that number of tests.
This is the moment when the coronavirus testing regime needed to be shifting efficiently into high gear. The number of new coronavirus cases seems to be doubling roughly every seven days. Hospital admissions are rising, even if fatalities are still low. In an effort to slow the spread, the government has restricted private gatherings to just six people. Further lockdown measures are expected Thursday for the north of the country.
Schools in England are already seeing a higher absence rate compared to the same time last year as the merest sniffle or cough sets in motion a chain of reactions that has in some cases resulted in entire year groups being sent home, consequently driving up demand for testing.
And it’s not even autumn yet. Consider this: On any given winter day during normal, pre-pandemic times there will be 500,000 people with symptoms consistent with Covid-19, according to estimates by an expert on the government’s main scientific advisory body.
Of course Britain’s not the only country struggling to turn around tests on time as my colleague Lionel Laurent wrote. In some ways, such problems aren’t that surprising given the complexity involved in setting up a comprehensive and efficient mass-testing system from scratch.
First, the U.K. government had to establish a large network of testing sites, which had to be linked to processing labs and online booking systems. Then there is the transportation of tests, sourcing of materials such as swabs and reagents and the delivery of timely, accurate results. Bottlenecks or problems in any of these elements could impact the working of the whole system and create capacity constraints.
Even so, Britain’s testing system was handicapped by two very early mistakes.
The first was its late start as the U.K. ignored the World Health Organization’s guidance to “test, test, test,” deciding it would focus testing in the hospital setting. Ever since the policy was, inevitably, reversed and testing became a priority, Britain has been trying to get its act together. Hancock set ambitious targets and the government poured billions into achieving them. It has come a long way, conducting more tests than most other EU countries, as Johnson and Hancock constantly note. But it’s still not meeting demand, processing tests quickly enough or making them available where they are needed.
The second mistake was in the testing system’s structure once Johnson made it a priority. The key lessons of the successes in Germany or South Korea – the importance of an agile decentralized approach and creative partnering with the commercial sector – were missing in Britain’s top-down approach. (In some ways the Moonshot project gets Britain closer to the more diversified, if not exactly decentralized, approach that was so successfully built in a very short span of time in these countries.)
This sense of exceptionalism has been costly in terms of resources, time and undoubtedly lives. Johnson and Hancock have largely attributed the present problems to an enormous spike in demand, primarily as schools reopened. Of course more people in pubs and restaurants, the lifting of lockdown restrictions and travelers returning from abroad have no doubt also contributed to a rise in case numbers and demand for testing. Government messaging has also been confusing: People were told when in doubt to get a test and then that they were overloading the system.
Long delays in getting test results in some cases, the increase in the number of voided (invalidated) tests and reports of tests being sent to Germany and Italy for processing suggest the problems may go beyond the increase in people seeking to get tested. Even the demand-surge explanation raises disturbing questions. The government shouldn’t have needed a crystal ball to foresee these challenges and try to model their impact.
When asked about all these things, both Johnson and Hancock tend to be defensive rather than forthcoming about the failures that need to be fixed. That’s made it hard to avoid the sense that the government struggles not only to make the right decisions on policy direction, but to properly execute the policies when it does get the direction right and to anticipate problems along the way. This has fueled questions about competence and they are unlikely to go away.
More transparency and a clear indication of how the problems are being addressed would go a long way toward reassuring people that the government doesn’t just make mistakes, it learns from them.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Therese Raphael is a columnist for Bloomberg Opinion. She was editorial page editor of the Wall Street Journal Europe.
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