In the early days of the pandemic, ministers believed and told the public that the UK was leading the way in Covid testing. Scientific advisers to the government appeared to share this view and were probably a factor in its widespread belief. At the first Sage meeting in January 2020, assembled experts said a Covid test would be ready within days and could be “scalable across the UK in weeks”.
That assessment was off the mark. The UK was actually one of the first countries to develop Covid tests, but it lost the advantage by failing to deliver them. The inability to ramp up testing capacity had serious ramifications. Scientists had no clear picture of the size of the outbreak, while the preponderance of tests that did exist left many vulnerable people dangerously exposed, including those living in care homes.
The extent of the problem was clear from the data. At the end of January 2020, Public Health England, now the UK’s health protection agency, was able to conduct only 400 to 500 Covid tests a day. In the six weeks to 11 March 2020, less than two weeks before the first lockdown, the UK carried out fewer than 30,000 Covid tests. This equates to less than a day for each parliamentary constituency. Around the same time, in mid-March 2020, Germany was testing 50,000 people a day.
A month before the then Health Secretary, Matt Hancock, asked Prof Chris Whitty, Chief Medical Officer for England, for advice on testing for care home admissions, the UK abandoned all testing in the community. The decision, taken on 12 March 2020, went against the advice of the World Health Organization and marked a shift in England’s management of the pandemic from “prevention” to “delay”, it amounted to an acceptance that The virus was out of control.
The then Deputy Chief Medical Officer for England, Dr Jenny Harris, defended the decision to halt community testing, saying it was “not an appropriate intervention” given the prevalence of the virus. But two months later, he admitted to the Commons Health Select Committee that the decision was partly due to a lack of testing capacity. Another factor was that the government’s strategy was based on a flu pandemic, with testing mandated to end once community transmission was established.
Without the ability to publicly track the pandemic, tests were prioritized for the NHS where staff and patients were at greater risk. But ministers were aware that care home residents were also extremely vulnerable to outbreaks. According to messages from Hancock, he received advice from Whitty on 14 April that anyone being admitted to a care home – whether from hospital or the community – should be tested for Covid and isolated if necessary. To be given A spokesman for Hancock said they had accepted this, but told an operational meeting later that day that it was not possible to test everyone who moved into the care home.
The main concern at the time was that patients could be discharged from hospitals, where Covid outbreaks often occurred, directly into care homes without being tested. Hancock sought to reassure critics that “from the very beginning” the government had thrown “a protective ring around our care homes”, but there was no requirement for entry from the community, and on 2 April 2020 the government The advice said negative tests were “not required” before transferring patients from hospitals to care homes.
It was not until mid-April that a Covid test was required to allow hospital patients to be discharged into care homes. But even then, the guidance assumed patients could be safely separated upon arrival. In fact, many care homes lacked the facilities to do so.
There was even less protection for care home residents from people recruited from the community and from the care workers themselves. The lack of testing of staff in particular meant that social care workers unwittingly spread the virus, at times between the many different households where they were employed. Failure to prevent outbreaks in care homes led to more than 40,000 Covid deaths among residents between March 2020 and April 2021, more than a quarter of Covid deaths in England over the same period of the pandemic.