UK winter plan: The Liverpool system of mass community testing

Prime Minister Boris Johnson yesterday (23 November) announced his UK winter plan, proposing a mass community testing scheme as seen in Liverpool, stricter Tiers, and weekly tests for prison staff

Speaking today, PM Johnson explained that the UK will exit the winter lockdown on 2 December, as planned. Drawing on a parallel with wartime leaders, the PM said in the early moments of his announcement: “I’m acutely conscious no other peacetime Prime Minister has asked so much of the British people.”

Currently, the UK has been in various states of lockdown for nearly ten months, with some cities in a deeper state of lockdown than others via the Tiered system. The PM suggested that the Liverpool strategy to roll-out mass community testing (153,000 tested so far), was one of his key strategies to dampen the R number while the country waits for vaccines to pass regulatory checks.

What changes can you expect to see across England after the lockdown ends, and before the vaccine arrives?

Expanding the Liverpool plan

The PM suggested that all Local Authorities who are in Tier Three post-lockdown could be given a “six week surge of testing”, similar to the one trailed in Liverpool over the last two and a half weeks. He proposed that regions which underwent the Liverpool plan would have “a much greater chance of easing the rules” they currently have – suggesting that maybe Tiers could change, depending on how community testing impacts the R number.

Former regional director of Public Health England, Mike Gill, commented on the viability of the Liverpool testing scheme: “The queues of people seeking tests in Liverpool suggest the initial acceptability of this pilot is high, at least to some. Its ethical basis, however, looks shaky. The council claims, wrongly, that the test detects infectiousness and is accurate. In fact, if used alone it will lead to many incorrect results with potentially substantial consequences.”

The deteriorating situation of care homes

The situation in care homes has been highly contentious, as people find themselves unable to support their elderly loved ones in a meaningful way. Many residents do not respond well to Zoom, especially those suffering from severe forms of Dementia. PM Johnson proposed that by 2021, care home residents would be allowed to have 2 visitors, who would be tested twice a week to retain their right to visit. These will be done via newly available rapid testing, which can turnaround results in 30 minutes. Carers who are living in their own homes and looking after highly vulnerable people will then be offered a weekly test, beginning from yesterday. These tests are also currently being deployed in the NHS workforce.

Weekly tests for prison staff and more key workers

Touching on a newer list of key workers, not as openly acknowledged as NHS staff or care home workers, PM Johnson promised to deliver them weekly testing. This includes all staff in prisons, all people working in food manufacturing, those involved in COVID vaccine deliveries and any administrators working to get vaccines out.

5 days of isolation, instead of 14

After being in contact with someone who has tested positive for COVID-19, current guidelines ask people to then isolate for 14 days to confirm that they are not carrying the virus to other people. Currently, the PM himself is in this period of isolation after Ashfield MP, Lee Anderson, was tested positive last Thursday.

The theoretical way that isolation periods could be brought down to five days, is by giving an individual rapid testing, everyday of their five day isolation period.