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Mass testing in Liverpool – more questions than answers

Doctors in Unite sent the letter below to Professor Allyson Pollock and colleagues, in support of their letter to Liverpool MPs questioning the rationale for mass testing of the people of Liverpool. A link to their letter, and a BMJ blogpost by Dr Angela Raffle, Consultant in Public Health appears below our letter.

9th November 2020

To: Allyson Pollock, Professor of Public Health, Newcastle University;  Anthony J. Brooks,  Professor of Genomics and Bioinformatics, Leicester University; Louisa Harding-Edgar, General Practitioner and Academic Fellow in General Practice, Glasgow University;  Angela E. Raffle, Consultant in Public Health, Honorary Senior Lecturer in Public Health, Bristol Medical School Department of Population Health Sciences, University of Bristol;  Stuart Hogarth, Lecturer, Department of Sociology, University of Cambridge. 

CC: Dr Matt Ashton, Director of Public Health, Liverpool.

Dear Allyson, Prof Brooks, Dr Harding-Edgar, Dr Raffle and Dr Hogarth,

Doctors in Unite would like to support your letter expressing concerns about the mass testing for COVID 19 in Liverpool.

We are surprised that Dr Ashton, Director of Public Health for Liverpool is enthusiastic about the pilot and would be interested to hear his reasoning.  If there is more detailed information which has led him to this conclusion, that we are not party to, we would be willing to reconsider our position in the light of any such evidence.

We believe that there is a place for testing of a sufficiently-sized random sample of individuals if it is to determine more accurately the prevalence of COVID 19 in society, in fact we called for this early on in the pandemic, it is in place nationally and could usefully be augmented to generate local results. However opening the testing to everybody detracts from the randomness of the sample, which becomes self-selected, and creates a significant issue of false negative test results which needs to be considered.

Mass testing with the aim of suppressing the virus, without adequate Test, Track, Trace, Isolate and Support is in our view unlikely to be successful. As you point out even a very small false positive rate will mean that people who are not infected will be told to self-isolate and there will be a larger number of these individuals and their families the more people who are tested.  Without income protection many people are likely to decline to be involved.

We believe that the Westminster Government response to the COVID 19 pandemic has been appalling and that many lives have been unnecessarily lost. It is time for the Government to abandon their populist approach and to start to be led by the science.

Best wishes

Dr Jackie Applebee, Chair, Doctors in Unite

Letter to Liverpool MPs:

https://allysonpollock.com/?page_id=3345

BMJ blogpost by Dr Angela Raffle