Build reserve testing capacity to tackle next pandemic, UK researchers urge

Reserve testing capacity should be set up to help the UK better tackle the next pandemic, researchers who helped lead the country’s early Covid response have said.

In a report published in The BMJ journal, scientists from the University of Cambridge said a “human bottleneck”, due to historical cuts in public health funding, delayed the UK’s scale-up of Covid testing in the early stages of the country’s pandemic response.

They argue that a system of reservist lab scientists should be established now to provide surge capacity that will help the country respond faster – and more effectively – to future infectious disease outbreaks.

“Because Covid-19 testing wasn’t scaled up quickly enough, we couldn’t detect all cases quickly enough to try and stop the spread of the disease,” said Dr Jordan Skittrall, the report’s lead author.

“It was frustrating to hear politicians’ promises to repeatedly scale up Covid-19 testing capacity during the early stage of the pandemic. The scale-up was extremely challenging: a lot of expertise is needed to get the tests working in the early stages of dealing with a new pathogen,” he added.

As a clinician at Addenbrooke’s Hospital in Cambridge, Dr Skittrall put his normal work on hold to help interpret Covid-19 test results in the lab in early 2020, and ensure the right clinical responses were carried out.

“In early 2020 we were working until late at night, with very few people processing tests for the whole country,” said Dr Skittrall.

“The speed at which people were having to work, and the difficulty of trying to scale up the process in a busy hospital lab made me realise there was a real human bottleneck. We needed more people to process the tests.”

In the Cambridge University report, the researchers recommend recruiting a relatively small number of highly skilled scientists, who would be paid on retainer, to help in the initial phases of an emergency, adding that the risk of another pandemic such as Covid-19 happening is ever-present.

The scientists considered a number of options for providing scientific surge capacity and concluded that the best scenario would be a mix of highly skilled paid reservists, and volunteers who could be called on when required and trained rapidly.

“There’s an extent to which the emergence of an infectious disease is a random process, but a pandemic like Covid-19 is guaranteed to happen again at some point,” said Dr Skittrall.

“In the UK we’re in the privileged position of having the right scientific skills to respond to the next big outbreak. But we need to make sure that we have these people ready, so that when something does happen they can hit the ground running.”

The report suggests building up a large reserve of volunteer staff who do not have specialist skills but could be trained quickly in an emergency and paid only when needed.

Those working in sectors of the economy likely to close during a pandemic — such as entertainment and hospitality — would be ideal candidates as voluntary reserves, the scientists add.

Since the beginning of the pandemic, more than 200 million PCR tests for Covid have been conducted.