Covid-19 mass testing programmes

Mass testing programmes for covid-19 should be drawing on the UK’s considerable track record in delivering high quality screening programmes for communicable and non-communicable disease.1234 Testing of people with no signs or symptoms has important differences from testing that aims to reach a diagnosis when someone has sought help for a problem. In diagnostic testing, the clinician-patient relationship usually affords a degree of judgment and safety. The clinician knows the person, gives explanation and advice, explains the limitations of tests, and obtains implicit or explicit consent.

For tests performed outside this context—such as screening, surveillance, or case finding—these safeguards are missing and the pitfalls are numerous. The aim is risk reduction, with a constant need to balance benefit, harm, and affordability. The common feature is the offer or mandate of tests for a population or group.5 Uses are numerous and include epidemiological research, communicable disease control, protection of others (such as criminal record checks for workers), commercial gain (such as direct-to-consumer genetic tests), and reducing health risks as in the 11 national screening programmes …