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Covid-19: Is the UK carrying out more tests than anywhere else in Europe?

BMJ 2020; 370 doi: (Published 08 September 2020) Cite this as: BMJ 2020;370:m3497

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  1. Gareth Iacobucci
  1. The BMJ

Last week at Prime Minister’s Questions Boris Johnson claimed that the UK was now carrying out more covid-19 tests than anywhere else in Europe.

In response to a question from the Labour Party leader, Keir Starmer, the prime minister said, “Not only are we getting the pandemic under control, with deaths down and hospital admissions way, way down, but we will continue to tackle it, with local lockdowns and with our superlative test and trace system, which, before opposition members sneer and mock it, has now conducted more tests than any other country in Europe.”1

But how accurate was this claim?

Statistics compiled on 4 September by the Our World in Data project, run by the University of Oxford and the Global Change Data Lab, show that the UK was conducting 2.47 tests a day per thousand people.2 This is higher than in most countries in Europe, but below Denmark and Malta (both at 4.94 tests a day per thousand people).

However, while the dataset provides figures for all tests as a seven day rolling average, the team that provided it noted that the number of tests does not refer to the same thing in each country. “Some countries report the number of people tested, while others report the number of tests (which can be higher if the same person is tested more than once). And other countries report their testing data in a way that leaves it unclear what the test count refers to exactly.”

Jon Deeks, professor of biostatistics at the University of Birmingham, said that though the data were interesting, direct comparison was a problem if it was unclear what was being counted. “Several key countries, like Germany, are working on regional control models and probably don’t have the centralised data collection service,” he noted.

A feature of the UK data is that they include tests that have been sent out to people at home or in satellite locations but not necessarily completed. The UK also counts serology antibody tests as part of its overall numbers (under pillar 4 of the Department of Health and Social Care’s testing programme3).

Deeks said that few countries were counting serology tests, which were likely to be inflating the UK’s figures. “Most countries are not using serology tests outside of seroprevalence surveys—which seems a very sensible approach,” he said. “The important question is whether the PCR tests are being done, and whether they are being done in the right people at the right time, and that those people are getting the right medical help, and contact tracing is done.”

Given the lack of uniformity in data collection, it is not possible to firmly establish the accuracy of the claim that the UK is carrying out more tests than any other European countries.

But more broadly, Deeks questioned the merit of using the number of tests conducted as a benchmark for assessing how the testing system is performing.

“I would suggest that the performance metrics they should be looking at is whether people who need PCR testing get a test within 24 hours of need (tick 1), get the results in 24 hours of response (tick 2), together with a conversation with an appropriate healthcare practitioner (tick 3) and contact tracer (tick 4),” he said.

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