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Covid-19: Government ramps up “Moonshot” mass testing

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4460 (Published 17 November 2020) Cite this as: BMJ 2020;371:m4460

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Screening the healthy population for covid-19 is of unknown value, but is being introduced nationwide

Rapid Response:

Coronavirus mass testing - a gross waste of money and resources

Dear Editor

England's health secretary, Matt Hancock, says "Mass testing is a vital tool to help us control this virus and get life more normal".[1]  

I disagree. Extraordinary amounts of money and resources are being expended on testing around the world - is this justifiable?

In Australia 9,872,011 tests have been conducted with 0.3% being positive.[2]
 
According to Gareth Iacobucci's report, "as at 16 November the Liverpool pilot had tested 100,000 asymptomatic people, of whom 700 (0.7%) tested positive for covid-19".[1] [3] 

In the Australian and Liverpool examples, there appears to be a huge waste of resources with this mass testing, with more than 99% of the tests being negative.
 
How much is all this testing costing, not just money and direct resources, but also in causing disruption in people's lives, worry about results, loss of productivity etc?

A WHO report providing guidance for surveillance during an influenza pandemic, published in 2017, recommends "case-based reporting (the counting of individual cases) should cease once there is broad community transmission in a country - at this point, syndromic data from sentinel sites, hospital-based data and systematic laboratory testing should be used instead".[4]

Doesn't this mean that widespread testing of asymptomatic people should be ceased? 

Surely scarce money and resources can be better targeted in the coronavirus response? As Professor Allyson Pollock says, mass screening proposals risk causing harm through "significant diversion of healthcare resources".[1]

Ongoing testing and questionable 'case' numbers are being used to implement drastic limitations on people's freedom of movement and association around the world, including lockdowns which interfere with people's right to earn their own living, to freely associate with others, to simply live their lives freely. 

There must be an urgent reappraisal of the worth of mass testing. 

References:
1. Gareth Iacobucci. Covid-19: Government ramps up "Moonshot" mass testing. BMJ 2020;371:m4460
2. Coronavirus (COVID-19) current situation and case numbers. Australian Government Department of Health: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov...  As accessed 27 November 2020.
3. Re "tested positive for covid-19". I argue the reference to 'covid-19' is incorrect terminology, and this should be "tested positive for SARS-CoV-2": See: Re: Covid-19 vaccines...or SARS-CoV-2 vaccines? Clarification needed. BMJ 2020;370:m3258
4. WHO guidance for surveillance during an influenza pandemic. 2017 Update: https://www.who.int/influenza/preparedness/pandemic/WHO_Guidance_for_sur...

Competing interests: No competing interests

27 November 2020
Elizabeth M Hart
Independent person investigating the over-use of vaccine products and conflicts of interest in vaccination policy
Adelaide, Australia