Encouraging self-testing of coronavirus infections at home twice a week for all adults in England is a misguided policy, unlikely to reduce transmission, warn public health experts.
Coronavirus tests per case detected are already higher in the UK than anywhere in the world, and the value of adding universal low-risk testing is unknown, yet is being introduced without plans to measure the costs and consequences, wrote Angela Raffle and Mike Gill, Public Health Consultants with experience in both communicable disease control and screening programmes, in an editorial of The BMJ.
“The priority continues to be improvement of the testing programme for everyone with symptoms no matter how minor or non-specific and all their contacts,” they said.
While acknowledging that response in a pandemic requires speed, without training and proficiency testing for those taking and reading samples, may not help, they added.
“SARS-CoV-2 self-testing by asymptomatic members of the public is unlikely to reduce transmission,” the experts wrote
According to the UK government, “up to one third” of cases in the UK are symptomless. Yet evidence is growing that transmission arises overwhelmingly from people with symptomatic infections and their contacts, they wrote.
They pointed out that the World Health Organization has never advised testing low risk people, and both the EU and the US Centers for Disease Control and Prevention (CDC) recommend screening tests only for those where risk is highest.
“Current efforts are undermined by secrecy, quality failures, underused capacity, and a misplaced focus on low yield uses,” they write.
“Both the laboratories and the rapid tests could be targeted to deliver a substantially more effective and cost effective testing service founded on the public service principles of sound evaluation, strong ethics, high quality, and full transparency.”