SCOTLAND is carrying out less than one third of the tests it has the capacity to do in the Covid-19 crisis – as concerns grow about the nation's test, trace and isolate strategy in any future easing of lockdown.
Official figures show that over the week since the Scottish Government announced it had met its self-imposed target over the ability to test, it was carrying out an average of 2,640 tests a day in hospitals, care homes or the community.
Meanwhile, the nation had the ability to carry out more than 4350 tests a day in NHS labs and a further 4000 at the Lighthouse Laboratory in Glasgow.
It comes as Hugh Pennington, emeritus professor of bacteriology at Aberdeen University, warned the Scottish Government that testing capacity, turnaround times and the ability to test locally has to be up to speed for test, trace and isolate to work.
He said he could "see no reason" why any laboratory conducting the Covid-19 RT-PCR tests "could not significantly increase" testing capacity.
The Scottish Government came under fire earlier this week after public health professor Linda Bauld warned there was a “big problem” with the test, trace, isolate strategy – with the turnaround for test results currently averaging 30 hours. Other countries are doing it in four hours.
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In his latest observations to ministers, Mr Pennington says it has been "well known for many years" that care homes provide an environment which facilitates the spread of a range of microbial pathogens and that "frequent and repeated testing" of those going into them "is the only preventive measure that will be significantly effective".
Concerns have also been raised about the ability to test frontline workers in Scotland during the Covid-19 crisis.
The Scottish Government is reviewing its Covid-19 testing strategy after the Deputy First Minster John Swinney was left “frustrated” by reports home care workers had been told to travel to the other side of Scotland for tests.
Nicola Sturgeon said that by Friday, the NHS capacity to test was to rise to 6500-a-day – meaning Scotland would have the ability to carry out 10,500 tests a day – on top of the UK-organised drive-throughs.
On April 3, the First Minister set out an aim to "proportionately" match with 10% of the 100,000-tests-a-day pledge by the UK health secretary Matt Hancock. Data shows that both the Scotland and the rest of the UK have been failing to meet that aim in the past week.
The Scottish Government had been preparing to have the ability to test – referred to officially as "capacity" – in Scotland's laboratories to rise to more than 3,500 daily by the end of the month.
On May 1, the First Minister said the ability to test had actually exceeded that and had risen to 4350 tests a day with NHS laboratories operating in all health board areas, without relying on the Lighthouse lab.
She announced testing in care homes in Scotland will include testing of all residents and staff – whether or not they have the virus – in homes where there has been a confirmed case.
But she admitted: "Laboratory capacity is one thing, what matters is the volume of testing we do and the clinical objectives we set for testing."
Herald on Sunday analysis of Scotland's new way of reporting of testing launched on May 1 reveals that Scotland has been consistently lagging way behind the rest of the UK in terms of its per-capita testing rate.
On Friday alone Scotland was completing 807 tests per million of population - 44% less than the 1453 per million of population for the whole of the UK.
Official Scottish Government figures show that 2769 tests were carried out on Friday, with a further 1,628 completed at regional drive-through centres organised by the UK government, which provides extra capacity for checks. The 4397 tests carried out was a drop of 335 on the previous 24 hours and 916 less than the week's peak of 5313, on the day the First Minister announced the new testing aims.
Testing for coronavirus is seen as a crucial factor to easing out of lockdown – allowing the country to effectively isolate cases and their contacts to contain any spread.
Both the UK and Scottish governments have been coming under fire for unpreparedness and a failure in mass testing in the current coronavirus pandemic.
Mr Pennington emphasised the importance of wider testing in his latest observations.
He said: "Mass community testing will be needed to identify infectious but asymptomatic individuals as part of the contact tracing process. When new case numbers have significantly declined and when it is evident that the decline is being sustained for several days, it should be possible to start contact tracing to hunt down the virus."
Professor Bauld echoed the need for community testing in evidence given to MSPs last week.
"We look like we are getting it right on hospitals... we have limited information from high-risk settings so that's care homes and other settings where you have vulnerable populations who particularly urgently need tested and staff need testing. As far as I am aware we don't have data, and have not yet got the capacity in primary care and out-of-hours settings," she said.
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"If we are going to have a mass testing programme, which we need to do for test, trace,isolate, we need real time data from those settings so we can figure out what is going on. My understanding is Wales are a step ahead of us in time of these real time data issues."
Sir Harry Burns, the former Chief Medical Officer for Scotland, meanwhile, warned that we have "a long way to go on test, trace and isolate at this time" – pointing to worries about the quality of tests as well as the number.
He pointed to South Korea as an example of a country which is "far more aggressive" in terms of identifying people who might spread it adding: "And that's why the testing is important."
South Korea has suffered just 256 coronvirus fatalities from a population of 51.64 million while Scotland has seven times that death toll with about a tenth of the people.
"Test people to see who is capable of spreading it, trace the contacts and isolate all their contacts, as well as them," he said. "That is the way in which you control any infectious disease."
He added: "We should be testing the whole population. We need to know how widespread the virus is in the population, once you know that, you know who might still be out there that might be infected.
"We need to be looking at the folk capable of spreading it and those are predominantly health and care workers, and we need to be testing them on a regular basis."
The Scottish Government said it was significantly scaling up its testing capacity.
A spokesman said; "We now have overall NHS lab capacity of 6,259 tests a day. Together with the capacity available through the Glasgow Lighthouse lab (4,000), the normal maximum daily capacity for analysing tests in Scotland has reached 10,259, increasing to 12,000 by mid-May. As of 8 May, 93,570 total tests had been carried out for Covid-19 and 69,191 people had been tested. 13,149 people to date have tested positive.
“Testing alone will not keep infection rates down. It must be used alongside other crucial measures such as physical distancing, good hand and respiratory hygiene and disease surveillance.”
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