‘TEST, test, test”. Those were the words two weeks ago of the head of the World Health Organisation, and they have been seized on ever since by critics of the UK’s handling of the coronavirus pandemic.

Experts – both armchair and real – claim we are not testing enough people, not testing the right people, taking too long to produce results, or just lagging behind much better organised nations such as South Korea or Germany.

The exact words of Dr Tedros Adhanom Ghebreyesus, the director-general of the WHO, were this: “The most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate.

“You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected.

“We have a simple message for all countries: test, test, test.

“Test every suspected case.

“If they test positive, isolate them and find out who they have been in close contact with up to two days before they developed symptoms, and test those people too.”

READ MORE: Scotland set to hit 3,500-a-day testing target by end of April - but peak could already have passed

In general, it would appear the UK is falling short of the WHO guidance. We do not test every suspected case: those with mild symptoms are simply told to self-isolate at home and in most cases never know whether the cause was Covid-19 or another member of the coronavirus family – the common cold. It is little wonder the public are left feeling cynical that VIPs such as Prince Charles are tested.

As things stand, testing is carried out routinely in intensive care units and on other hospital patients with possible symptoms.

In circumstances such as an outbreak in a care home, staff and residents would be checked, and key workers including NHS staff in Scotland are finally being tested –although health boards have been told to prioritise departments where need is greatest.

If there is any part of the testing regime where the UK truly dropped the ball it must be this: in the midst of the most serious public health emergency in a century we have been losing frontline staff – potentially needlessly – because of a lack of testing.

But things have not been standing still. Scotland is working towards a target of being able to process 3,500 tests a day by the end of April, with capacity already having increased in a few weeks from 750 to 1,900.

And the UK is not really so poor by international standards. According to the Our World in Data Project, UK testing rates per million population are the sixth highest in the world.

Our testing rate (960 per million people) is nearly double that of France or Finland and three times what it is in the Unites States.

It is also true, however, that Germany is testing twice as many people and South Korea more than six times as many.

There has been some speculation on social media that these countries also have some of the lowest mortality rates in the world from Covid-19: 0.9 per cent in Germany and 1.7% in South Korea, compared to 6.4% in the UK. But it is not clear that higher testing is linked to lower mortality.

Japan, which tests just 118 people per million, has a death rate from coronavirus of just 2.6%.

It really depends who we are testing, and in the UK, it leans disproportionately towards those sick enough to end up in hospital and, consequently, more likely to die.

It is also not the case that there is no community surveillance – though it again is geared towards detecting the obviously unwell.

READ MORE: Early lockdown should mean Scotland has lower death rate from coronavirus than rest of UK

In Scotland, GP surveillance normally used to detect how prevalent seasonal flu is was massively expanded in March from 41 to 200 GP practices, encompassing 1.2 million patients, and is now being carried out via the new appointment-only community assessment hubs.

One of problems with a lack of randomised, mass community testing of course is the “tip of the iceberg” scenario.

There is growing evidence to suggest that patients infected with the virus can pass it on during the incubation period – thought to last around five days – before they are displaying any symptoms.

If it really is the case – as First Minister Nicola Sturgeon and Chief Medical Officer Dr Catherine Calderwood have repeatedly stated – that the confirmed cases are a “significantly underestimate” of the true scale of the infection within the population then many of those will be people not yet aware they pose a danger.

Telling people to self-isolate without testing arguably also makes them more likely to take a risk not staying home.

Of course, with lockdown measures now in place free movement has been curtailed considerably. The balance between targeted testing and en masse social distancing restrictions –albeit rolled out at different stages of countries’ epidemic curves – has been the pattern for Europe.

As the lockdown ends, attention will turn to antibody testing to identify those with virus immunity and a return to more containment-style testing and contact-tracing of patients. Good surveillance will be vital in preventing a “second wave”.

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