Thread by @MerryMichaelW

COVID-19 and public health - thread from @AllysonPollock .

Liverpool mass testing, 06 November 2020

The UK has over 20 years experience of delivering evidence-based, systematic, high quality screening programmes, which deliver more good than harm at affordable cost.

This experience tells us that if you embark on a screening programme without having carefully evaluated it first, without a proper quality assured pathway, without certainty of test performance in field settings, without full information for participants ...

... and without the means to ensure that the intervention needed for those with positive results does indeed take place, then you will end up with an expensive mess that does more harm than good.

From what we can tell, the current proposals for screening the City of Liverpool using SARS-CoV-2 rapid tests are not fit for purpose.

It is called a ‘pilot’ yet there appears to be no research design.

There is no concrete evidence that screening of this nature is helpful in outbreak control.

It appears to have no system design for who is eligible, how they will be contacted, how they get results, what advice they will be given, how this will be followed up, and how this will be INTEGRATED with test and trace and with local health and social care services.

The tests being proposed are new and there is little data about their performance in field settings, so therefore many people will be given false results.

The harm from false results includes unnecessary isolation (for false positives), and false reassurance with potentially riskier behaviour (for false negatives).

Our concerns are that the Liverpool screening will fail to realise any benefit, and will cause harm through diversion of resources – including by distracting from solving the problems with the test and trace programme.

Letter to Liverpool MPs, 05 November 2020