Thread by @whippletom

Just some more thoughts on this, because I don't think people realise quite how big our testing infrastructure has become - or how wide. 1/x

First, testing itself. Currently, we are PCR testing about 300,000 people a day, and recording over a million including lateral flows. This is us on a quiet day

Other countries have done more when pushed, but none do so at this level this consistently. But this is just the front end of our testing infrastructure.

It is blindingly obvious to anyone with GCSE level stats that you can't rely on self selected samples. We needed an opinion poll of covid - random testing.

It is so blindingly obvious that we have two systems to do this - ONS and Imperial's React.

Yet....

No other country does this. These surveys don't just tell us what is going on with infections now. They are solid data on transmission, reinfections etc.

This was the head of the German pandemic response's reference to it, and other things.

https://twitter.com/codendahl/status/1482652290347581441

What other things? The next biggest is genomics. In March 2020 a bunch of geneticists met in London to consider what they could do. They thought it would be a good idea to sequence as much as possible. A lot of people thought that was silly.

thetimes.co.uk/article/genomi…

People continued to think it was silly through the summer, when Britain produced more genome sequences than the rest of the world combined - of this slowly-mutating virus that clearly wouldn't have concerning variants. Then Alpha happened.

Still, now, Britain sequences A LOT

It doesn't stop here. There is Siren, a study run by @SMHopkins . By regularly testing healthcare workers, who we know get infected more, PHE, then UKHSA, collected the most rapid data on vaccine protection and reinfections, among other things.

snapsurvey.phe.org.uk/siren/

There is Comix - regularly asking people about daily contacts. Again a bunch of scientists got together and just thought, what will we need in a pandemic, then they did it. This is week 98. They didn't expect 98 weeks. But we have 98 weeks of continuous, consistent data.

There is the vivaldi care home study - because we need good data on antibodies in the most vulnerable groups, in a pandemic that affects the most vulnerable ucl.ac.uk/health-informa…

There is the Icnaric intensive care audit - to see what happens to those worst affected.

There is wastewater sampling because everyone, except the queen, poos

There is loads more. A lot of this happened because some great scientists just took the initiative and did it.

Now the question is, what next for the UK's covid industrial complex? Some will be scrapped. Some will be repurposed.

Genomics has proven itself, and will be a key tool of public health.

The ONS knows it will have to slim down eventually, but many think it has a lot of value yet. It may get smaller and broader, looking at other diseases. Almost certainly the households involved will be followed for years to come, to see covid legacy. thetimes.co.uk/article/dont-d…

Along with clinical trials and the vaccines, it strikes me that covid surveillance is something that has been done very well, and doesn't get enough recognition. Did it make a difference to our pandemic? No idea. But the world has been grateful.

Here is my piece about it

https://twitter.com/whippletom/status/1492957952478752781

Addendum - as a few have rightly pointed out, the UK standard self-selected testing is high, but not the highest. I shouldn't have put that in without checking properly (it's not in the piece itself).