London: Britain's success at vaccinating faster than anywhere else in Europe is putting pressure on Prime Minister Boris Johnson to figure out what comes next.
While Israel is emerging as the global test case for a country's ability to inoculate its way out of COVID-19, the UK is a pilot for whether nations can do enough to end damaging lockdowns and essentially learn to live with the disease.
The key, Johnson believes, lies with mass testing in workplaces, schools, shopping centres and theatres to make sure that employees, pupils and customers are COVID-19-free. He's expected to set out details in a statement to Parliament on Monday as part of a "road map" out of lockdown, and some companies in retail and hospitality are already gearing up.
Hundreds of thousands of tests could be sent out by post every day, including to secondary school pupils. The idea is to come down on outbreaks "like a ton of bricks," according to Foreign Secretary Dominic Raab. It is these rapid tests, rather than "vaccination passports" being considered by other countries, that the government wants to be part of daily life.
The UK has suffered the continent's highest death toll and its economy sank by the most since the Great Frost of 1709, albeit with a rebound in the fourth quarter. But on the other extreme, Britain has injected more than a quarter of its population with at least one vaccine shot and is also a frontrunner in identifying potentially more dangerous mutations of the coronavirus.
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The question is not how to eradicate Covid, but to get to a point where people will never again be banished to their homes, schools closed and stores shuttered. Critics say previous testing failures contributed to the country's death toll, while some epidemiologists say that potential route to a new normal is fraught with risk given the unreliability of so-called lateral flow tests compared with those that take longer to process.
"If you just scatter tests around like fairy dust, it is not going to work," said Gabriel Scally, president of epidemiology and public health at the Royal Society of Medicine. "They're always looking for the silver bullet, the one thing that will sort it all out. Any public health doctor would tell you that doesn't work."
Johnson is well aware he's walking a tightrope. Many within his governing Conservative Party are calling for the reopening of the economy more quickly. Retail sales that are the economy's lifeblood fell more than twice as fast as expected in January, a report on Friday showed. The government has signaled that it plans to proceed cautiously even with new cases and deaths falling dramatically, and more than a quarter of adults already vaccinated. Initial measures will include allowing some schools to reopen and permitting people in care homes to have "one regular indoor visitor" from March 8. The visitors will have to be tested before entering the facility and have to wear personal protective equipment, Health Secretary Matt Hancock said in a statement Saturday.
The concept of mass testing is nothing new for the U.K. In September, Johnson announced to great fanfare his "Operation Moonshot" plan for millions of tests a day. While that language appears to have been dropped, the plan was resurrected, with the prime minister declaring on Feb. 15 that rapid testing would allow the "toughest nuts to crack" "-such as nightclubs and theaters"-to open.
A 22 billion-pound ($31 billion) testing program has ramped up UK capacity to rates that are among the highest in the world, with more than 760,000 tests carried out in one day earlier this month. That includes both lab-processed polymerase chain reaction, or PCR, tests that take a day or two, and the lateral flow tests that can give results within 30 minutes.
Companies are keen to embrace the rapid tests. Kate Nicholls, chief executive officer of the UKHospitality group, said the industry stood ready to roll out mass testing to make sure nightclubs and events such as conferences and weddings could restart "as swiftly as possible."
Supermarkets are in talks with the Department for Environment, Food and Rural Affairs on devising a workable solution for testing shop workers and want the focus to be on tests that can be taken at home or in the community, rather than in stores, according to four people with knowledge of the discussions. Workers in the warehouse depots of some supermarkets are already trialing lateral flow tests because that's easier to manage than inside busy stores, one person said.
More businesses need to be encouraged to use regular tests to ensure a safer working environment, the Confederation of British Industry said. "That's where the business focus is right now, rather than clamoring for the introduction of a domestic vaccine passport," a spokesperson said.
Johnson has rejected the idea that venues will demand vaccination certificates before people can enter and the government is only looking into how it can give people proof of inoculation to travel overseas should other countries require evidence. Ministers have also said it's up to businesses to decide if they want to require their employees to have the vaccine.
Some companies are looking into potential "no jab, no job" contracts. Barchester Healthcare, which runs more than 200 care homes in the UK, said it was considering whether "staff who refuse the vaccine on non-medical grounds will, by reason of their own decision, make themselves unavailable for work."
Health and social care workers already get regular tests, and businesses with more than 50 employees can order rapid tests via a government website.
But there are concerns about false reassurances, and indeed how testing would work in practice for customers rather than workers.
The UK Cinema Association told the Daily Mirror newspaper that asking a 250-strong audience to take a test and wait 30 minutes before seeing a two-hour film "seems impractical." It is also unclear whether companies will"-in the longer term"-need to pay for the tests themselves rather than the state.
Some scientists believe the real focus should be on incentivising people to stay at home for the required 10 days of isolation to ensure they don't pass on the virus regardless of any mass testing. Dido Harding, who runs the UK's test-and-trace programme, said this month that at least 20,000 people a day in England were failing to self-isolate properly.
Government officials say that lateral flow devices are effective at detecting Covid-19, though anyone who tests negative should recognize that no test is 100% accurate.
"If hundreds of thousands of people are tested per week with lateral flow tests, there will be many false results," said Duncan Robertson, a disease modeler at Loughborough University in England. If a negative test is seen as a "green light" to visit a nightclub there's a "very real risk that people will engage in more risky behaviors when they may in fact be COVID-19 positive."
