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Eilis O'Hanlon

The World Health Organisation advice is clear: test, test, test for coronavirus. So, why then are we doing so little of it in Northern Ireland?

Eilis O'Hanlon


What alternative is there if experts are accurately to track the spread of coronavirus and fine-tune their response to it, asks Eilis O'Hanlon

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Coronavirus testing kit (Ben Birchall/PA)

Coronavirus testing kit (Ben Birchall/PA)

Coronavirus testing kit (Ben Birchall/PA)

Yesterday, Northern Ireland suffered its second death from coronavirus, adding weight to the warning by Health Minister Robin Swann that we may be facing a "plague of Biblical proportions" if Covid-19 isn't beaten.

Still, despite promising a large increase in testing, the figure is only going up from 200 to 800 tests a day. Something doesn't add up.

The World Health Organisation's advice as to the most effective way to stem the tide of the coronavirus couldn't be clearer - "test, test, test".

That's what countries which have managed best to contain the spread of the virus, such as South Korea and Singapore, have been doing from the start.

There, they do widespread "community testing", which means taking swabs from people and checking them for infection before they even show symptoms.

In South Korea, there are walk-in booths where anybody can be tested in seven minutes.

By comparison, the number being tested in Northern Ireland, where positive cases rose to 128 yesterday, remains a fraction of what's needed.

How are we supposed to know where we're at when it comes to coronavirus without testing to see how far it has spread in the community already? To put the figures in context, when Northern Ireland reaches the point of testing 800 people a day in another week's time, that will represent 0.04% of the population, which more or less corresponds to the UK's testing target nationwide.

South of the border, they're planning to increase tests to 15,000 a day and open a number of drive-through testing centres. There's one currently being built in Offaly.

Once the Republic reaches the 15,000-a-day target, that will represent 0.3% of the population.

In other words they'll be testing seven times more people than we are - and even that isn't considered enough by virologists.

Where does that leave Northern Ireland, if not dangerously exposed?

Worryingly, some people still seem to be looking at the Republic and concluding that, because they currently have more infections than we do, we must in a better position than our neighbours.

That line of thinking fundamentally misunderstands the situation. Testing only finds the cases of infection that are already out there. Not testing simply means you haven't identified those positive cases yet. It doesn't mean they don't exist.

If there was to be a massive programme of testing in Northern Ireland, it would lead to a sharp rise in the number of positive cases; but that, counter-intuitively, would be a good thing, because it would be because of an increase in the number of people who have Covid-19, but are asymptomatic, or have very mild symptoms.

What you want is to see the number of such non-serious positive tests increasing, while controlling the number who need critical care.

Crucially, catching people at an earlier stage allows them to go into quarantine, thereby slowing down the community spread of infection. If you don't know you're infected, you're less likely to stay at home.

Increasing the number of people in quarantine will in turn relieve pressure on the NHS further down the line. As Robin Swann has acknowledged, there are just 126 critical care beds in the whole of Northern Ireland, and the number of ventilators is only set to rise by 40 to 179 by the end of the month.

The system will quickly become overwhelmed.

The tests are not foolproof. There can be false negatives, and, just because someone is free of infection at the time of testing, doesn't mean they won't subsequently get coronavirus.

Nor should the logistical difficulties involved in instigating a regime of large scale testing be underestimated. Public Health England is currently only managing to carry out 2,000 tests a day for a population of over 55 million people.

That number is set to rise too, though again by nowhere near enough

It won't be cheap either. Finding the money to pay for a public testing programme on the scale of South Korea would not be a given in Northern Ireland.

The row over budgets back when the Executive was restored in January may feel like ancient history now, but the structural problems remain.

Finding the money may mean making sacrifices elsewhere, as the local administration doesn't have the same ability as central Government to borrow gargantuan sums of money to deal with crises, and there's no way, with the economy going down the tubes, and people being laid off left, right and centre - 10,000 workers lost their jobs in Northern Ireland in the past week alone - that local taxation can take on the burden.

But whatever difficulties there may be in instigating a large scale testing programme, what alternative is there if experts are to accurately track the spread of the disease and fine tune the official response to it?

Right now, the rhetoric of biblical plagues which the Health Minister had adopted is, hardly surprisingly, alarming people.

Politicians are using that language so that everybody takes more seriously the public information advice about the importance of social isolation and of regularly washing hands, but it can create anxiety where less needs to be.

Fear cannot be eliminated entirely, because the potential for something even more terrible than we face at present remains; but the anxiety can be managed.

In fact, it's essential that we alleviate it to avoid panic. Testing is one way to provide that reassurance. It could be that the number who are infected is not as bad as our worst fears. In South Korea, the number of positive cases has turned out to be just 4% of the tested population.

If the same holds true in Northern Ireland, the nightmare scenario foreshadowed by the Health Minister, with over 9,000 deaths in a short period, might mercifully never come to pass.

The only way to know for certain is by quickly testing huge numbers of people.

The responsibility for making that happen lies with the whole Executive, not the Health Minister alone.

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Health Minister Robin Swann

Health Minister Robin Swann

Photo by Kelvin Boyes / Press E

Health Minister Robin Swann

Robin Swann took on the most difficult brief at Stormont after the two main parties ducked the challenge, and, as he deals with an unprecedented, fast moving emergency, the former Ulster Unionist leader deserves to be supported rather than sniped at.

Nonetheless, the answers given so far by the Health Minister and the Chief Medical Officer to the puzzling question of why we're not testing people as widely in Northern Ireland as in other parts of the world have been patchy, inconsistent, and not a little bit unconvincing.

If there are good reasons for it, they need to be better communicated.

Until then, people are entitled to demand that the threat of a biblical plague be met with a response of equally biblical proportions.

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