We are dropping the ball on Covid-19 testing

The equanimity with which the Sinn Féin leader Mary Lou McDonald met her two week wait for the results of her Covid-19 test was something of a surprise. Usually such things are grist to the mill of opposition party leaders; a stick to beat the Government. One can only presume that her innate ability to tune into the national mood has cautioned her against making political capital out of her own misfortune.

It would be brave to second guess McDonald on this. There appears to be pretty widespread satisfaction with the way the Government has gone about its business. Attacking it – and by association the thousands of HSE staff currently in the path of the storm – could backfire badly.

Such is reality of politics but that does not alter the fact that we have big issue with our capacity to carry out Coronavirus testing here. In the absence of politicians, it is being left to a handful of medics and scientists to bang the drum on the issue. Some of them are approaching the sort of rock star status briefly enjoyed by a handful of economists during the financial crash in 2008.

And the comparison does not end there. If we learned one thing in the aftermath of the financial crash, it was that small countries with small leadership groups have a limited capacity to deal with multiple interconnected problems and a tendency to group think.

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It is imperative that this doesn’t happen again and we don’t let our recognition of the achievement of the last eight weeks blind us to the fact that, as things stand, we will struggle to create a mass testing regime that is big enough and good enough to allow us exit lockdown once the virus is contained.

The importance of a rigorous testing regime as a prerequisite for ending restrictions was underscored by the European Union on Wednesday in its proposal for a common European road map for the phasing out of a containment measures.

The timing of the lifting of restrictions should be dictated by three criteria, according to the EU.

The first is that it must be clear that the spread of the disease has significantly decreased and stabilised for a sustained period.

The second is that the member state’s health service is on top of the problem; “for example taking into account the occupation rate for intensive care units, the availability of health care workers and medical material”.

And the final criteria is having in place an appropriate monitoring capacity, “including large-scale testing capacity to quickly detect and isolate infected individuals, as well as tracking and tracing capacity”.

It's pretty obvious that we are doing as well if not better than most EU states on the first two criteria but our problem is with the third. There is no league table of tests across EU member states but some figures are available for the total tests carried out to date. We can divide them by population to adjust for country size but any comparisons carry their own health warnings. It's clear, however, that some countries such as Italy, Germany and Denmark are in a different league with something like 17,000, 16,000 and 12,000 tests carried out per million people. We are at 8,600, which is closer to Spain (7,600) but ahead of the UK at 5,200.

However, Spain is one of the first European countries to start lifting restrictions and it’s also clear that factors other than testing capacity will determine what is essentially a political decision, taking into account myriad issues such as behavioural fatigue and economic hardship. But all the science would suggest that your testing regime will determine whether you have to reintroduce the measures at some stage in the future. The ability to detect and jump on a new outbreak requires widespread and efficient testing.

Ultimately each government will have to make its own decision about where the trade-off lies. Some will chose to live with future outbreaks of the virus until a vaccine is ready and others will seek to suppress and contain it. The latter option is open only to those countries that conduct mass testing.

It would be nice to have the choice rather than have it forced on us by an inadequate testing regime. But, in the end, our decision may not be entirely of our own making as whatever regime pertains in the North will have a bearing on what happens here as the prospect of closing the border is a non-starter.

If – as seems to be likely – the UK ultimately chooses to live with the virus and not carry out mass testing that would have to be taken into account by the Government here. Perhaps it already is and that explains our rather sanguine approach.