Sir Harry Burns raises concerns about 'quality control' of virus testing
Scotland’s former chief medical officer Sir Harry Burns has told MSPs he is worried about a lack of quality control in COVID-19 testing, saying “we’ve got a long way to go on test, trace and isolate”.
Burns, who led Scotland’s response to the H1N1 swine flu pandemic and is now a professor of global public health at the University of Strathclyde, also said: “we should be encouraging wearing masks.”
He made the comments as he appeared before the Scottish Parliament’s COVID-19 Committee on Thursday morning.
“The lockdown that we have right now is essentially test, trace and isolate without the testing and the tracing,” Burns said.
“If we are going to move in a way that lifts lockdown, and allows people to go about their business, meet their social needs and so on, then we need to know who is infected and who is at risk of spreading the virus to other people.
“There’s been a huge emphasis on testing, people have set goals, that’s all very well as long as you know that the testing is accurate and know what you’re going to do – there’s no point testing unless you’re going to trace the contacts.”
He said he had heard “slightly worrying things about the testing process”, including that a nurse who took her husband and two children to a drive-through testing station was handed the testing kits and the family was asked to “swab their own throats”.
“Well, if any of you have ever tried to swab your throat or stick a swab up your nose, or whatever, I’m not sure that I would trust a 14-year-old to do it properly,” Burns said.
“The quality control around this thing, I’m not sure that it’s there. The fact that there is so much emphasis on the number of people being tested a day, suggests that, you know, just get through as many as you can, never mind the quality."
He continued: “We need to be sure the testing that’s done is accurate and is giving you the appropriate information, and then there is appropriate follow up.
“The tracing app that’s being piloted I think is an important thing, although from what I’m hearing in Singapore – only 20 per cent of people downloaded it – we’ve got to encourage more than that to do it here. But we need also to have people out there who are prepared to go and trace contacts, because then you isolate them and what you’ve got is a more focused form of lockdown.
“It’s that process on not just focusing on the testing, focusing on the tracing. We’ve got a long way to go on test trace and isolate.”
He also warned that there was “inconsistency” around the testing protocol.
“Again, I hear stories of people going to these hubs, these primary care hubs, that are suspected of having COVID, and these people being told ‘yeah you’ve probably got it, just go home and stay indoors for two weeks’. And they go home to a home where they have young people and they have not been tested,” Burns said.
“So, there is an inconsistency across the place, some of these examples are not Scottish examples they are stories that I’m hearing from down south, but there’s an inconsistency here so we need to have a protocol in place that sees people suspected of having it being tested properly, not just being told to self-isolate.”
On wearing masks, Burns said there had been “muddled thinking” about the evidence and said: “We should be encouraging mask wearing.”
“The evidence that if you wear a mask and you’re negative, it protects you, the effect of that is rather slight. But if you are a carrier, and you are capable of spreading it, and you wear a mask – the evidence that that will reduce the spread is very significant.”
He gave an example of a poster in Spain which showed two people have a chat, standing side by side, one with the virus and one without, both not wearing masks.
“The person that’s negative has a 90 per cent chance of getting COVID. If the person who is positive is wearing a mask, the person that’s negative has a 10 per cent chance of becoming positive.
“So, the idea that wearing a mask will protect you getting it, the evidence for that is not strong, but if you’ve got it and you wear a mask, then your chances of spreading it are a lot less.”
On care homes, Burns said: “Test people going in, make sure people who are positive are not going in.
“We need to realise that the outbreaks that we’re seeing in care homes tells us there are people in those care homes are circulating it and spreading it,” he said.
“If one of these elderly residents are exposed to it, they’re much likely to get it, and the nurses may then spread it unwittingly.”
Burns also encouraged more sharing of information and advice between countries like Spain, Italy and Germany, and said elimination of the virus was “not going to be very successful, until we get a vaccine”.
Burns said his experience with swine flu had taught him “pandemics are complex systems, where lots of different interests come together, and managing such complexity is hugely difficult”.
“The critical thing is to learn from the process, not to blame people for doing things that you don’t think were right. Just share ideas, learn what works and apply it,” he said.
“In terms of our current state with coronavirus, there is a fair amount of finger pointing going on all over the system, which I don’t think is helpful. At this stage we should be focusing on trying to understand what we can do to manage our way out of this, to get economic recovery, social recovery, and do it in a way that limits almost to zero any further damage that this virus can do. A very positive approach to thinking our way out of this is what I’m interested in.”