The UK failed to prove its resilience to a Pandemic and the government hopes to re-cast the nation as a scientific superpower by using the lessons of the crisis to deliver better research, more precision healthcare, and a more streamlined pathway to new.
The government's decision to substantially cut back on free Covid testing, as part of Boris Johnson's living with Covid strategy, already threatens to undermine innovative trials. They are crucial for understanding how drugs keep patients out of hospital, how immunity is holding up in vulnerable care homes and hospitals, and how the epidemic is unfolding around us.
The Oxford University-backed Panoramic trial is one of the largest and most important clinical studies in the UK. More than 10,000 people have signed up to help researchers figure out who will benefit the most from Covid antivirals. Most participants in the trials were unvaccinated, despite the trials showing that drugs such as molnupiravir can substantially reduce hospitalisations for vulnerable patients.
In the UK population, where most people arevaccinated but many remain vulnerable because of old age or underlying health conditions, Panoramic aims to help researchers get a grip on how antivirals work. The results should support what doctors expect to become a central pillar of Covid care, which will provide antivirals to vulnerable people within days of symptoms coming on. 1.3 million people in the UK have been identified as eligible for antivirals, but the number may grow as the Panoramic results come in.
If the trial goes ahead as planned. There is a belief that Panoramic needs free tests for the over-50s and vulnerable adults under 50 until at least September, but free tests will end on 1 April with a possible exception for those aged 80 and over and people with compromised immune systems. If the trial needs more tests, the funding will have to be cut from other budgets.
The Vivaldi trial is an important project that is being put at risk. The most vulnerable in the country are the care home staff and residents who have low immunity to infections. The national testing programme to measure vaccine effectiveness and reinfection rates in residents and staff is linked to the study. Much of the intelligence that informs decisions on the need to re-vaccinate staff and residents will be lost with the scaled back free testing.
Similar concerns surround the UK Health Security Agency's Siren study, which draws on Covid test results to assess how quickly tens of thousands of healthcare workers are reinfecting with Covid as the epidemic unfolds, and so shed light on how quickly immunity is waning among frontline workers.
The Office for National Statistics Covid infections survey has seemingly been spared, but to what extent is unclear. The weekly picture of the UK's Covid epidemic is provided by the survey. As free community tests end, the survey will become more valuable, but it will also be scaled back, raising questions about how clear a picture health officials will have of the UK situation in the months ahead.
One area where the UK is truly world class could be affected by the loss of most free testing in the community and the expected scaling back of the ONS survey. The nation's impressive genomic surveillance effort has served as an early warning for new variant not only for the UK but for the world. The testing that it taps into is as good as the surveillance. The next warning may not come as fast if free tests are not available.
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