The UK's Covid epidemic will dim the lights at the end of March. Free testing will be stopped for the majority of people in England and other countries in the UK in the coming weeks and months, despite the fact that infections are rising.
Scientists warn that ending community testing could put vulnerable people at risk and undermine efforts to understand the virus, even though the government argues that it is time to manage Covid as we do other infectious diseases.
Symptom testing will be free from 1 April for certain groups. The Department of Health and Social Care hasn't given any information on which groups will be eligible.
The change in policy after the winter seems dramatic.
Tackling Covid has cost a lot: free testing, contact tracing and research studies are not cheap. There is a high level of immunity across the country and the Omicron variant is less severe than it was at the start of the Pandemic.
The end of free community testing means that most people won't know if they have the virus unless they pay for a test, meaning that they will pass it on to others they wouldn't have tried to protect. The situation is likely to get worse in more deprived areas.
The success of vaccines and other approaches in tackling the severity of Covid, as well as less severe variant, may suggest that that is not the problem it once was, as rising infections have once again put significant pressure on the health service. Even hospitalisations with Covid can cause logistical difficulties and put vulnerable people at risk.
A lack of knowledge about previous infections could make it difficult to get appropriate care for long Covid and could even affect disability claims after occupational exposure.
Prof Azra Ghani, an epidemiologist at Imperial College London, said it was unclear how interventions will be delivered to the most at-risk patients without current testing.
The rise and fall of Covid will be affected by attempts to track the rise and fall of infections.
The government has cut funding to several Covid programmes, including the React study, which looks at infections in the general population on a larger scale. With the loss of community testing, there would inevitably be a delay in detecting the variant and that could have global ramifications.
Even our understanding of the severity of Covid and how well vaccines work could be affected without community testing data.
It will no longer be possible to estimate vaccine efficacy against mild disease, and so reductions in efficacy will only be apparent two to three weeks later when impact on hospitalisation is observed.
Prof Christina Pagel is the director of the clinical operational research unit at the University College London.
Prof Mark Woolhouse, an epidemiologist at the University of Edinburgh, believes that reducing community testing is not unreasonable, as it is not how most diseases are monitored.
He said that additional funding was needed to cope with the burden of infections and hospitalisations, as well as a plan to ensure vulnerable people were protected, for example through regular testing of their contacts and immediate provision of both tests and antivirals.
It would be a major surprise to me and many other people if we didn't have a significant wave this year.
Experts agree that plans must be put in place to deal with the consequences of the end of free community testing.
Woolhouse said that living with Covid should not be seen as ignoring Covid.
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