[quote Thewiseoneincognito]@RedToothBrush if we scrap testing we would lose sequencing for variants no? When the vaccine escaping one arrives, how will we know it’s here? Will we be testing the dead and the ones hospitalised with ‘pneumonia’?
If testing and isolation goes then booster uptake will start to dwindle too which will then create more opportunities for infections to climb.
The whole concept at this stage just seems like a very bad idea regardless of the money it’s costing us.[/quote]
I said we would lose lateral flow testing not PCR testing early in the new year.
We will definitely continue to do PCRs but I think it will be more restricted to severe cases, which result in hospitalisation. That will mean we will be able to continue to sequence but at a lower level. And arguably thats possibly not a bad thing. Firstly because sequencing is extremely expensive and secondly because we are currently doing a daft percentage of all the world's sequencing and I think there is a viable argument that says we don't need to be doing as much as that to be able to identify problems or potential problems. We only really know that a particular varient is a problem after you get a certain number of cases and hospitalisations. We probably would get enough data from sequencing severe cases alone. To try and explain it better; we might be up lots of new variants but thats not what we are looking for. What we are looking for is a sudden large number of people with a new variant who end up in hospital. Thats how you identify a variant of concern. You might get a new variant which displaces an older one which has lots of people catching it but its less virulent so less people are hospitalised. That a change but its not one we need to be concerned about. Our concern only involves hospitalisations and deaths in large numbers - and you actually don't identify that from sequencing large numbers of assymptomatic or mild cases. I would argue further that by the time you identify a new variant which is problematic its probably already too late to contain it easily. And unless you have similar levels of testing abroad, identifying problematic new variants in hospitals there you are flying blind anyway to an extent. We already know what individual protein spikes do, because we've been able to work that out from the data we already have. And we know how to deal with the viruse in different ways now and how this might change in future from modelling.
Our understanding of covid has now come on so much and our infrastructure in vaccine production and vaccine treatment is such that we are now better placed to deal with new difficult variants as they emerge than previously. I think the risk of a vaccine dodging variant is now somewhat overstated - we've moved on from that. That doesn't mean there isn't a risk; it means we think we can still identify the risk, respond to it promptly and have a number of different ways we can deal with it that we didn't before. The reality is there isn't a tangible benefit in carrying on sequencing to the level we have compared to the likely actual risk to a new covid variant.
This really is a fast moving area of research because we've thrown the kitchen sink at it. A lot of fears now are based on an historical position which we've now long since passed but the majority of the public probably don't fully appreciate and understand that.
Realistically research should start to be going into threats from future viruses (particularly other coronaviruses) now rather than threats from covid variants, because the former offers wider protection which also covers covid variants to an extent.
I think we are reaching the point where we have to ask hard nosed questions about what more we achieve by mass sequencing in the UK.
It has usefulness still in some other parts of the world for track and trace pursuing an elimination / minimisation strategy still but this isn't something we can do in the uk because thats not how we are handling the pandemic now.