We are all fed up with COVID-19. It has dominated our work, it’s all we talk about (let’s be honest, it’s the only thing to talk about), it’s disrupted all our lives, and changed the way we can live our lives.
That is why Liverpool City Council invited the Department of Health and Social Care to work with it on the MassAsymptomatic Serial Testing (MAST) pilot.
It aims to find asymptomatic cases, particularly in high-risk settings, to help prevent and reduce transmission in the community, thereby helping the city get back to low levels of infections, and to as close to normal as possible.
“Health inequalities are widening, with the life expectancy gap… now standing at 13 years”
The pilot kicked off in early November and lasted for around a month. The Army helped administer new, rapid, ‘lateral flow’ tests – with a turnaround time of around an hour – alongside the more familiar PCR swab tests, which need to be processed at a lab and take a day or two.
In addition, around 40,000 home testing kits were sent to people and communities unable to get to one of our many testing centres.
As first was going to press, more than 183,000 people have been tested, and ‘lateral flow’ tests have confirmed 866 positive cases of COVID-19.
We will be reviewing our whole experience and sharing our findings indue course, and the pilot is being fully evaluated.
The hard facts are that COVID-19 has already had a devastating impact on Liverpool. Between 1 January and 31 July, there were 623 more deaths than in the same period last year, caused almost entirely by COVID-19 (536 recorded deaths).
Health inequalities are widening, with the life-expectancy gap between the highest and lowest electoral ward now standing at 13 years. Out of our 30 wards, 28 have seen a reduction in life expectancy, with eight seeing a decrease of more than four years.
There will also be a long-term impact on health if we don’t try to contain the virus as quickly as possible.
We will see delays to diagnosis and treatment for serious diseases, such as cancer; a deterioration in our physical health caused by deteriorating mental wellbeing; there is likely to be a rise in alcohol dependency and substance misuse; and we don’t know what the impact of ‘long covid’ will be, or the economic impact of COVID-19.
So, the work we have been doing over the past few weeks could be a game-changing moment for our city. We are exploring SMART testing (systematic, meaningful, asymptomatic, repeated testing), which would provide ‘test to release’ and ‘test to enable’ opportunities.
It could mean that, in specific situations, people who are contacts of a positive case get released from their quarantine period earlier. This could, for example, relate to emergency services personnel and other frontline key workers.
We are also exploring the opportunities to allow greater freedoms and flexibilities around care home visiting initially, and potentially expanding this to weddings, funerals, and wider commercial or night-time economy events.
This could lead to a shift from people getting a negative outcome as a result of a positive test, to getting a positive outcome as a result of a negative test.
All of this is learning we are keen to pass on to other places, to help get life back to something approaching normal as soon as possible.