On 6 November, Liverpool became the first city in the UK to undertake a mass testing programme for the virus that causes Covid-19, with the hope that all 500,000 residents will be tested at least twice at a variety of sites – mostly leisure centres – manned by 2000 army personnel. Liverpool’s mayor, Joe Anderson, and his director of public health, Matt Ashton, said they hoped between 5000 and 10,000 people a day would come forward for testing; by the end of the first week, the council announced that 90,000 tests had been carried out. Among them was mine.
I’ve lived in south Liverpool since 2012, in a fortunate pocket surrounded by parks. Lockdown in that sense has been easy to get through, except that my father’s care home, a 15-minute bike ride from my house, has been closed to visitors since March. In the deceptive summer lull I was allowed to sit with him – two metres away, wearing a mask – on the patio when the weather was good, but that was stopped in September when the infection rate in Liverpool rose rapidly as tens of thousands of students arrived in the city. (‘£9K FOR WHAT?’ asked a sign made from neon Post-it notes in the window of one city centre student block.)
Now I’m back to leaving bottled ale, crisps and stationery on the doorstep of the care home, to be picked up by staff wearing latex gloves. (My dad, who has dementia, used to be a clerk and finds his drawersful of pens and paper clips reassuring.) If mass testing helps end his incarceration, and enables his carers to hold their grandchildren born in lockdown, I’m all for it. I think.
The effect on Liverpool of both Covid-19 and lockdown has been disproportionately severe, with the council’s head of intelligence and analytics, Richard Jones, reporting that 28 of the city’s 30 electoral wards have seen a reduction in life expectancy. The gap between the longest-lived and shortest-lived people across Liverpool, by area, has increased to 13 years.
The council has a funding gap of £44 million this financial year, which it can’t hope to fill even partially if the restaurants and bars in the city centre end up closing for good. Not only did Liverpool’s leaders quickly accept a reduced rate of furlough pay – 67 per cent, rather than 80 per cent for the national lockdowns – to enter Tier 3 restrictions in October, but they leapt at the offer of £100 million worth of rapid testing kits and the logistical services of the army.
But is mass testing a good idea? Allyson Pollock, a professor of public health at Newcastle, has expressed her alarm (she isn’t the only one). Where is the research design, the ethical clearance, the assurance of data protection, the setting out of pros and cons for anyone offered the test? On what basis, Pollock and colleagues asked Matt Ashton, has this been agreed to, when the government’s expert advisory group cautioned against the efficacy of mass asymptomatic testing? The WHO guidance is ‘to focus on contact tracing and identification of clusters’, and ‘does not recommend mass screening’.
The instructions that come with the testing kits being used in Liverpool – rapid lateral flow tests, bought by the government from the California-based firm Innova for £105 million – say they are not intended for use in community settings, and their accuracy in detecting asymptomatic cases is disputed. Of the first 23,000 tests conducted over four days in Liverpool, only 154 returned positive.
Leeds City Council, unlike Liverpool, decided not to introduce mass testing, because of unanswered questions about ‘the quality and sensitivity of the tests; the implications of false positives and false negative results; the impact on workforces and services; how tests will be managed and link with NHS Test and Trace and our local tracing and support team’ and ‘how mass testing will be linked to financial and broader support to self-isolate’.
Liverpudlians, though, have been encouraged to feel proud and excited about mass testing: to be grateful that their predicament has been noticed. Jürgen Klopp said to take part is to do something not just for ourselves but for all Liverpudlians. I know as well as he does that ‘NHS’ Test and Trace is a shitshow, but decided to do it anyway.
Trying to book a test on the first day, I was offered a home test because there were so many people at the test centres. Having attempted to administer a home test before – on my son a couple of months ago, when he was selected for sample testing – I wanted someone else to do it. It was impossible to get the cotton swab to his tonsils without touching his tongue first, which the instructions said would make the test invalid. He’s nine and very ticklish, admittedly, but there must be a whole lot of invalid home tests going back to the labs.
By Monday the ninth there were 3500 testing slots available at the leisure centre where I usually go swimming. The queue was short and fast-moving, and outnumbered by soldiers. By the time I’d taken out the plastic wallet containing my printed out QR code and passport – specified on the booking form I’d been approached by a young soldier with a strong Geordie accent, wearing a disposable mask and a flimsy plastic apron.
He asked me to re-register the details I’d entered on the gov.uk booking site, even though I had the QR code with me. ‘Have you got your phone?’ he asked. I don’t have a smartphone: hence the print out. Sighing slightly, he got out a tablet and asked for the details I had already filled in on the website. This meant giving my full name, date of birth, full address and mobile number – twice – in full earshot of everyone else in the leisure centre foyer. He didn’t ask to see my passport. He gave me a small registration card and pointed me towards the sports hall.
It looked like a polling station. There were thirty or so white, three-sided booths, each with a small window hatch and a mirror at eye level, next to an A4 poster. Nothing else. I was directed to Bay 2 and another soldier popped his head up on the other side of the hatch. ‘Hello, how are you today?’ he asked.
‘I’m a bit sweaty,’ I said, regretting it immediately. ‘I cycled here.’
‘But it’s freezing out there, hahaha! OK, I’m going to give you this swab,’ he said, efficiently removing the protective packaging from an elongated cotton bud. ‘Take the end of it, follow the instructions on the poster and give it straight back to me. Don’t do anything else with it.’
Oh my sweet Lord, I thought, and after coming all this way. That’s what the mirror was for, then. I looked at the swab, identical to the one I had used on my son, and then at the poster, which had instructions for self-administering a swab test. Blow your nose first, it said. Ah. There were no tissues provided and I hadn’t been told to bring any, only hand sanitiser. I had some in my bike pannier but now I was inside, holding a sterile stick. And what were you supposed to do with that while you’re blowing your nose?
I skipped the nose-blowing. Onto the next step. While looking in the mirror, the instructions said, open your mouth and point the swab towards your tonsils without touching your tongue or the sides of your mouth. Then rub it first on one tonsil, then the other. I looked intently into the mirror and directed the swab into my mouth. I gagged instantly and started spluttering. The soldier smirked through his little hatch.
‘I thought you were going to do it!’ I croaked, my eyes watering.
‘It’s OK, take your time, there’s no queue today,’ he said gently.
I had another go, with the same result: gagging, spluttering, streaming eyes. There didn’t seem to be any way to get the thing in without my tongue springing up in the way. As I wiped my eyes with my other hand, I overheard an officer showing three other service personnel the booths. ‘This is the same set-up you’ll have on your site,’ he was saying, ‘they’re quick to build.’
On the third attempt I made a desperate jab straight towards the back of my throat, poked around on either side for a few seconds and took it out again. It hurt. I would feel a strange scraping sensation every time I swallowed for the rest of the day. Did that mean I’d done it right or wrong? Next I had to put the swab in my nostril and twirl it around the sides for five seconds. Did my not blowing my nose first make the test invalid? I’ll never know. I handed the swab back to the soldier, who told me the results would be sent to my phone within an hour.
As I left the sports hall through the one-way system, it echoed with military barking. ‘Next!’ ‘To the door!’ ‘Bay free, sir!’ I remembered the last time I had been in the hall, with my daughter and her reception-year classmates, staggering around on a bouncy castle to the deathless sound of George Ezra’s ‘Shotgun’. That had been in February. Only nine months ago.
Thirty minutes later, I was outside the university library. My phone vibrated with a message from the NHS: ‘Your coronavirus test result is negative.’ Do I trust it, I asked myself, and go inside?