How many of the government's 100,000 tests make it back to the laboratory?

Coronavirus test kits are mailed out and count towards government targets, but a significant number are not being processed. 

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On 14 March, Health Secretary Matt Hancock wrote in The Telegraph that he would act with “maximum transparency” during the coronavirus pandemic. Six weeks later, he’d forgotten his promise.

On 1 May, he claimed his pledge to “carry out” 100,000 tests a day had been fulfilled, with official figures showing 122,000 tests on 30 April. But that included more than 40,000 tests counted when they were posted to households or to distribution centres. Hancock has still not said how many of those kits made it back to laboratories for a positive or negative result. Every day, his department publishes figures inflated by these mail-out tests – and ministers celebrate passing the 100,000 target.

It is now apparent that many tests posted to households never make it to the lab. Once you receive a home test kit, you must swab your nose and throat and arrange courier collection. Several people told New Statesman their swabs were never picked up by Royal Mail-owned eCourier, which the government has contracted for the service.

An eCourier representative told one of these people that some members of the public arrange collection of their test but never complete the swab. Another courier said they have arrived to pick up swabs only to find the tests have already been collected. 

One person enquiring about their swab was told by a testing coordinator that around 2 to 3 per cent of tests (about 200) arranged for pickup every day are not collected. (A Royal Mail spokesperson said they did not recognise that figure, but could not give a more accurate one because the company does not disclose details of contracts with clients.)

On 22 May, Professor John Newton, the head of the UK’s coronavirus testing programme, was asked a simple, direct question at the Science and Technology Committee by chair Greg Clark: what percentage of home testing kits have been returned to labs? Newton had no good answer. “Well, to begin with, a relatively, I mean, I think something like more than, certainly more than half, and we would like to get that amount up,” he said. 

Newton did not have an up-to-date figure to hand but said: “it can be provided by the programme, I’m sure.”

“Will you write to the committee straight after [this] meeting?” asked Clark. “Yes indeed, of course,” said Newton. That was at 10:11 am. At 10:57pm, the Department of Health responded to New Statesman’s questions about the testing regime. On the proportion of home test kits returned to labs, a spokesperson could only say: “Professor Newton has said that information will be given to the Health and Social Care Select Committee in due course.”

They provided the same answer to a question about the 2 to 3 per cent figure for uncollected tests. On 29 May, the office of Zarah Sultana, a Labour MP who sites on the committee, confirmed that Newton had still not supplied an up-to-date figure.

This opacity is obscuring the true test count. What we know for certain is that a proportion of the tests in the official tally are never carried out, and the impact goes beyond simply massaging the figures.

Sue, a woman from Wiltshire with lupus who retired last year from local government consultancy to travel more (“Timing could have been better!”), booked a test earlier this month. When it arrived, she arranged a courier for between 8am and 4pm the next day and completed the swab. “We even left the front door open with the test on the doormat to ensure there was no hold up for the courier, but by 6 pm still no collection,” she said.

“I rang the test helpline at 6pm and the contact informed me it would be too late to arrange another collection as the test was only viable for a few hours. I was asked to arrange for a new test kit the next morning. I went back online the next day and the computer responded that as I had already recently had a home test kit, I could not have another and would have to go in person to a local test centre. Nearest centre to me was Swindon. This would be an hour's drive each way.

"As I am on the NHS most at-risk register and have been advised to not leave home and totally shield until 30 June I was not prepared to make this journey and gave up on the testing.” (Royal Mail requested Sue’s details so it could check with eCourier why her swab was not collected, but could not provide a conclusive reason in time for publication.)

Her story is echoed elsewhere. Jess, an NHS cardiac physiologist from London, said her test was not collected when it was supposed to be, and was eventually picked up five days after she swabbed. Anyone ordering the test kit is told that they must swab either the day of or night before the collection. “I am sure my result will come back as inconclusive, or if it is positive I won't believe it is a valid result,” she said. “My partner is isolating for the next few days regardless, whereas we were hoping for some clarity from the test.”

Jess was told that a courier had turned up, but nobody was home. She says she was in the whole day – the same dispute was replicated in other cases. With a programme this large, miscommunications are inevitable. In some instances, people will order tests and never complete them, even after booking a courier (the Department of Health said it is “working with the world’s leading behavioural scientists to do everything possible to further improve return rates”, and that people should only order a test “when they really need one”).

The point is that Jess will not receive reliable results for her test. Others, such as Sue, will not receive results at all, and will be left wondering whether they’ve had the virus. And yet all those tests posted out, as well as any replacement tests sent because the first was not collected, are counted in government totals.

Fiona, a divorced mother of two who works in a primary school in the Cotswolds, never had her swab collected, and by the time she could rebook a test, it would have been nine to ten days after her symptoms started. “I didn’t reorder or retest as there didn’t seem any point and I didn’t want to waste valuable resources by doing so, especially as there was no guarantee that it would be collected again anyway.” (Royal Mail also requested her details, but could not follow up in time for publication.)

It’s “deceitful and wrong” that the government counts tests like hers in its figures, she said. “The general public are being lied to. I can only assume that that is why the tests which are not being collected are not being tracked, because if they were, it would have a huge impact on the numbers that the government are publishing. It would probably bring their ‘testing’ numbers down by thousands.”

A Royal Mail spokesperson said: “We have developed a scaleable collection network for testing kits to ensure they are collected from the customer and returned to the testing laboratories as quickly and as safely as possible.

"We pride ourselves on the high quality of the collection service that we provide. On rare occasions a collection may not take place for a variety of reasons including the cancellation of the testing service or the customer not being contactable at the address. We have the resources in place to scale up to meet the government’s needs over the coming months.” Other customers New Statesman spoke to recalled a positive experience of the collection service.

The Department of Health told the New Statesman that 330,000 home test kits had been posted as of 22 May, around a tenth of all coronavirus tests. We do not know how many were wasted. Is it thousands? Tens of thousands? 100,000? Without transparency from the government, we can only guess.

 
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