People in parts of Birmingham have been told to get a coronavirus test regardless of whether they have symptoms, in a significant break from government policy.
The UK government said earlier this month that people who do not have Covid-19 symptoms should not get tested because the system is struggling to keep up with demand. The same applies in Wales, Scotland and Northern Ireland.
However, there has been concern among scientists and public health leaders that this meant countless coronavirus cases were being missed and that it hindered their ability to track the disease.
The biggest programme of home testing in England revealed earlier this month that 72% of people who tested positive had shown no symptoms on the day of the test or the week prior. Separate analysis by the Office for National Statistics found that only 16% of people testing positive for coronavirus reported symptoms on the day of their test.
Birmingham city council said on Tuesday it would offer a “drop and collect” testing service for people “regardless of if you have symptoms” due to a rise in cases.
Due to a rise in Covid-19 cases & #Brum being placed on national watchlist, we've launched a drop and collect service to provide an easy option to get tested – REGARDLESS of if you have symptoms. We’ll be knocking on doors in parts of the city to offer the free tests 1/2 pic.twitter.com/x7aSIdSGrv— Bham City Council (@BhamCityCouncil) September 22, 2020
Under the scheme, volunteers drop off a test and then collect it within the hour. The council said it would be knocking on doors in the worst-hit parts of the city to offer the free tests. The scheme will only apply to areas with the highest infection rates.
The UK’s second biggest city has seen its infection rate soar in the past month, with cases rising from 324 in the week to 28 August to 1,048 in the week to 18 September. Its infection rate is 83.6 cases per 100,000 people, almost triple the average for England.
Local authority leaders in other badly-hit areas, including Oldham and Rochdale, have expressed concern at the decision to stop testing symptomless people because several studies suggest they can spread the disease as much as as people with symptoms.
A study of 213 patients with mild Covid-19 in South Korea found that people without symptoms had comparable viral loads to symptomatic patients, meaning they have about the same capacity to spread it.
The study, published in the journal Thorax, concluded: “Asymptomatic individuals were frequent among those infected with Sars-CoV-2, but harboured a comparable viral load compared with that of symptomatic patients and may thus act as a meaningful driving force for the community spread of Covid-19.”
The main symptoms of Covid-19 include a new and persistent cough, a high temperature and a loss or change to your sense of smell.
The health secretary, Matt Hancock, said on Monday he wished he had known earlier that symptomless people can spread Covid-19 – despite the government’s Scientific Advisory Group for Emergency (Sage) warning in February that it was a possibility.
Asked on ITV’s This Morning programme what he would change most about the government’s response since March, Hancock said: “I wish that we’d known earlier how the virus spreads before people have symptoms, because that changes how you manage it.
“Because at the start we thought it was only when you have symptoms that you can spread it, but actually it’s before and that means things like, if you’re perfectly well, then you need to be more careful – so that’s led to changes in the face mask policy.”
The government has pledged to test every care home worker once a week, and residents once every 28 days, in part due to the concerns about the disease being passed from symptomless people to the very vulnerable.