Operation Moonshot: The UK Government’s COVID Calamity

Written by Andy Rowlands on October 13, 2020. Posted in Current News

On September 11^th, the British Medical Journal ran an article about the government’s Operation Moonshot; their plan to test millions of people daily by 2021.

The article states, in part:

The documents show a proposed three stage rollout. They state that the UK will carry out between 200 000 to 800 000 tests a day between September and December 2020. This might break down to:

• 200 000 tests a day on people with symptoms,
• 100 000 a day on people without symptoms in local areas to suppress outbreaks,
• 250 000 a day on people without symptoms in the NHS and care homes, and
• 100 000 a day through national prevalence studies.

From December the plans propose increasing daily capacity to between two and four million. This would involve mass testing of all homes in local areas or whole cities when prevalence rises (430 000 tests a day), testing high contact professions such as teachers every week (100 000 a day), and testing people to allow them to enter high risk settings, such as visitors to hospital and care homes.

The plan then states that there would be “full rollout” in early 2021 to 10 million tests a day, to “enable people to return to and maintain normal life.” [Author’s note: having to be tested every day for potentially years is to be considered ‘normal’?] At this stage, weekly testing would be made available progressively to the whole population to allow people to go to high risk events by using a “digital passport” to show they have tested negative for the virus.

Alongside mainly commercial partnerships, the documents also state that a number of new tests and technologies would need to be used, including some that do not yet exist.

The documents show that there have been discussions over how to incentivise people to be tested. They point to enforcing testing “via a sanction-based model” or through “offering individuals opportunities/access from being tested,” such as being able to attend events.

I have mentioned in previous articles what this ‘sanction-based’ approach would mean. As it stands at the moment, if you refuse a Covid vaccine, you could be barred from using public transport, barred from going into most shops, barred from going to pubs, restaurants, museums, exhibitions, concerts, and barred from being able to work.

The BMJ article continues:

The plans say that testing could be used to “give people assurance that, at least for a limited time, they are unlikely to have the virus and are at low risk of transmitting it to others.”

They say, “A negative test result (or potentially a positive antibody result) may inform not just whether you could attend an in-patient appointment, but if you go to work that day, access a venue, get on a flight or visit an elderly relative.”

In reference to the non-PCR tests, it is repeatedly noted that “new types of test are likely to be less accurate [than PCR], introducing some level of risk.” In terms of how testing would affect behaviour, the documents say that regular testing “might make people behave in safer ways, by building covid-safe routines into their daily lives, or less safely by giving false a degree of comfort.”

The article notes Operation Moonshot is costed at a hundred billion pounds. It finishes by saying:

The documents state that the objective of the mass testing programme is to “utilise the full range of testing approaches and technologies to help reduce the R rate, keep the economy open and enable a return to normal life.” They say that Moonshot has been described by the prime minister as the “only hope for avoiding a second national lockdown before a vaccine, something that the country cannot afford.” (Emphasis added in all paragraphs)

It can be seen here www.bmj.com

On the 22^nd September, the BMJ followed up that article with another, with the title Operation Moonshot proposals are scientifically unsound.

This second article is highly critical of the Moonshot programme, and states:

The polymerase chain reaction (PCR) swab test is useful (but not perfect) for detecting SARS-CoV-2 virus RNA in symptomatic patients. However, problems arise using the test for purposes that disregard symptoms or time of infection—namely, case finding, mass screening, and disease surveillance.

This is because PCR is not a test of infectiousness. Rather, the test detects trace amounts of viral genome sequence, which may be either live transmissible virus or irrelevant RNA fragments from previous infection. When people with symptoms or who have been recently exposed receive a positive PCR result they will probably be infectious. But a positive result in someone without symptoms or known recent exposure may be from live or dead virus, and so does not determine whether the person is infectious and able to transmit the virus to others.

If PCR is used to identify cases through mass testing of healthy people, it will deliver positive results in individuals with previous resolved infections, new infections, and potential re-infections, as well as false positives in people genuinely not harbouring the virus (around 0.8% of all tests performed). Identifying the truly infectious—who must isolate—is not straightforward, even with a clinical history. For example, between 4% and 41% of cases are asymptomatic, with a risk of transmission roughly half that of symptomatic cases, but a positive test in those with no history of symptoms could indicate either current infection or previously resolved asymptomatic infection.

Real concern exists that many people who are not infectious (and not likely to become infectious) will receive positive test results, and together with their contacts, will be forced to isolate unnecessarily. In the context of mass surveillance, this could be a majority of those who test positive. Using PCR for population screening—even with a lower maximum Ct value cut off—is not epidemiologically sound. The balance of costs and harms against the potential benefits has not been evaluated.

Now, Operation Moonshot has proposed that mass screening with less accurate point-of-care tests will help “reduce the ‘R’ rate, keep the economy open and enable a return to normal life.” Could this work?

The Moonshot proposals are based exclusively on computer modelling, not empirical evidence. Critically, the model considers repeated use of tests that are positive only in infected people with high viral loads of SARS-CoV-2. The crux of the assumptions in the Moonshot modelling is that the test must have a high chance of being positive when a person is infectious and a low chance when they are not.

Frequent repeat testing is necessary as the proposed test will only identify people with new infections when their viral load becomes high. Since Moonshot proposes use of point-of-care tests, delays in receiving results would be eliminated and isolation can be immediate. But no point-of-care tests approved for home use are currently available.

One fundamental challenge is that proper evaluation of any point-of-care test destined for mass screening requires a robust and reliable way to identify true infectiousness: we need a reference standard against which the new test’s performance can be compared. Viral culture is one option, but culture based tests are hard to run and have high failure rates.

The Moonshot proposals have been condemned for not considering the potential harms from repeated frequent testing of whole populations. All tests generate some false positives and false negatives. The consequences of high false negative rates are most serious in symptomatic people who can transmit disease. Up to 30% of people with SARS-CoV-2 infection are missed by swab based PCR testing, for example.

False positives become a problem when individuals and their contacts have to self-isolate unnecessarily. Even with a specificity of 99%, proposals to do 10 million tests a day will generate many thousands of false positive results, causing unnecessary but legally enforced isolation of both cases and contacts with potentially damaging consequences for the UK economy and for civil liberties. (Emphasis added in all paragraphs)

It can be seen here: www.bmj.com

We can conclude from this the PCR test will generate more false positives the more tests that are done, and more people will be told to self-isolate when they do not need to. The number of ‘cases’ will increase ever further, and result in more damaging restrictions, which will hurt the economy and individual livelihoods even more than they already have been.

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About the author: Andy Rowlands is a British Principia Scientific International researcher, writer and editor who co-edited the new climate science book, ‘The Sky Dragon Slayers: Victory Lap‘

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