Liverpool is attempting mass COVID-19 testing during the UK's lockdown — but the reaction to the program is mixed

• Liverpool's mass COVID-19 testing program, a pilot in Prime Minister Boris Johnson's "Operation Moonshot vision," is dividing public health officials and politicians, according to The Washington Post.
• The Post reported that as of November 3, Liverpool's weekly rate of COVID-19 tests was 300 cases per 100,000 residents, and as of November 21, the rate was 158 cases per 100,000 residents.
• Angela Raffle, a senior lecturer at the University of Bristol, told The Post that the mass testing efforts are the "most unethical proposals for use of public funds or screening."
• Other public health officials have decried the accuracy of rapid tests, and pointed out that the testing strategy, which will expand to other cities in England next week, will consume the equivalent of 77% of the NHS budget.
• According to an analysis from BBC Newsnight, only 4% of residents have participated in some of Liverpool's poorest communities.

Liverpool, the UK's fourth largest city, has implemented a mass swabbing and testing program to curb the spread of COVID-19 — and according to new reporting from The Washington Post, there are mixed feelings about the program.

As a local effort in the UK's "Operation Moonshot vision," about a third of Liverpool's 500,000 residents since the start of November.

The implementation of the pilot mass testing program in Liverpool was part of a broader effort to conduct six-week testing surges across the country's "Tier 3" cities after the national lockdown ends next week. Tier 3 is the UK's most restrictive set of COVID-19 lockdown measures. Testing started in Liverpool one day after the national lockdown was announced on November 6.

Liverpool has since moved down into the less onerous Tier 2, unlike nearby Manchester, or Newcastle, Nottingham and Leicester. Liverpool's venues, businesses and restaurants can now reopen for business. Some politicians have ascribed Liverpool's improved performance to the mass testing program.

Public spaces are being used as testing sites, and the army is assisting with logistics as residents are initially swabbed in their nose and throat and get results in about an hour. If a resident's sample is marked positive, they are offered a polymerase chain reaction (PCR) test, which is more accurate.

According to The Post, as of November 3, Liverpool's weekly of coronavirus cases was 300 cases per 100,000 residents, and as of November 21, the rate was 158 cases per 100,000 residents.

Within three weeks of testing in Liverpool, British politicians began widely lauding the program, while many public health officials questioned the effectiveness and cost of it, according to The Post.

Prime Minister Boris Johnson, called Liverpool a success story and model for other cities to follow. Health Secretary Matt Hancock also praised the effort and claimed that in Liverpool, cases had declined by two thirds.

Some critics have aimed their concerns at the rapid tests used in Liverpool, which can have serious accuracy issues and potentially only correctly identify around half of the asymptomatic carriers.

Angela Raffle, a senior lecturer at the University of Bristol, told The Post that the mass testing efforts the "most unethical proposals for use of public funds or screening." Raffle added that the space of a few weeks between tests is not particularly helpful, and said that in order for mass testing to be effective, residents would have to be tested every few days.

One UK study, published by Royal Society Open Science, argued that with 10 million weekly tests, together with household quarantine and systematic contact tracing, the mass testing strategy could help lower the spread.

Some other public health experts are claiming that the shrinking number of cases could also be a result of the national lockdown, and not solely the mass testing strategy.

There are also unknowns about how the program is being tracked and studied, according to Jon Deeks, a professor of Biostatistics at the University of Birmingham, who told WIRED: "The Department of Health is being incredibly secretive about what it is going to do, and how this pilot is going to be evaluated. There's a National Screening Committee, which we've had in the UK for 20 years, and they've been sidelined from this."

The Cabinet Office did not immediately respond to a request for comment.

In medical journal BMJ, Mike Gill, the former director of Public Health England, was also critical of the pilot, which he called "an unevaluated, underdesigned, and costly mess" and claimed that it absorbed the equivalent of up to 77% of the NHS' national budget.

At the start of December, 40% of England's population will be eligible for mass testing, and the government's goal is to swab 10 million people a day. The effort will cost more than $130 billion dollars according to The Post.