Surging demand following the reopening of schools has generated a backlog of 185,000 tests, just as the pace of infections threatens to explode.
With Britons fretting last week that a new six-person limit on gatherings would effectively cancel Christmas, Prime Minister Boris Johnson unveiled what he called Operation Moonshot, an audacious plan to test 10 million people every day for the coronavirus and restore life to normal by winter.
But by Tuesday, the reality of earthbound life in a pandemic reasserted itself: Before a second wave of the virus had even crested, unprocessed samples overwhelmed Britain's labs and people waited in desperation for tests while the reopening of the country's schools and businesses hung in the balance.
The country cannot meet the current demand, yet the prime minister plans, within a few months, to conduct more than 40 times as much testing as it does now.
"We are sleepwalking into a second surge of the pandemic without really having learned the lessons from the first," said Dr. Rinesh Parmar, an anaesthesiologist and the chairman of The Doctors' Association UK, an advocacy and professional group. "We are set for a perfect storm of problems heading into the winter."
Britain has suffered more coronavirus-related deaths — 57,528, according to official records compiled from death certificates — than any other nation in Europe. But as new cases receded over the summer, Johnson's government created incentives for people to dine out, urged them to return to their offices and dithered over whether to require face masks before mandating them in mid-July for enclosed spaces.
Crucially, experts said, the government also failed to prepare the country's labs for an inevitable spike in demand for tests as schools reopened in September and cases of everyday coughs and colds surged along with the coronavirus. Confirmed new cases in Britain, which had fallen below 600 a day in early July, have reached about 3,000 a day.
The testing programme is now so saturated that it has started sending overflow samples to labs in Italy and Germany. At one point Monday, people in England's 10 riskiest coronavirus hot spots — including areas of Manchester, the second largest city — were unable to book tests. Some people were told they would have to travel 200 miles to get tested.
The programme recently reached a backlog of 185,000 swabs, The Sunday Times of London reported this weekend. And after urging people in July to get tested regardless of any symptoms, the Conservative government is reported to be drawing up plans to restrict access to testing in an attempt to deal with what officials described as "frivolous demands."
Britain's opposition Labour Party seized on the difficulties, barraging Matt Hancock, Britain's secretary of state for health, at an appearance in the House of Commons on Tuesday.
"The secretary of state is losing control of this virus," Jonathan Ashworth, Labour's lead lawmaker on health issues, said of Hancock. "He needs to fix testing now."
Hancock acknowledged "operational challenges" in the testing system that he said could take weeks to resolve, even as he pinned most of the blame on people seeking tests who did not have symptoms of the coronavirus.
Johnson has walked away time and again during his political career from the smouldering ruins of failed moonshots. His rosy attitude did not fade when the coronavirus landed in Britain this year, despite the pandemic continually proving him wrong.
In mid-March, he promised to "turn the tide" on the virus within 12 weeks. His government at first downplayed the need for virus testing on a massive scale, defying the experts, and instead invested in untried antibody tests — which, as it turned out, didn't work.
After Johnson's government reversed course on viral testing and pledged to test 100,000 people a day by May 1, that goal placed such a huge strain on public laboratories that they were left scrabbling for the supplies they needed to meet the demand. It took almost four months more, until late August, to push the figure above 200,000 tests in a day.
In July, he floated a "more significant return to normality" by Christmas. His pledge to build a "world-beating" contact tracing programme remains unfinished; many contact tracers spent the early days of their employment watching Netflix.
Still, defying the warnings of a key government adviser, Johnson set out his new target last week for a high-speed diagnostic programme that by early 2021 could test 10 million Britons a day, or every person in the country once a week. Documents obtained by The BMJ, a medical journal, mentioned a price tag of 100 billion pounds ($192 billion) and acknowledged that the technology to process so many tests so quickly did not exist.
The government adviser who warned against the plan, John Bell, a professor at the University of Oxford, said in a radio interview that the problems with the government's existing testing programme were a result of underestimating demand once students returned to class this month.
"What has been underestimated was the speed at which the second wave would arrive but also the pressure put on the system from children returning to school and the testing demands associated with that, and people increasingly out and about," he said. "So, I think they are definitely behind the curve in terms of getting the necessary tests for what we need today."
Beyond the uptick in demand, some officials have also suggested that shortages of staff and reagents, the chemical ingredients used in tests, may be contributing to the crisis.
The shortages have rippled through schools, where students returned to classes at the beginning of the month, highlighting the dangers of sending children back to classrooms without a strong testing programme in place.
Teachers said that start-of-term headaches and sniffles began to spread almost immediately, but there was little way of knowing if they were a sign of something worse.
One London teacher said that at her school of more than 1,000 students, administrators had been supplied with fewer than 10 self-administered coronavirus test kits. They told teachers that they were reserved for emergencies, she said.
A teacher in southwest England who came down with symptoms of the coronavirus this weekend said he was facing several days out of the classroom, after efforts to schedule a test for the virus failed. His school managed to help arrange a test more than an hour's drive away, he said, and the results are expected to take two to three days.
The shortage of tests is not just a problem in the schools. Because they cannot get tested for the virus in time, some patients have had to cancel scheduled operations at the last minute, doctors said.
Even general practitioners — the usual refuge for families dealing with colds and flus — have not been immune from testing difficulties. While hospital doctors have better access to testing, general practitioners generally have to book swabs the same way their patients do.
In a survey conducted by The Doctors' Association UK on Saturday, doctors described being asked to wait days and travel hundreds of miles for tests.
"That leaves an already stretched health service even more stretched," Parmar said. "It's a real affront to the 600 health care workers we've lost if we don't learn the lessons of how to do this better, how to look after our health care workers and prevent the spread of the virus and enable testing so people can actually isolate."
Written by: Benjamin Mueller
© 2020 THE NEW YORK TIMES