A simple saliva test could replace quarantine and unlock travel – so why won't the Government act?

Professor Karol Sikora
·4 mins read
Politicians love hyperbole but whichever way you look at it Britain’s testing system is far from ‘world beating’ - getty
Politicians love hyperbole but whichever way you look at it Britain’s testing system is far from ‘world beating’ - getty

Our travel companies are struggling for survival and the UK hospitality industry is on its knees. Our cancer centres are full of vulnerable patients urgently needing complex treatments. So, what’s the connection?

In both cases we need to ensure that we maintain environments free of infection. The only way to do this is by effective, repeated and reliable testing. Politicians love hyperbole but whichever way you look at it Britain’s testing system is far from ‘world beating’.

Our administration is poor by international standards, but our scientists are not. It’s why there is so much frustration growing. Other countries have shown real imagination and innovation to tackle some of the issues we all face, so why can’t we?

Scientists are providing answers and we have some of the brightest, but for reasons unknown ministers seem unwilling to fully embrace them. No industries have been more impacted than travel and hospitality. Both have been suffocated by ludicrous and inconsistent quarantine rules. Paris, Frankfurt and Amsterdam airports are for the first time now handling more passengers than Heathrow. The continent is getting airborne but we’re still stuck in the hangar.

Whether it’s a plane or a radiotherapy machine let’s start thinking outside the box. The challenges are the same. We need to ensure that we reduce the risk from people entering who can transmit the virus, whether it be staff, customers or patients. Covid-free zones are essential.

There are only four assessments we can use. Taking a history of symptoms, checking temperature, blood testing for antibodies and detection of the virus by either polymerase chain reaction (PCR) or by picking up its specific proteins.

Checking for the presence of viral RNA by PCR is the most reliable current test. But we’ve all seen the images of health professionals in terrifying hazmat suits sticking swabs up noses. It’s not only intrusive, but risky for whoever’s taking the sample. For some months it’s been clear that saliva testing can match its effectiveness, at far less hassle and cost.

Self-testing is fraught with difficulties; sticking a swab far enough up your nose to collect the sample is just unpleasant. Collecting saliva in a tube is far easier and so much more reliable.

The swab test is not only intrusive, but risky for whoever’s taking the sample - getty
The swab test is not only intrusive, but risky for whoever’s taking the sample - getty

False positives are a real issue however the sample is collected, but with saliva testing fragments of dead virus don’t hang around as they do in the cells lining the nasal passages. In our view, it provides a clearer picture of what’s really going on.

It’s all too easy to criticise the Government’s quarantine scheme with no credible solutions, but we have one. Testing on arrival is an option, but anyone could be infected on the flight and it wouldn’t show up at the airport. So, instead of the current 14-day quarantine, give arrivals a saliva kit to use five days after getting home. If it’s negative, they’re free to leave, dramatically cutting down the inconvenience.

There is currently a team, Halo Verify, of extremely talented and dedicated young scientists in the depths of Imperial College’s start-up labs in White City feverishly looking for new ways to make the saliva test better, faster and cheaper.  

With our Cancer Centres they are running a UK first pilot project on cancer. Keeping the virus out of Rutherford’s buildings is crucial; we have some extremely vulnerable patients undergoing treatment that affects their immune system.

Temperature testing, distancing, and all the other usual methods are used, but nothing will be as effective as weekly saliva testing. Every Tuesday our staff give a sample and early the next morning we have the results. The long turnaround on government tests is causing chaos. Operations are on hold, precious beds remain empty and surgeons are twiddling their thumbs because patients can’t get the clearance to enter hospitals. 

Halo are also testing a major international airline’s long-haul crews at Heathrow on departure. By the time they get to their destination the results are available.

In both the airline and cancer treatment settings understanding the prevalence of the virus in the staff is the key to achieving Covid-free environments. What Rutherford and Halo are doing should be used as a template where there are large cohorts of potentially vulnerable people in care homes, prisons and schools.

Expanding current testing capacity rapidly is possible. And pooled testing is attractive when the virus is rare. Here, several samples are added together and tested as a whole mix. If a positive is found, then then individual testing can locate the infected. No ludicrous waits, no health professionals needed, no swab up the nose.

The travel industry has been brought to its knees, worried parents can’t get tests for their ill children, and the flaws in swab testing are becoming more apparent. The saliva solution is ready and waiting. If Government really wants to have a ‘world-beating’ testing system, then just embrace it.

Professor Karol Sikora is the Chief Medical Officer at Rutherford Cancer Centres. Dr Nigel Kellow is the Chief Medical Officer at Halo Verify.