They call it April Fools’ Day for a reason. From tomorrow, 1 April, Boris Johnson’s government will end the provision of free lateral flow and PCR tests for the majority of people in England.
Ministers have announced that only a limited number of groups will now have access without having to pay. That includes symptomatic hospital patients when it is required for their care, and people living or working in “high-risk settings” such as care homes and prisons. Free asymptomatic testing will remain available for care home and patient-facing staff in the NHS, but only when there is a high prevalence of the virus and it is determined that infections may spread quickly.
By ending free testing just as coronavirus infection rates soar – and a cost of living crisis leaves people without spare cash – the government is creating a perfect storm for illness. People will now be in the dark as to whether they have the virus, unless they can afford a test or choose to buy one, and could go into public spaces while infected, spreading the virus to people they would previously have protected by self-isolating.
The public health messaging is clear enough: don’t worry about Covid any more, but if you insist on bothering, you can pay for a test yourself. Or as Sajid Javid, the health secretary, put it: now that free testing has ended, people with Covid symptoms should “socialise a bit less”.
With the partygate scandal back on the political agenda, it may be in Johnson’s best interests to pretend that coronavirus is old news, but it is in no one else’s. Scientists have been all too clear on the likely consequences of ending free testing: increased infection rates, extra pressure on an already struggling NHS, more people getting long Covid, delays in detecting new variants. Also bear in mind that ministers have just axed funding for our world-leading infection tracker system.
The government claims that its testing plan will at least still protect the most vulnerable to coronavirus – but it appears that the majority of clinically vulnerable people, and the people they come into contact with, will not be eligible. Some high-risk people who need to have Covid treatments, such as antivirals, will be granted free tests, but government guidelines say they are only to be used once they are ill and already showing symptoms. It’s the public health equivalent of closing the stable door after the horse has bolted. This fundamentally misses what has been so valuable about large-scale testing over the past two years: it’s not that high-risk people can see if they have Covid, but that those they’re due to come into contact with can.
It is good news that ministers have relented and will not just test NHS and care home staff when they have symptoms, but it’s concerning that asymptomatic frontline workers will be left untested outside times of vaguely defined “high prevalence”. Public sector workers enduring real-term pay cuts can hardly be expected to pay for regular tests themselves, and it is negligent to tell patients they should be treated by an untested medic. Roughly a third of people who have coronavirus don’t show any symptoms, and hospitals – which are by their nature frequented by sick and vulnerable people – will always be areas of high risk of infection. It is not enough for an asthmatic mum to worry about catching Covid in the shops, bus and classroom – now she has to risk it from her respiratory nurse.
The government’s plan commits to testing care home staff, but there is little word on carers and personal assistants who work in the community, many of whom go into multiple disabled and older people’s homes each day. Nor is there any help for unpaid carers, despite them largely living in poverty and already worried about going out and bringing back germs to their vulnerable family member. Putting the financial burden of testing on to disabled people and their families during an energy crisis, which will itself hit people with disabilities hard, is outright cruelty. In the coming weeks, vulnerable care users will be forced to choose between buying an LFT to keep well and paying energy bills to keep warm.
There is also little help in the plan for people visiting elderly or disabled relatives in care homes, except a pledge that asymptomatic testing will remain available to “a small number of care home visitors who provide personal care”. Care home visitors may end up having to pay about £73 a month just to see loved ones, according to the Alzheimer’s Society, or else risk walking in being potentially contagious. Ministers’ infamous “protective ring” around care homes seems to have cracked once again.
From the very beginning of the pandemic, there have been voices seeking to downplay the threat of the virus to falsely suggest that protective measures are both restrictive and unnecessary. In many ways, the end of free testing is the ultimate example of this narrative. Not content with low sick pay, no mandated masks or ending the legal duty to isolate with Covid, England is about to abandon a public health tool that has undoubtedly saved many lives in the pandemic. That this is being done just as hospital admissions from Covid rise again is a national act of self-sabotage.
Some will say “we can’t afford testing”, but common sense says we cannot afford not to. The cost of increased hospitalisations as well as the fallout of long Covid will probably dwarf any testing costs; lateral flow tests make up a tiny fraction of the £2bn testing budget. Others will praise ditching LFTs as a sign of liberty restored, although it’s unlikely that this cohort will include the clinically vulnerable. Those who want their “freedom” will need to explain what it is exactly about access to universal healthcare that is so restrictive.
Ultimately, there is a choice: embrace the low-restriction, preventive measures that enable us all to get back to normal life as safely as possible, or accept uncontrolled transmission of the virus. The path taken reflects the extent to which the government really believes that every life matters. When it comes to that particular test, they have certainly failed.
Frances Ryan is a Guardian columnist
