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Case/Article Review 2
The government delayed the findings of a Public Health England study that questioned the accuracy of a covid antibody test as it was about to announce that it had spent £75m (€84.3m; $99.4m) on buying one million of those tests. If the test is used in the community as intended, and assuming that 10% of recipients have previously been infected, around one in five positive AbC-19 tests would be a false positive, the findings suggest.
The study findings contrast with those of an earlier study - not yet peer reviewed, which was funded by some of the consortium developing and producing the test—that suggested that the test gave no false positive results. Clinicians stated, “Apart from limited surveillance to estimate the proportion of a population that has been infected, widespread use of this assay in any other role could risk considerable harm.”
Emails show a discussion between PHE and the Department of Health and Social Care on how to handle an announcement by the health minister James Bethell that the government had bought £75m worth of tests from Abingdon Health.
PHE staff warned of “significant risks” in not publishing the PHE evaluation showing the low accuracy of the tests and asked whether holding back the results had been agreed by ministers.
A Department of Health and Social Care spokesperson said that the one million tests it had bought were not intended for “widespread public use.”
The findings of the BMJ study suggest that the test can deliver a sufficient degree of accuracy for surveillance studies of the population, but laboratory confirmation of positive results is likely to be needed if these tests are to be used to provide evidence of protection from the virus.
Outline the main issues raised.
(Reference Adapted from: https://www.bmj.com/content/371/bmj.m4353)
Example Candidate Response
The article brings to light the difficulties inherent in trying to make fast decisions in the field of public health. There must always be an interplay of some form between cost and benefit - and, in a situation like this, between efficacy (or safety) and time.
In this instant the government’s decision to delay publicly revealing tests results shows a lack of transparency that is ethically unacceptable.
The article illustrates the difficulty of making fast informed decisions, and of relying on testing funded by the private entities that develop medicines.
Based on the information provided, one could argue for the importance of ensuring that high level decisions on medical purchasing are greenlit by clinicians as well as politicians.
We also must question the way funds are being distributed here, and if this is in-line with the principle of Justice - that is, bringing the most good to as many people as possible. Poor investments like this will mean a lack of funding in other areas.