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Scientist and volunteer reservists needed for next pandemic

A system of reserve scientists and volunteers should be set up prior to the next pandemic to prevent the ‘human bottleneck’ that delayed the initial scale-up of testing during the COVID-19 crisis, according to Trinity Senior Postdoctoral Researcher Dr Jordan Skittrall and colleagues.

Outlined in The BMJ, such a reservist system would require a relatively small number of highly skilled scientists, paid on a retainer basis, and a larger pool of volunteers, who could be called up and trained rapidly. This would help the UK respond more quickly and effectively to future outbreaks of infectious disease.

In 2020, insufficient PCR testing capacity had consequences for other health services, including delays to making hospitals COVID-secure, knock-on delays to scheduled surgery, and slower than ideal identification of people with COVID in the community, which in turn delayed contact tracing.

‘Because COVID-19 testing wasn’t scaled up quickly enough, we couldn’t detect all cases quickly enough to try and stop the spread of the disease,’ said Dr Skittrall, first author of the report and Clinical Lecturer at the Department of Pathology.

It was frustrating to hear politicians’ promises to repeatedly scale up COVID-19 testing capacity during the early stage of the pandemic. The scale-up was extremely challenging: a lot of expertise is needed to get the tests working in the early stages of dealing with a new pathogen.

Dr Skittrall studied mathematics before training as a medical doctor.

Dr Skittrall is also an Honorary Specialty Registrar in Infectious Diseases and Medical Virology. Like others at Addenbrooke’s Hospital and the Biomedical Campus, at the start of the pandemic he halted his day job researching genetic conservation in viruses, and joined the effort in Cambridge to interpret COVID test results in the lab.

In early 2020 we were working until late at night, with very few people processing tests for the whole country. The speed at which people were having to work, and the difficulty of trying to scale up the process in a busy hospital lab made me realise there was a real human bottleneck. We needed more people to process the tests.

The UK had ‘the right scientific skills’ to respond to the next big outbreak of infectious disease, which is a matter of when, not if. ‘But we need to make sure that we have these people ready, so that when something does happen they can hit the ground running,’ said Dr Skittrall.

In total, laboratories in the UK have conducted more than 200 million PCR tests for SARS-CoV-2, the virus that causes COVID-19. Dr Skittrall says the accumulated expertise and streamlined processes means that a reservist lab system would not require massive investment.

Skittrall, J P et al. ‘Preparing for the next pandemic: reserve laboratory staff,The BMJ, September 2022. DOI: 10.1136/BMJ-2022-072467

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