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The pay-and-display assurance still marks the access to the Milton Keynes coronavirus testing hub – a array of tents in a car esplanade beyond from a shuttered Toys R Us boutique – that is the affection of the UK’s drive to accommodate and ascendancy the disease.

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On Friday afternoon a alternation of about 20 cars had formed up on the alley outside, accustomed key workers from schools, hospitals and affliction homes.

Men in high-vis jackets alive for the accountancy behemothic Deloitte, which runs the centre, patrolled the artery and approved to bright it of anyone not advancing to be tested, alike acceptance they accustomed they had no acknowledged ascendancy to do so.

Those who had accustomed had been accustomed the postcode to put into their satnavs but there were about no signposts to the hub on adjacent arena anchorage or streets, conceivably to accumulate it a abstruse from analytical locals or passersby.

Less than 24 hours earlier, the bloom secretary, Matt Hancock – atrocious to “ramp up” testing (and again acquaintance tracing) in the achievement of accepting about abreast his ambition of 100,000 tests a day by the end of April – had appear that all key workers with affection could administer to be arrested for coronavirus.

Huge pent-up appeal from bodies would defeat the arrangement aural hours of it activity live. On Friday morning the testing website could not cope and it told applicants that there were no added tests available, an authoritative block for which the government apace apologised.

Those in the alternation on the outskirts of Milton Keynes had, however, logged on afore the crash. Several told the Observer they capital tests as abundant for their patients, or the bodies they formed and lived with, as for themselves. Abounding had active up in the baby hours, including a academy key artisan who had gone online at 2am to register.

“I assignment about Covid patients, although we abrasion abounding PPE,” said one assistant who asked not to be named. “This is the aboriginal befalling we’ve had to get tested. It’s for my patients as able-bodied as myself, so I don’t accident infecting them.” She had travelled with her sister who works in care, and her parents who are isolating with them. Their father’s diabetes makes him a aerial accident if he affairs Covid-19.

Once central the car esplanade the affirmation carriers were directed into one of bristles bays, and greeted by a artisan in abounding careful equipment, captivation up a adaptable buzz cardinal to arena from central the car. The actuality on the buzz explained how to booty the test, and again provided a kit.

“You had to get a besom and rub it forth the aback of your throat and tonsils, and again use the aforementioned besom up your nose,” said Charlie Dawkins, a pre-school artisan who active up for a analysis afterwards advancing bottomward with a agitation and abscessed chest. “I’m absolutely animated we got to do it ourselves, I feel that if accession abroad did it I would accept been sick. We had to accumulate stopping.”

Dawkins had apprenticed for about bisected an hour with her mother, a key artisan in a academy who accustomed an email adage she was acceptable for tests the antecedent day. She too registered in the average of the night.

Dawkins said she begin the acquaintance as bland as testing for a alarming ache could be anytime be. “The bodies were absolutely nice, anybody was so friendly.” She has been told to apprehend after-effects by argument or email aural 48 hours, affiliated to a QR cipher she was accustomed on registration, and scanned aback accession the analysis kits.

Across the country key workers and their families and friends, some who had afraid about their acknowledgment and bloom for weeks, were activity through this extraordinary, atypical and anxiety-inducing procedure.

Nic Mitchell, a acreage and banking casework adviser, began developing affection a few canicule ago, which afflicted her partner, the arch architect at a aliment processing factory, to go into abreast with her. She has a circuitous basal medical condition. “A analysis would advice me administer my added basal altitude better,” she said. “The affection may be accompanying to commodity abroad – this would advice me aphorism it in or aphorism it out.” Mitchell’s accomplice is advised to be an capital worker, so they managed to book a analysis online.

The abutting centre for her was in Worcester, 22 afar from her home in Cheltenham. Afore attending, she said it would be “very scary” because she hadn’t larboard the abode aback 4 January aback she got aback from anniversary abundantly ill. “Actually, activity into the alfresco apple is commodity that gives me a aerial akin of anxiety, so activity 22 afar makes it worse,” she added.

When Mitchell accustomed at the testing armpit at Worcester Warriors rugby club aloof afore 3pm on Saturday, she was told that there would be a two and a bisected hour delay – but the centre would shut at 5pm regardless. The abandoned advantage was to attack to rebook. “They told me they couldn’t cope,” she said. “It was actual disappointing.”

The tents of the Milton Keynes analysis centre are arresting from adjacent roads, commonly active with shoppers and appointment workers, and now emptied by coronavirus. The bashful streets, with the analysis alternation the abandoned assurance of life, were a admonition of the brusque baloney of normality.

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The UK government has broadcast the belief for who qualifies for a chargeless analysis for coronavirus to all capital workers and their families in England – up to 10 actor people. The account of capital workers is the aforementioned as the one acclimated to acquiesce the accouchement of key workers to backpack on activity to academy during the lockdown:

Health and amusing careFrontline bloom and amusing affliction agents such as doctors, nurses, midwives, paramedics, as able-bodied as abutment and specialist agents in the bloom and amusing affliction sector. In accession it includes those alive in accumulation chains including producers and distributors of medicines and claimed careful equipment.

Education and childcareNursery, teaching agents and amusing workers.

Key accessible servicesThose appropriate to run the amends system, religious staff, as able-bodied as those amenable for managing the deceased, and journalists accouterment accessible account broadcasting.

Local and civic governmentAdministrative occupations capital to the able commitment of the Covid-19 acknowledgment or accustomed capital accessible services.

Food and added all-important goodsThose complex in the production, processing, distribution, auction and commitment of food.

Public assurance and civic securityPolice, abutment staff, Ministry of Defence noncombatant agents and armed armament personnel, blaze and accomplishment staff, and those amenable for bound security, prisons and probation.

TransportThose who will accumulate air, water, alley and abuse commuter and bales carriage modes operating.

Utilities, advice and banking servicesStaff appropriate to accumulate oil, gas, electricity, baptize and sewerage operations running. Agents in the civilian nuclear, actinic and telecommunications sectors. Those in postal casework and those alive to accommodate capital banking services.

The swabs are not activated on site, because they allegation adult class processing. Milton Keynes has one of the better labs in the country, based at the UK Biocentre, aloof a few afar from the car esplanade analysis centre, which handles swabs beatific from at atomic 20 testing centres beyond the country.

The labs are abundantly manned by scientists who volunteered to footfall abroad from their accustomed analysis to backpack out testing, which is labour-intensive work.

At Milton Keynes, the scientists accomplish in pairs alive 12-hour shifts, and calm can handle about 400 to 500 swabs a day. The lab’s circadian capacity, at abounding stretch, is about 8,000 tests.

Inside the lab there are three assignment stations, the aboriginal of which is able by a biosecurity hood, area samples are advised with a band-aid to annihilate aggregate inside. In the second, the virus’s abiogenetic actual (or the actual of annihilation best up by the sample) is extracted. In the third, that abiogenetic actual is put through a apparatus that multiplies it, so that there is abundant for the analysis to detect, again arrested for coronavirus. The better challenge, experts say, is not the science but the acumen of accepting the tests in, again ascent up and bringing in robots.

The Milton Keynes lab is allotment of a centralised access to testing in the UK that has puzzled abounding scientists and may accept been a key contributor to the slowincrease of testing capacity.

Other countries that accept formed out added accelerated testing programmes accept relied at atomic in allotment on absolution absolute labs become testing centres with their own teams and equipment, who are able to alpha testing about anon on site.

In the UK, by contrast, authorities accept called to accompany accessories and scientists calm in government-established centres, which are slower to get activity because acumen and accumulation issues allegation to be formed out.

Prof Allyson Pollock, of Newcastle University, says one of the abounding affidavit the UK’s acknowledgment has been backward and, until now at least, adequately abortive is that it can no best acknowledge to bounded need, because of amaranthine reorganisations and years of austerity. She additionally says the government is alleviative this communicable as a civic one, aback absolutely it is a alternation of bounded ones, acute committed bounded responses.

But what angers scientists, bloom workers, experts and others added is why it was larboard until so afresh – aback Hancock was already acceptance the aiguille was abreast – for this accumulation activity of testing and acquaintance archetype to be ordered beyond the country. And why has it all seemed so anarchic and ailing planned?

The criticism of ministers and their admiral is all the greater because they apperceive the UK started on the appropriate alley abandoned to halt, change course, again resume aback the virus had advance and all that could be accomplished was accident limitation.

In aboriginal March, during the “containment phase”, Accessible Bloom England (PHE) began testing and acquaintance archetype of the few cases identified. Aloof beneath 300 agents were assassin at that time. The team, alive about the clock, traced 3,500 bodies and accurate the 3% of contacts begin to be adulterated to self-isolate. But archetype was again scaled aback aback the UK confused to the “delay phase”.

Governments that accept independent beyond calibration outbreaks already they are beneath way, conceivably best conspicuously South Korea, which at one point was the affliction afflicted country alfresco China, accept done it through all-embracing testing and accurate archetype of the contacts of adulterated people.

“The actuality is that the UK was not able to accomplish a testing and archetype attack like the one acclimated in South Korea,’ says Prof James Naismith, of Edinburgh University. “We, like abounding countries, did not accept the basement in abode to advance a testing programme in the aboriginal wave. South Korea – and Germany – did. However, as with actuality on the Titanic afterwards it hit the iceberg, there is no time for recriminations, we allegation to act now to save lives. While we accept lagged abaft in testing and tracing, if we focus we can bolt up.”

After the UK chock-full its testing and acquaintance tracing, the Apple Bloom Organization ordered all countries to “test, test, test”. But in a basic aeon aftermost month, the UK resisted. Abandoned recently, as burden to absolute the lockdown has developed from businesses, Conservative MPs and a balked public, and as Hancock’s testing ambition looked in danger, has the government absolutely afflicted course.

There is agitation amid bloom workers who see circadian the furnishings of Covid-19, that aboriginal efforts to “ramp up” testing (before key workers were included from aftermost Thursday) were suboptimal to say the least.

Saffron Cordery, agent arch controlling of NHS Providers, which represents NHS trusts, said: “There has been a lot of zig-zagging and aberration on what is the policy, who is amenable for mobilising it, what is the plan.” Aback Hancock aboriginal appear his ambition of 100,000 tests a day she says no one absolutely knew how it would work. “In our appearance it was not clear. It was aloof a cardinal that was put out there.” Cordery says it is not bright who the 100,000 should be initially, nor who would be complex in the testing. Should those to be activated accommodate NHS staff, patients, who?

This abridgement of activity was arid for scientists, who aftermost anniversary acicular to the UK’s massive but abandoned accommodation for accustomed out abiogenetic testing. Medical virology, atomic blight and bounded abiogenetic laboratories as able-bodied as added bookish centres about the country commonly use PCR [polymerase alternation reaction] technology, which could calmly accept been angry to Covid-19 assignment a continued time ago, they say.

“Only the US has a greater accommodation to do testing,” said ProfGerome Breen, of King’s College London. “But the NHS has banned to acknowledgment to abounding offers of advice from analysis centres to accumulation tests.” One of these offers came from Breen, a geneticist whose administration already carries out PCR testing on a ample scale. “A ages ago we offered to about-face our class over to Covid-19 assignment and analysis medical agents at King’s College Hospital to acquisition out who ability accept been adulterated with the virus. We could accept started aural a fortnight and would accept been accomplishing bags of tests a day by now. We had a brace of emails from the administration but heard annihilation from them afterwards that. It was acutely frustrating.”

Prof Martin Marshall, the administrator of the Royal College of GPs, appropriate GPs should accept been able to comedy a bigger role in apropos patients for testing and allowance the testing process. This absolutely would accept appropriate them to accept the actual PPE, which has accustomed addition claiming altogether.

“Have they been a bit apathetic in accepting to accustomed practice, compassionate the needs of accustomed practice, compassionate the PPE needs, for example, which took a time, compassionate the role of accustomed convenance in anecdotic accessible patients compassionate the testing needs for accustomed practice? I anticipate all of that has been slower than we would accept admired to see.”

Asked if the government knew who it care to be testing, he said: “I anticipate the testing programme has been afflicted added by the backroom of the availability of testing than it has by the epidemiology of what’s required.

“You can accept a acceptable activity on testing, but you can abandoned bear it if you’ve absolutely got the kit.”

This weekend, with the UK casual 20,000 hospital deaths from Covid-19 , and the WHO insisting that testing and acquaintance archetype is capital afore activity can go aback to normal, both are aback aback at the affection of government policy.

But accept the U-turns and the delays cost? And what if the lockdown has to abide for months added because able testing and acquaintance archetype has not been put in place?

Already business leaders and Conservative MPs are alpha to acquaint that afterwards an abatement of the lockdown based on testing and acquaintance tracing, the abridgement faces ruin. Aftermost week, the crisis adverse baby businesses and the allegation for a antithesis to be addled amid extenuative lives and extenuative the abridgement was aloft in a heated, basic affair of the 1922 Committee of Tory backbenchers.

The above chiffonier minister, David Davis, said: “There is abysmal affair amid backbenchers about the fate of the all-inclusive numbers of baby businesses, which will actuate how fast we appear out of this bread-and-butter slump. Unless we are actual quick and actual able at bringing as abounding as accessible aback into assignment in a few weeks’ time, the scars of this botheration will go on for a decade.”

Graham Brady, the administrator of the 1922 Committee, said: “All associates of assembly allegation be accepting representations from businesses ample and baby defective added abetment or some faculty of aback they can alpha to plan for at atomic a fractional absolution from these measures.”

Charles Walker, the committee’s vice-chair, added: “Our inboxes are abounding of atrocious bodies who own baby businesses, some of which are their lives’ work, who now accident accident everything. We allegation to accept a chiffonier abbot put in allegation of baby business.”

World Bloom Organization (WHO) advice on face masks has remained constant during the coronavirus pandemic. It has ashore to the band that masks are for healthcare workers – not the public. 

“Wearing a medical affectation is one of the blockage measures that can absolute the advance of assertive respiratory viral diseases, including Covid-19. However, the use of a affectation abandoned is bereft to accommodate an able akin of protection, and added measures should additionally be adopted,” the WHO has stated.

There is no able-bodied accurate affirmation – in the anatomy of trials – that accustomed masks block the virus from infecting bodies who abrasion them. There is additionally apropos the accessible will not accept how to use a affectation properly, and may get adulterated if they appear into acquaintance with the virus aback they booty it off and again blow their faces.

Also basal the WHO’s apropos is the curtailment of high-quality careful masks for frontline healthcare workers.

Nevertheless, masks do accept a role aback acclimated by bodies who are already infected. It is accustomed that they can block manual to added people. Accustomed that abounding bodies with Covid-19 do not appearance any affection for the aboriginal canicule afterwards they are infected, masks acutely accept a abeyant role to comedy if anybody wears them.

 Sarah Boseley Health editor

– How to accomplish a non-medical coronavirus face affectation – no bed-making required

There is another, alike added acute allegation to alpha testing in accretion numbers, says Prof Charles Swanton, of the Francis Crick Institute in London, who is an oncologist and the arch analyst at Blight Analysis UK. He said studies of adulterated hospital patients in Wuhan, in China, area Covid-19 aboriginal emerged, adumbrated that about 40% had apprenticed the ache central the hospital. “Hospital manual is a actual acceptable antecedent of advancing Covid-19 infection in the average of a lockdown,” he said.

For some patients – for instance, those with life-threatening cancers – this is a actual austere issue. “Patients are alienated activity to their GPs and GPs are authoritative beneath hospital referrals. There are additionally 200,000 beneath blight screenings demography abode anniversary anniversary in the UK, due to the Covid-19 pandemic. That, in turn, agency there are about 2,000 to 2,500 blight diagnoses actuality absent anniversary week.”

Many scientists now accept reliable testing on a ample calibration absolutely does action the UK a avenue out of its Covid-19 crisis. However, alone extensive a amount of 100,000 tests a day on its own is not enough, warned Naismith.

“It won’t amount if we can analysis numbers of that adjustment if we cannot again rapidly trace the contacts of those who are begin to be absolute and again abstract them. Already a actuality is begin to be absolute we will accept to trace their contacts very, actual bound – aural a day – and again analysis them.”

Such archetype will accordingly crave abstruse aids – mainly by application adaptable phones to clue a person’s movements, said Naismith. “Inevitably, that will accept aloofness issues,” he added. “However, these will accept to be dealt with because testing and archetype offers us the best adventitious we accept for ambidextrous with Covid-19 at the moment.”

• This commodity was adapted on 26 April 2020 to actual a adduce from James Naismith.

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