The COVID-19 pandemic has triggered an unprecedented demand for diagnostic tests. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is highly contagious in the presymptomatic period, when the viral load is high. In the effort to reduce transmission, for the first time in infection diagnostics history, testing is being aimed not only at symptomatic, but also at asymptomatic individuals, both in the health care setting and in the community.

Shortages in PCR reagents and platforms, related to the demand for large-scale testing, fuelled the effort for alternative diagnostic solutions. We have read with interest the Journal of Infection (JoI) article, regarding the laboratory based assay chosen by the British government, for SARS-CoV-2 mass testing (Operation Moonshot), a loop mediated isothermal amplification (LAMP), produced by OptiGene. 1, 2 The testing of saliva by OptiGene direct ORF1ab LAMP (with no RNA extraction), in newly built laboratories under the management of acute NHS Trusts, is costing the taxpayer over 400 million British pounds and has resulted in the movement of key staff away from essential roles in acute NHS Trust diagnostic laboratories, at short notice.