Mass testing for COVID-19: January update on lateral flow tests

The Government’s COVID-19 Winter Plan, relies on three things to provide the UK with a “route back to normality”: vaccines, treatments and testing. In addition to laboratory-based tests, lateral flow tests are being used for rapid testing in communities and workplaces. What are the latest data on how good these tests are? What are the pros and cons of using them for mass testing?

Mass testing for COVID-19: January update on lateral flow tests
  • Resource

    COVID-19 glossary

    The most common scientific terms used in research that relates to COVID-19. This glossary will help you understand materials that describe the biology of Coronavirus and the spread of COVID-19. It can assist in the reading of research papers and help you understand language used in drug and vaccine development. It also has a comprehensive list of international and UK organisations involved in public health, their institutional acronyms and descriptions of their work.

  • POSTnote

    Mental health impacts of COVID-19 on NHS staff

    Media headlines have predicted an increase in mental ill health among NHS staff during the COVID-19 pandemic. This POSTnote gives an overview of the scale and quality of current evidence on the mental health and well-being of NHS staff before and during the pandemic. It also discusses how staff are supported and the options for introducing other effective interventions as the pandemic continues.

  • Rapid response

    Mass testing for COVID-19 using lateral flow tests

    The COVID-19 Winter Plan, published 23 November, relies on three factors to provide the UK with a “route back to normality”: vaccines, treatments and testing. In addition to PCR testing, lateral flow devices are now being rolled out across England and Wales for the rapid testing of certain occupational groups, community testing and as an alternative to self-isolation following exposure to the virus. How well validated have these tests been? Are they accurate enough for their proposed purposes? And how have they performed to date in mass testing trials?

  • Rapid response

    Test, trace and isolate programmes for COVID-19

    Test, trace and isolate programmes across the UK are under pressure as COVID-19 cases rise in all age groups and demand for tests grows. Further pressure comes from people seeking tests because they have symptoms caused by other respiratory viruses but need a test in order to rule out COVID-19. The Scientific Advisory Group on Emergencies has described the impact of current test and tracing on the transmission of the virus as “marginal”. How does test and trace work and what are the current challenges limiting its effectiveness in reducing COVID-19 cases?

  • Rapid response

    The latest in COVID-19 testing: developing new technologies

    On 9 September, the Prime Minister announced a moonshot plan for mass COVID-19 testing. Recently there have been capacity issues in the NHS Test and Trace programme and current technologies cannot be scaled easily to millions of tests per day. So, how is COVID-19 testing undertaken, how reliable are current tests, and what technologies or strategies are emerging that would make this moonshot feasible?

  • Rapid response

    Interpreting COVID-19 test accuracy

    Testing people to see if they are currently infected or previously infected with SARS-CoV-2, the virus that causes COVID-19, is a key component of medical management, public health monitoring and research. Diagnosing people as having active infections is a fundamental part of any test and contact tracing system. Improving the speed and accuracy of tests that detect current infections is a research priority and the focus of recent UK Government investment and policy decisions. Antibody tests are also an important tool to understand how many people in the population have been infected and how their immune system responded.

  • Rapid response

    COVID-19 in children: July update

    There is very good evidence that children who have COVID-19 are much less likely to develop severe symptoms and much less likely to die from the disease than people in older age groups.There is good evidence that children under 13 years old are less susceptible to developing clinical disease (this means having recognisable signs and symptoms) than adults. It is not yet clear whether this is also the case for older children. There is some research indicating that children aged 13 years and under may be less susceptible to infection than adults, but the confidence in this evidence is low. There is insufficient research to say whether this is the case for older children. There is some evidence to suggest that children transmit the virus less than adults, but more research is needed to reduce uncertainty. Children are more likely to catch an infection from adult(s) in their household. There is evidence that schools are a low-risk environment for transmission. There are some limited data suggesting that children from a black, Asian or minority ethnic background may be at higher risk of severe disease, consistent with evidence for adults. Large and well-designed studies are needed in order to draw firm conclusions. Pregnant women are not more likely to contract the virus. Transmission of the virus from mothers to babies is low. Some babies born to COVID-19 positive mothers will develop an infection; these babies are not at increased risk of severe disease.

  • Rapid response

    COVID-19 therapies

    This article was updated on 1 May and again on 6 July. Since its original publication on 17 April, the number of COVID-19 clinical trials has increased from 524 to 2,378. There is no cure for COVID-19. Researchers are testing existing drugs to see if they act against SARS-CoV-2 or alleviate the symptoms of the disease. New drugs are also in development, but this is at a very early stage. Results from trials on existing drugs have already been reported with some positive findings. Dexamethasone is a cheap steroid drug that reduces the risk of death of ventilated patients by 35% and by 20% for patients requiring oxygen therapy. Remdesivir is an antiviral drug; there is good evidence that it can reduce the length of time that hospitalised COVID-19 patients are ill. Negative findings are valuable because they allow researchers to focus on other drugs; there is good evidence that hydroxychloroquine does not offer any benefits to treat COVID-19 patients. Research to see if it might have a protective effect for at-risk groups, such as healthcare workers, is ongoing. There are numerous trials in progress to test a range of drugs that act on the immune system.

  • Rapid response

    COVID-19 and social distancing: the 2 metre advice

    An infected person produces respiratory droplets when talking, coughing and sneezing. These are responsible for the transmission of virus between people. Droplets can travel up to 2m, with finer aerosols containing smaller viral particles travelling even further. Numerous complex and interacting factors influence how they move and settle onto surfaces, and how infectious they are. The further away a person is, the fewer droplets they will be exposed to and so their risk of being infected with the virus reduces. The advice on 2 m distancing is a risk assessment based on relative not absolute risk; 2 m does not represent zero risk. Measures to mitigate the increased risk of reducing physical distancing include ventilation, physical barriers (screens and face coverings), reduced building occupancy and enhanced cleaning. These will vary according to the context. The wider range of social distancing practices will need to be maintained to contain viral transmission even if the 2 m advice changes. Social distancing and other public health measures are likely to be needed long-term, until a vaccine or more effective treatments for COVID-19 are available. There are numerous knowledge gaps about SARS-CoV-2 transmission; research to address them will inform policy-making.