Thursday 24 December 2020

Why Does a Rapid Screening Test for Covid-19 Work in One Situation But is Suspect in Another?

The answer to this 'riddle' is, that the rapid Lateral Flow Test is equally dodgy (it's a poor predictor of infection) in both situations. Political expediency, makes it, however, a 'solution' in one case and a 'cause of concern' in the other. It seems that the plan for UK University students to return to their alma maters, after Christmas, has, for now, been put on hold (dismissed by some as 'half baked'). The students were supposed to get a negative test shortly before making their staggered return to their University halls (so that testing at these institutions would not be overwhelmed). It has now been recognised that a negative test result guarantees very little and that students could pick up an infection on their actual return travels (https://www.theguardian.com/education/2020/dec/24/covid-ads-to-prepare-students-for-university-return-delayed-amid-rapid-test-concerns). This is a serious consideration, when the country is facing widespread post-Christmas lockdowns in an attempt to limit the transmission of the 1.1.7. Covid-19 variant. There are Universities in most relatively large towns and cities and their students are currently very widely dispersed. It looks like a recipe for extremely rapid and widespread viral transmission (as does the plan for re-openning schools after Christmas, using the same Lateral Flow Test). The Lateral Flow Test is, however, 'a welcome solution' for the impasse in Kent. This followed the initial French banning of truckers (possibly carrying the seemingly highly-infective variant of Covid-19), returning via Dover and the Eurotunnel to Calais. It is now proposed to move the estimated 10,000 trucks, currently marooned in that county, after rapidly screening the drivers. To help the process, 26 French firefighters (pompiers) have now arrived carrying 10,000 tests. These will operate in addition to the UK's 4 current mobile test sites, with a further 5 being set up (https://www.theguardian.com/world/2020/dec/24/french-firefighters-arrive-in-dover-with-10000-covid-tests-for-lorry-drivers ). It all sounds a bit like overkill (although the entente cordiale is welcome). So why the difference? In the case of the Universities, it will be very evident, if a botched scheme results in a serious and widespread rise in infections. In the case of the truckers, however, appearance of the 1.1.7.Covid-19 variant in France (inevitably the case) can never be tied to a particular test on a particuar driver. And, anyway, the UK Transport minister has promised to solve the Kent trucking blockade 'by Christmas'. And we know how reliable their Christmas promises are!

1 comment:

Paul Brain said...

In spite of my (and other people's) concerns about the accuracy of the cheap and rapid lateral flow test, I note that it has been defended by 'Liverpool Professors' (perhaps with a vested interest in that City's mass trial programme). The trials have been popular with people getting tests before seeing their loved ones at Christmas (https://www.theguardian.com/world/2020/dec/23/scientists-in-liverpool-mass-covid-testing-trial-defend-rapid-tests). I'm sure the test is useful in giving an overview of things like levels of asymptomatic infection (even here it is not wholly representative as some people in the gig economy don't dare take it). I just think that as the test cannot guarantee that an individual does not have the virus, there is a danger that people have false confidence. For example, I wouldn't use the test to show someone was safe to work in a care home (or to be transferred to a care home from a hospital bed).

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