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13 January 2022

Why the government would be foolish to ditch lateral flow tests

They're the one part of Test and Trace that has proved a success.

By Kit Yates

Rapid mass testing via the unpleasant swabbing, the careful squeezing, and the anxious wait has become a key tool in the government’s strategy to minimise the disruption caused by Covid. So it was surprising to read the Sunday Times report on 9 January that “free lateral flow tests face the axe under plans for living with Covid”. 

The phrase “learning to live with Covid” often trotted out by government ministers is seemingly being taken at face value, and to mean the removal of all traces of Covid mitigations and a return to our lifestyles in 2019. But the absurdity is that we should be drawing more readily on the lessons we have learned about how to reduce the impact of Covid. We know from experience that readily available rapid testing both helps us monitor the Covid situation and can also keep people safe. Taking away the tools we have to diagnose and measure the UK’s epidemic won’t help to control the situation – and smacks of pretending it is not happening. Covid is not a problem that will go away if you close your eyes and hope for the best.

It has been reported that more than £6bn has been spent on the lateral flow mass testing program in the UK. Yet this is a small part of the total £37bn budget of the Test and Trace programme, which has largely been labelled a failure including by the likes of the Commons spending watchdog. It is odd that we should jump to get rid of the one aspect of Test and Trace that has proved successful: the UK routinely conducts more tests per head of population than any other country. Indeed, it is entirely possible that the benefit of these rapid tests has outweighed the considerable cost – when the knock-on effects of preventing infections are considered: preventing employees catching the virus from asymptomatic individuals, who would not otherwise be aware that they had Covid, has clear benefits for the economy. Protecting the vulnerable who might otherwise end up in hospital or worse also has obvious benefits.

The rapidity that lateral flow results become available gives them a clear advantage over PCR tests, making people more likely to get tested and have the agency to act on their results without delay. Moreover, given many of the novel anti-Covid drugs need to be administered as quickly as possible for maximum effectiveness; it has been suggested that rapid diagnosis via lateral flow tests might be an appropriate mechanism for granting access to these drugs in a timely manner.

Yes, lateral flow tests are not a silver bullet, they can’t tell you definitively whether you have Covid – but used in in conjunction with other mitigations, lateral flow tests can make all the difference: The government’s announcement last week that positive lateral flow tests will temporarily not require a confirmatory PCR test clearly indicates their belief in the importance and utility of the rapid tests. What a strange move it would be to drop them altogether.

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