Lateral flow tests - if they allow school children to bypass self isolation why not use them within the nhs?

[YuleAreBeingUnREASTIEable]

I was talking to a friend who works in the nhs yesterday. She has had time off because of waiting for covid test results for her dc. During that time she was asked to come into hospital regardless because they were so short staffed. It seems so many are off ill or self isolating that the whole system is close to collapse.

Which made me think, if lateral flow tests are being rolled out as a way of keeping children in school because they don’t need to self isolate if they test daily, why haven’t they already done this for hospital staff self isolating.

My logic is because the tests aren’t so accurate, but then why are they safe for those in schools (where distancing is impossible with the current guidelines)?

I really wouldn't trust them when its relating to people working with unwell patients. A friend had 4 negative lateral flow tests, despite having covid symptoms and testing positive on a pcr.

I've actually been very measured in my thoughts on the virus.

I knew winter would be dire, even with this new strain, but I also knew once we made it through in terms of covid and the usual winter ailments, we really would turn a corner.

I'm afraid after the simultaneous attack on my family by 1)forcing me and my dc back into hundreds of others with no masks, and 2)removing our 1 main safety blanket... Ie isolation and bubbles..

I actually think there is nowhere to head except a societal breakdown.

@YuleAreBeingUnREASTIEable

I mean, I’m kind of lost for words. How can the lack of distancing between children remain when we’re relying solely on such a flawed system. All schools will end out closing for longer in the long run surely?

This would be a good outcome, in my opinion. I am appalled that they are changing the policy to this and I have written to my MP about it. All of the public health, pandemic management policy is to identify contacts and isolate them. Nobody in their right minds would suggest putting those contacts back into classrooms with 29 other kids, no masks and no social distancing, to spread it around a bit further. And the poor teacher, of course. It’s an absolute shit show and I am furious about it. It is going against EVERYTHING that infection management says to do. I don’t understand how it is being allowed.

@anascrecca

I work for the NHS and do them twice a week

Yep my mum is the same. She got a box the week before Christmas.

This is the reason I am refusing consent for my children and I will happily tell the school why.

@Athinginitself

I really wouldn't trust them when its relating to people working with unwell patients. A friend had 4 negative lateral flow tests, despite having covid symptoms and testing positive on a pcr.

I've read quite a bit about them not doubting what you are saying obviously this happened to your friend. But they are more likely to give a false positive (as in you have covid when you don't) than the other way round.

Also with your friend it could be they had a lower viral load. As apperently they lateral flow tests are more accurate the higher the viral load and therfore the more potentially infectious you are.

So obviously not perfect! But something.

I'm a teacher and feel so unsafe with this proposal.

False negatives are such a concern.

@TheGreatWave

This is the reason I am refusing consent for my children and I will happily tell the school why.

Problem is - while that will mean your child will be asked to isolate when they've had a close contact - it won't prevent your child from being sat in a classroom with several other kids who should be isolating.

I think it's the other way round they are more likely to give a false negative than a false positive, but they miss a lot of cases. Useful for picking up some asymptomatic cases but not for general testing.
With my friend she did a test before work which was negative, then started to feel mildly unwell and took a pcr on the way home, did another 2 tests whilst waiting for results..symptoms developed during this time and she was v symptomatic with classic symptoms but still tested negative with lf. Why she did so many tests I have no idea!

@TheGreatWave

This is the reason I am refusing consent for my children and I will happily tell the school why.

Me too. Unless they tell me they can isolate in addition.

Problem is - while that will mean your child will be asked to isolate when they've had a close contact - it won't prevent your child from being sat in a classroom with several other kids who should be isolating.

I can only do my part, the whole thing is a farce.

So very specific but not very sensitive, I think useful in a school setting (logistics aside) as they will pick up some asymptomatic cases, but the worry is people change their behaviour as they are falsely reassured.

This article describes the poor performance of these tests with students an University of Birmingham...

www.bmj.com/content/371/bmj.m4941

"The UK government’s plans for community testing for covid-19 received a further blow this week when early results from students testing at the University of Birmingham and universities in Scotland showed that tests had a sensitivity of just 3% and that 58% of positive test results were false".

The sensitivity of just 3% means they missed 97% of cases who would test positive on a proper PCR test.

@Athinginitself

So very specific but not very sensitive, I think useful in a school setting (logistics aside) as they will pick up some asymptomatic cases, but the worry is people change their behaviour as they are falsely reassured.

Nope - the specificity is poor too.

Yes - they are OK for mass screening. But this is not what schools are being told to use them for.

They are being told - take the kids who had close contact with confirmed COVID-19 cases when infectious. Then instead of having them isolate - allow them back into school if they can pass one of these dodgy tests.

We use them in my trust too for testing with no symptoms..if we test positive we have to get PCA test and isolate while we wait for test result.

Hmm that's interesting this article seems to be describing something quite different..v few false positives but a lot of false negatives. www.bmj.com/content/371/bmj.m4848

Either way not good enough for testing. Maybe for a screen of everyone to pick up a few unknown cases, no good if kids will be told not to isolate if they have been in touch with a positive case.

[quote Athinginitself]Hmm that's interesting this article seems to be describing something quite different..v few false positives but a lot of false negatives. www.bmj.com/content/371/bmj.m4848[/quote]
Both BMJ articles describe loads of false negatives.

The Liverpool one says 50% of cases missed (48.9% sensitivity)...

www.bmj.com/content/371/bmj.m4848

The University of Birmingham one says 97% of cases missed (3% sensitivity)...

www.bmj.com/content/371/bmj.m4941

It was always going to happen. I'm only surprised they are offloading offering tests at all - Us4Them scrawled the writing on the wall for schools a long time ago.

I'm starting to believe that if it's ethically acceptable for school communities to operate in this way, wider society might as well get back to normal and stop SI for close contacts (however of course it's unethical and shouldn't be happening).

@cheninblanc

I've got them, I do 2 a week and report back to gov.uk

Me too.

Some of you need to read the OP. The problem isn't with the mass testing, it's using daily lateral flow instead of isolation.

"bobbiester Thu 31-Dec-20 21:19:25
So, to confirm, no one in the nhs is using these lateral flow tests INSTEAD of self isolating because of being with a close contact like it will be in schools?

Nope - because they don't have enough sensitivity for that.

They are good for mass screening for picking up infections you had no reason to suspect. But they are not accurate enough to replace isolation of contacts.

The idea that schools are going to use them for this purpose is VERY worrying.

Even the very best performing lateral flow tests, administered by experts give you a sensitivity of 50-70%. Mean they miss 30-50% of positive cases.

And they are going to be use by non-experts to decide whether potentially infected kids can sit in classrooms??? shock"

Yep that's exactly what they're doing. teachers and students have no means of not consenting to being forced into close, extended contact of known close contacts of a positive case without ppe. It is shocking.

I'm worried as a teacher and a parent.

The weekend comment is even more worrying. So no isolation, despite being close contact so football training, matches meal out, see granny etc at the weekend.

I just can’t get my head around this. So they will only show up positives with a higher viral load than the usual test, but people can be most contagious just before symptoms start when their viral load is less (?), so effectively stopping self isolation in favour of these tests is going to cause more spread of covid and schools will probably end out closing due to lack of staff...but that’s ok because the govt tried to keep them open...

The only useful way for testing like this in schools would be regular mass testing for picking up some asymptotic cases