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Lateral flow before you go

We’re writing this because it seems not everyone knows you can order more or less as many COVID-19 lateral flow tests as you like, for free.

Along with vaccines, which are understandably getting more attention, this is potentially a gamechanger in trying to prevent what we saw last summer – a slow build up of cases which, as we learned the hard way, can easily turn into something worse.

If you haven’t had the pleasure of doing one of these tests, it’s a bit fiddly first time, but we’ve now got into the rhythm of it. You get a result in 30 minutes.

We’re being encouraged to do them twice a week and report the results – but you don’t have to, if you’re worried about the government abusing your data.

They are not always reliable, and a negative test should not be seen as a green light to do what you want. However, if everyone who was going to socialise did one before they went out, and then didn’t go out if they tested positive, that could play a significant role in suppressing any third wave.

It’s not mandatory – at the moment, anyway – but feels like it’s something we could all do, pretty easily, to help protect our fellow customers, hospitality workers and society more generally.

We’ll certainly be doing them regularly. Anything to help pubs stay open for good and make them really feel safe.

8 replies on “Lateral flow before you go”

Popular, or mass, self-testing has to be qualified as to their usefulness, certainly at an individual level and to be relied on as confirmation of an absence of infection. That has been made quite clear by the scientists, even if Johnson et al. differ, so do infer or advise otherwise is at the very least premature.

Jac Dinnes, review coauthor and senior researcher in public health, epidemiology, and biostatistics at the University of Birmingham, said, “Our review shows that some antigen tests may be useful in healthcare settings where covid-19 review is suspected in people with symptoms. Confirming a positive result from a rapid test with an RT-PCR [reverse transcription polymerase chain reaction] test, particularly where cases of covid-19 are low, may help avoid unnecessary quarantine.

“All antigen tests will miss some people with infection, so it is important to inform people who receive a negative test result that they may still be infected.”

https://www.bmj.com/content/372/bmj.n823

More popularly – in terms of media – there’s this at https://www.theguardian.com/world/2021/apr/25/covid-19-how-accurate-are-lateral-flow-tests

“One reservation is that those who receive a negative result from LFTs may still have the virus – experts have previously said this means the tests should be seen as offering a “red light” rather than a “green light”.

The regulator responsible for approving coronavirus tests for use in the UK, the Medicines and Healthcare products Regulatory Agency (MHRA), has expressed concern to government that people may be falsely reassured if they test negative on an LFT.

The MHRA has authorised LFTs to be used as a “red light” test – to find infectious people and order them to self-isolate – but not as a “green light” test to allow people greater freedoms if they test negative. The regulator is concerned that the government’s universal testing programme blurs the lines between the two.”

And

Individuals with negative LFTAg results should still observe social distancing and respiratory hygiene precautions (such as face masks covering the nose and mouth) whilst around others.

Positive results by LFTAg should be confirmed by testing in a laboratory (using reverse transcription-polymerase chain reaction testing (RT-PCR)) as a matter of urgency. In the meantime, individuals with a positive LFTAg result should self-isolate pending the confirmatory test result.

https://www.rcpath.org/discover-pathology/news/accuracy-of-lateral-flow-antigen-tests-for-covid-19.html

Don’t think there’s anything there we (and most people?) haven’t already understood. It’s this, plus vaccination, plus some lingering distancing, that means opening up gradually should work out OK.

One thing that’s not been talked about too much is how “lumpy” transmission is with this particular virus.

If R = 1, that doesn’t mean that 50 infected people will each pass it on to one other person. Instead it’s more like 40 will not infect anyone, 7 will give it to one person (typically in their household), 2 will give it to 5 people and one superspreader will give it to 33 people. So you might only need to identify 3 (or 4, or 5) people to potentially stop >90% of transmission. It’s not entirely clear why some people are superspreaders – it’s more than just hanging out in crowded indoor places, it’s a complex mix of where you’re infected, personal habits, and the amount of virus in your system.

So while there’s a lot of talk about lateral-flow tests only showing positive with 70% of PCR positives – but the ones that LFT miss tend to be the cases with a low viral load, or at least little virus in the upper respiratory tract, which are unlikely to be the ones that will be superspreading. They catch >90% of people with high viral loads, which are the ones to be worried about – the fuss about “LFTs don’t work” is unwarranted.

To be fair, one jab doesn’t actually give immunity from either catching or transmitting the virus. But post-jab I do feel reasonably safe, as long as I’m out in the open & not consciously breathing lungfuls of other people’s air.

Without giving chapter and verse on our medical history, at the time of writing, we had one jab between the two of us. But it’s less about our safety than doing something free and easy to make it less likely we’ll take it into a space where, say, a 25-year-old member of staff might pick it up. Also adds reassurance when mixing with family and friends, some of whom are vaxed, some not.

I suspect I will be in the minority here, but I will say it just the same. The thing is, I really don’t buy into the suggestion that every time I fancy popping out for a pint, I have to shove a miniature bristle brush as far up my nostril as pain and common-sense dictate, and then carry out some home- chemistry spot test. Just to prove that I don’t have Covid.

You say it’s not mandatory – at the moment, well thank heavens for that, as we’ve had to endure enough state interference in our lives, over the past 13 months, without having yet another layer of guilt invoking control added to the pile.

If you want to act like a couple of Good Samaritans, then fine, but please leave out the preaching, as it comes across as smug and self-righteous. We’re all playing our part, such as wearing masks -where required, frequent handwashing and maintaining an adequate distance from our fellow humans, where possible, without the need to boast about it.

Those of a certain age, have also been vaccinated. For example, I had my second Covid-jab earlier today, and if the scientists are to be believed, will have 95% protection against becoming infected, in a couple of weeks’ time. It’s also been demonstrated that the AstraZeneca vaccine significantly reduces transmission of the virus as well, so why would I wish to indulge in a spot of self-torture?

Finally, these lateral flow tests might be free to the end user, but someone (the UK taxpayer), is picking up the bill. We have already seen billions wasted on a non-functioning trace and track system, that was supposed to be “world beating.” Friends and acquaintances of government ministers are said to have greatly benefited from that particular fiasco – who is to say that another “close advisor” isn’t going to do very nicely out of this latest example of state-sponsored “nannying?”

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