Rapid turnaround tests for coronavirus are accurate and sensitive enough to be used in the community, says study

More than 23,000 people had been tested for covid-19 in the first three days of Liverpool’s mass testing trial
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April Roach @aprilroach2811 November 2020

Rapid turnaround tests for Covid-19 are accurate and sensitive enough to be used in the community, including for asymptomatic people, a new study has found.

Lateral flow tests deployed in Liverpool as part of the city-wide testing pilot scheme have been shown to have over 99.6 per cent specificity, the Department of Health and Social Care said.

Following an evaluation process, scientists concluded the the tests were sensitive enough to play a “major role” in the community, including testing asymptomatic people who are not showing signs of infection.

The assessment of the tests was carried out by Public Health England’s (PHE) Porton Down lab and Oxford University.

Sir John Bell, regius professor of medicine at Oxford, said: “The data in this validation report demonstrates that these inexpensive, easy to use tests can play a major role in our fight against Covid-19.

“They identify those who are likely to spread the disease and when used systematically in mass testing could reduce transmissions by 90 per cent.

“They will be detecting disease in large numbers of people who have never previously even received a test.”

Gunners from the Royal Artillery operate a coronavirus testing centre at Liverpool Football Club's Anfield stadium
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Forty different lateral flow devices were put forward, of which nine met the criteria to continue to full evaluation. Six made it to the third phase, and the Innova test, the one being used in the Liverpool pilot, is nearing completion of the four-stage process.

PHE Porton Down’s labs have shown four lateral flow tests to have a sensitivity of more than 70 per cent of cases confirmed by a lab-based PCR test, but importantly catch all those with high viral loads, meaning they are effective in identifying the cases who are infectious and are most likely to transmit the disease.

The fast turnaround also allows positive people to isolate quickly, reducing spread.

The results of the Innova evaluation published on Wednesday show the specificity of the test was recorded as 99.68 per cent – the overall false positive rate was 0.32 per cent, although this was lowered to 0.06 per cent in a lab setting.

It has an overall sensitivity of 76.8 per cent for all PCR-positive individuals but detects over 95 per cent of individuals with high viral loads, and minimal difference between the ability of the test to pick up viral antigens in symptomatic and asymptomatic individuals.

The evaluation concludes that the Innova, and other tests which meet PHE and Oxford’s standards, should be used in asymptomatic testing, as they offer the advantage of reducing risk and increasing capacity in addition to Lighthouse and NHS labs.

Health minister Lord Bethell said: “We are absolutely committed to using the latest testing technology to make asymptomatic testing available in more areas.

“It is right we’ve taken a dual-track approach to evaluating this technology – by piloting them in the field so we can understand how best to make these tests available, and by getting our world-leading academics and clinicians to undertake rigorous evaluation of their ability to detect the virus.

“I’m delighted that both are already demonstrating that lateral flow tests can be the reliable, highly sensitive technology we need to help get this virus under control, and return to as close to normality as possible.”

Susan Hopkins, chief medical adviser, NHS Test and Trace, added: “We are confident that these new tests, which have been rigorously evaluated, will make a real difference in how we protect people from this disease and help break chains of transmission.”

Additional reporting by PA Media.

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