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Covid lateral flow tests don’t work so well in children

Covid lateral flow tests don’t work as well in children, according to a study that casts doubt on whether they can curb the spread of the virus in schools.

All high school students in the UK are currently encouraged to take LFD tests at least twice a week.

But writing in the BMJs Evidence-based medicine, experts said the quick kits weren’t as effective as hoped in young people.

A team of British and German scientists pooled the results of 17 old studies, involving more than 6,000 children, that analyzed the efficacy of lateral currents in detecting Covid in young people.

The team found that the tests — which give results in just 15 minutes — generally detected only 64 percent of Covid-positive children.

Detection rates rose to 72 percent when children had symptoms of Covid, such as a new persistent cough or a change in taste and smell.

However, the smears saw just over half of the infected children who had no symptoms.

The authors said their findings mean that LFDs would not meet minimum standards set by the UK Medicines and Healthcare Products Regulatory Agency, the US Food and Drug Administration and the World Health Organization.

Each of these agencies requires Covid test kits to have a minimum success rate of about 80 percent.

It comes amid fears that children’s return to school could spark another surge in Covid cases just as the Omicron spike appears to be fading.

A new study suggests commonly used lateral flow tests fail to meet UK regulatory standards when used on children.  The analysis of available data found that even in children with Covid symptoms, the test kits detected only 72 percent of cases, 8 percentage points slower than the UK regulator's minimum accuracy standards

A new study suggests commonly used lateral flow tests fail to meet UK regulatory standards when used on children. The analysis of available data found that even in children with Covid symptoms, the test kits detected only 72 percent of cases, 8 percentage points slower than the UK regulator’s minimum accuracy standards

Regular lateral flow tests are an important part of the government's efforts to control the spread of Covid in schools.  Here's Erin Horn doing a test Outwood Academy in Woodlands, Doncaster in Yorkshire (file image)

Regular lateral flow tests are an important part of the government's efforts to control the spread of Covid in schools.  Here's Erin Horn doing a test Outwood Academy in Woodlands, Doncaster in Yorkshire (file image)

Regular lateral flow tests are an important part of the government’s efforts to control the spread of Covid in schools. Here’s Erin Horn doing a test Outwood Academy in Woodlands, Doncaster in Yorkshire (file image)

A new analysis suggests lateral flow test kits, like the one pictured, detect only about 64 percent of Covid cases in children, well below the UK regulator's minimum standard of 80 percent success

A new analysis suggests lateral flow test kits, like the one pictured, detect only about 64 percent of Covid cases in children, well below the UK regulator's minimum standard of 80 percent success

A new analysis suggests lateral flow test kits, like the one pictured, detect only about 64 percent of Covid cases in children, well below the UK regulator’s minimum standard of 80 percent success

Covid cases among children have exploded in the few days back at school, with a total of more than 240,000 confirmed or suspected Covid cases, with more children in isolation as well.  Regular lateral flow tests by students are an important part of government plans to contain the spread of the virus in schools, but a new study has questioned the effectiveness of such tests on children

Covid cases among children have exploded in the few days back at school, with a total of more than 240,000 confirmed or suspected Covid cases, with more children in isolation as well.  Regular lateral flow tests by students are an important part of government plans to contain the spread of the virus in schools, but a new study has questioned the effectiveness of such tests on children

Covid cases among children have exploded in the few days back at school, with a total of more than 240,000 confirmed or suspected Covid cases, with more children in isolation as well. Regular lateral flow tests by students are an important part of government plans to contain the spread of the virus in schools, but a new study has questioned the effectiveness of such tests on children

How to do a rapid lateral flow test?

Rapid lateral flow tests are for people who do not have Covid symptoms, such as fever, cough, or loss or change of smell or taste.

The tests give a quick result using a device similar to a pregnancy test.

People with Covid symptoms should do a PCR test.

Before performing a rapid lateral flow test, the NHS advises:

  • try not to eat, drink, smoke or vape 30 minutes before taking the test as this may affect the result
  • read the instructions carefully
  • clean the surface on which you are performing the test
  • check that nothing in the test kit is damaged or broken
  • start the test within 30 minutes of opening the test kit

If your test requires a throat swab:

  • open your mouth wide and rub the cotton swab over your tonsils (or wherever they would have been)
  • avoid the tip of the swab touching your teeth, tongue and gums
  • put the same swab in your nose (up about 1 inch or until you feel some resistance)

If your test only requires a nasal swab:

  • insert the cotton swab into your nose (about an inch up)

To complete the test:

  • insert the end of the swab into the tube so that it is in the liquid
  • squeeze the liquid from the tube onto the test strip
  • check the waiting time in the instructions that came with your test kit
  • wait for the time shown in your test kit instructions
  • read your result
  • report your result on the website of the central government

Researchers added that the findings only include samples taken by professionally trained individuals and not at-home self-testing, which likely only comes at the expense of accuracy.

The authors added that it is not known whether repeated, regular LFD testing would help alleviate some of these detection problems.

One of the authors, Dr Naomi Fujita-Rohwerder, of the Institute for Quality and Efficiency in Healthcare in Cologne, Germany, said the findings may cast doubt on the use of LFDs to detect Covid cases in children.

“Taking into account test-specific pooled results, no test in this review fully met minimum performance requirements as recommended by the WHO… the US… or the MHRA in the UK,” she said.

“This could have implications for the intended purpose of broad implementation of test programs.”

The authors only looked at studies that used eight different kits, meaning that some of the more than 500 tests currently on sale around the world may be more accurate.

All 17 studies included in the new analysis were published between early 2020 and May 2021, meaning they did not take Omicron into account.

The researchers did provide reasons why the tests did not perform accurately in detecting Covid in children.

Nor did they provide a comparative estimate of LFD accuracy in adults, although other studies have put it at 72 percent of symptomatic cases, although the UK government insists the tests catch more than 80 percent of the most contagious individuals.

Regular LFDs are one of the cornerstones of the UK government’s effort to curb the spread of the virus among children.

And the UK Health Security Agency (UKHSA) insists the kits remain the best way to detect Covid among the wider population.

Lateral flow testing has been in the spotlight for the past week as ministers urge Britons to take a test before meeting others, in an effort to reduce the chances of people unknowingly passing the virus on to others.

But dozens of Brits complained over the Christmas period that they only received a negative lateral flow result later to test PCR positive, raising concerns about the kits’ accuracy in detecting the Covid variant Omicron.

The check also comes with a change of guidance, with people now only needing a positive LFD test to self-isolate, and no longer needing follow-up with a more accurate PCR test.

According to official data, Covid rates in schools in England have risen in the first week after the Christmas holidays.

A total of 315,000 children were absent from public schools on January 6 due to Covid-related reasons. According to the Ministry of Education, this represents about 3.9 percent of students.

It was a marked increase from the 236,000 Covid-related absences recorded in the previous report on December 9.

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