Recommendation 4

The introduction of rapid-results testing was supposed to be a ‘gamechanger’ but confusion persists over why and how it should be used in different community settings. Around one-third of people who have coronavirus are asymptomatic. There is now a widespread roll-out of rapid tests (primarily lateral flow device (LFD) tests, which give results in 30 minutes) for local authority use and in other community settings, such as schools and workplaces. To support this roll-out, the government allocated a further £7 billion to NHST&T in December 2020 on top of £3 billion already budgeted. The Department had already purchased 384 million LFD test kits. However, a number of reports have raised concerns about the effectiveness and risks of mass testing using LFD tests, given their lower accuracy compared to laboratory- processed tests, particularly the higher risk of ‘false negatives’ (people who actually have the virus getting a negative result). NHS T&T told the committee that a negative test result means that an individual is around 77% likely to be negative for Covid-19. Initial NHST&T and PHE guidance for schools suggested that they could use LFD tests for daily tests as an alternative to self-isolation, but this advice has now been withdrawn. On 21 January, PHE announced that it would pause or scale back the roll-out of mass testing in schools, with further evaluation needed because COVID-19: Test, track and trace (part 1) 7 of the emergence of the new, more transmissible variant of the virus. Following the Prime Minister’s announcement on 22 February, schools will test students and staff regularly using LFD tests, but guidance on rapid testing in schools is yet to be updated. Recommendation: The Department and NHST&T should set out clearly how and why mass rapid testing should be used in each of the settings where roll-out is planned, alongside clear targets and updates on progress in the various sectors. Any plans should take account of the approved purpose and accura