Mass rapid tests in Liverpool cut hospital stays by a third
Mass lateral flow testing cut the number of people needing hospital treatment for Covid by 32% and relieved significant pressure on the NHS when the measures were piloted last year, a study has shown.
Liverpool conducted the first citywide testing scheme using rapid antigen tests in November last year, amid debate about whether or not lateral flow tests (LFTs) were accurate enough to detect the virus in asymptomatic carriers.
It expanded the project to cover the whole of the Liverpool region, offering people LFTs whether or not they had symptoms. Key workers did daily tests before going to work to show they were not infectious.
Now an analysis has shown that it was more successful than Liverpool’s scientists and public health teams had anticipated, after they compared Covid cases and outcomes in the region with other parts of England.
Professor Iain Buchan, dean of the Institute of Population Health, who led the evaluation, said: “This time last year, as the Alpha variant was surging, we found that Liverpool city region’s early rollout of community rapid testing was associated with a 32% fall in Covid-19 hospital admissions after careful matching to other parts of the country in a similar position to Liverpool but without rapid testing.
“We also found that daily lateral flow testing as an alternative to quarantine for people who had been in close contact with a known infected person enabled emergency services to keep key teams such as fire crews in work, underpinning public safety.”
The Covid-Smart project ran from December 2020 to July 2021, and 668,243 people – about 45% of the region’s 1.5 million residents – took part. Key workers saved 8,292 work days by taking the rapid tests instead of isolating. Of 34 Covid cases, only three were missed by LFTs. Buchan said that the results demonstrated that LFTs could be used to help keep the NHS functioning during the Omicron wave.
Ministers have adopted a similar model to avoid a “pingdemic” as infections have soared. Last week the government announced that doublevaccinated contacts of someone testing positive could avoid isolating if they took a daily LFT for seven days and continued to test negative.
Buchan said: “As the more infectious Omicron variant sweeps through communities this winter, access to rapid testing will be important for keeping key emergency, social care and NHS services afloat with test-to-release or daily contact-testing schemes.
“To make testing useful, communities need to understand how to use a test and what the results mean. Timing is critical – you can become infectious very quickly, so taking a test the day before you mix with other people is not as useful as taking the test just before you meet up.
“And the more you encourage those you mix with to ‘test before you go’ the more risk you will take out – this kind of crowd-sourced health security is the new normal.”
In October, researchers from University College London found that LFTs were more than 80% effective at detecting a Covid-19 infection of any level, and 90% effective at detecting those who were most infectious.
PCR tests are often described as the gold standard of testing, and they can spot genetic material from the virus within the body several weeks after a person stops being infectious. LFTs only detect material from the surface proteins of a virus which are found when someone is infectious.