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Covid: Use of lateral flow tests as alternative to self-isolation paused in secondary schools

School leaders have welcomed the decision to pause the use of lateral flow tests as an alternative to self-isolation in secondary schools.

The decision was announced by Public Health England (PHE) on Wednesday, January 20, and has been made due to the emergence of a new variant of the virus becoming “dominant” in the UK.

The government announced plans in December to introduce a widespread testing programme in schools, including the regular testing of staff and the introduction of daily contact testing for close contacts in secondary schools.

It meant that this month, the advice for secondary schools and colleges has been to conduct daily lateral flow tests with those pupils and staff who have been in close contact with a positive case instead of enforcing self-isolation.

PHE and NHS Test and Trace have been conducting pilots of testing in schools since October and the approach has been supported by SAGE and was included in the government’s Covid-19 Winter Plan.

However, the new variant of the virus has led the PHE to conclude that the balance between the risks and benefits of a daily contact testing approach is “unclear”.

In a statement, PHE said: “Since the announcement of the schools testing programme in December, we have seen the emergence of a new variant of the virus which has become dominant in the UK.

“The variant has been shown to have increased transmissibility and causes higher secondary attack rates. This increases the risk of transmission everywhere, including in school settings.

“In light of this changing situation, we now recommend that the roll-out of daily contact testing within schools is paused. This will enable the further detailed evaluation of changing circumstances including, potentially, lower infection rates and modelling work required to understand the benefits of daily contact testing in the this new phase of the pandemic.”

PHE said that schools should continue to test their staff regularly – “twice-weekly where possible, in line with recommendations for other workforces that need to leave the home to work” – and test pupils twice upon return to school, as has been the case since the start of January.

Geoff Barton, general secretary of the Association of School and College Leaders, said that his members were “relieved” that the use of lateral flow tests as an alternative to self-isolation has now been paused.

He added: “This use of these tests never really made sense because they don’t detect all those with the infection, so we could potentially have ended up with more infectious people in school than under the self-isolation system where close contacts are sent home. We have been making this point to the government repeatedly over the past few weeks.

“It is important to understand that this issue is about one specific use of these tests. We support the principle of using them for general mass testing of students and staff because this process should pick up at least a proportion of asymptomatic cases and improve safety. Our concern was purely over the idea of using them as a worse alternative to the existing self-isolation system for close contacts.

“Unfortunately, the government’s insistence on first trying to use them in this way and then having to do yet another policy reversal will have thoroughly confused parents, pupils and the wider public. Schools will once again be left having to unpick the confusion caused by the government.

“It is important that the government provides absolute clarity about the limitations of these tests. They are useful in detecting asymptomatic cases but they are not definitive and it is vital that individuals continue to follow the normal safety procedures even if they have a negative result.

“It is also vital that the government reviews the practical implications of mass testing in secondary schools and colleges which have been left with the enormous logistical exercise of recruiting and training large numbers of staff, and setting up testing stations.

“As a starting point, it would be much more straightforward if staff were able to test themselves at home on a regular basis, as primary staff are now being asked to do. This would relieve at least some of the pressure on testing stations, and make the programme more manageable.

“When schools fully reopen, mass testing is an important part of keeping them open and minimising disruption. The government has to do better.”

  • Public Health England: Daily contact testing in schools: statement from PHE and NHS TT about next steps, January 20, 2021: http://bit.ly/3iBRdSY