Africa can adopt international strategy for rapid testing – Experts
Holding back on rapid mass testing is now a public health emergency extending the war against COVID-19, say experts, and African countries can learn from the experiences in Europe and North America in relation to the benefits of rapid mass testing.
The UK was first to recognise the large-scale potential and is now deploying 400 million lateral flow rapid antigen test kits alongside the strategy for vaccinations as well as public guidance on masks, hand cleansing and social distancing.
But the lateral flow test (LFT) message is fast going global with World Health Organisation Special Envoy on COVID-19, David Nabarro, now commenting: “We’ve seen it (rapid mass testing) used in many different locations, particularly for example in trying to keep aircraft free of people who’ve got COVID or looking after major events.”
Using LFTs will keep economies open, health systems safe and allow audiences to attend entertainment and sporting events, he added.
A leading US mass testing expert, Dr Michael Mina of Harvard University, insisted rapid mass testing had been misunderstood by some: “The UK is one of the only countries that genuinely listened to the science and I spoke with Downing Street about the value of getting mass testing right.”
The UK Government initiative led the way offering LFTs, to essential health workers, the education sector, and local authorities. This mass rapid testing approach to suppressing transmission has now been extended to the workplace, via private sector and industry groups. Early adopters in the UK include the Royal Mail, DVLA and Tate & Lyle Sugars. This is expected to be significant in reducing the need for future lockdowns. Slovakia, like the UK, uses rapid lateral flow antigen tests with great success in their mass testing initiative, with extremely positive results.
Britain’s Health Secretary Matt Hancock said that around one in three infected people do not show symptoms, so testing was vital to break the chains of transmission; workplace testing offers peace of mind to those unable to work from home during lockdown.
He added: “LFTs have already been hugely successful in finding positive cases we would not otherwise find, and I encourage employers and workers to take up this offer to help protect essential services and businesses.”
Globally renowned journal, The Lancet, supports this approach after publishing an exhaustive study of quarantine and testing measures, and leading UK scientists and clinical experts have added their weight.
Senior researchers at Oxford University found that most sensitive LFTs detected 83-90% of all infectious cases of COVID-19 and, with the UK investing more than £1.5bn in these test kits so far, Oxford’s Regius Professor of Medicine Sir John Bell underlined the benefit of these removing infectious people from high-risk environments: “They’ve found 25,000 cases just in healthcare, which may have prevented tens of thousands of cases of the disease.”
Tim Peto, Professor of Medicine, Infectious Disease, Nuffield Department of Clinical Medicine, Oxford University addressed the contrasts between PCR (polymerase chain reaction) swab testing and lateral flow kits:
“PCR is very good at telling you’ve had the virus or got the virus, but it doesn’t tell you whether you are infectious or not and the other problem about the swab test is that it takes a day or two…to get the answer back. The LFT has the enormous advantage of giving you an answer in about 30 minutes.”
He said this allows immediate self-isolation and individuals can also quickly advise their contacts so, “within a few hours, a local outbreak can be detected. This can’t be done with the swab (PCR) tests” adding that LFTs “detect people with high viral loads…the very people who are infectious.”
The World Nano Foundation (WNF) promotes healthcare technology and has modelled this form of technology, predicting that mass testing is central to future pandemic protection.
The not-for-profit organisation’s Co-founder Paul Sheedy said: “Our research shows how healthcare diagnostics technology will shift dramatically to a more decentralised community early intervention model, against potential epidemics and pandemics.
“Our own COVIDlytics™ modelling shows that an intensive front line ‘Test to Suppress’ campaign using rapid test kits available to the individual will allow early detection and immediate isolation, reducing the need for lockdowns.
“And our simulation maps how consecutive daily tests for three days can rapidly identify and isolate infectious people. Weekly testing can then sustain a low infection rate even in a large population.
“A key point previously missed by some experts is that high quality rapid lateral flow tests are not for people who already think they have COVID-19; it’s about everyone else testing frequently to check they are not infectious.
“Used alongside vaccines, hand-cleansing, and social distancing, these simple tests are a vital component in the battle to defeat COVID-19, future variants or other viruses.
“Rapid community testing is simpler, faster, cheaper, ultimately more effective and mobilises everyone to help themselves and their relatives, friends, and colleagues – we can all play a part in keeping everyone safe.
“As West Africa reeled under the impact of Ebola (2014-16) the world watched with bated breath to see if the ‘beast’ would go global, but frequent mass rapid testing was deployed at community level multiple times over a few weeks – stopping that terrible disease in its tracks.
“With the work that we do, we know that there are even more exciting technologies on the way that will be central to the world’s fight for pandemic protection and future healthcare.
“We have already seen the danger from not being on our guard against renewed viral threats. Spanish Flu struck in 1918 and ultimately killed up to 50 million people in four successive waves, the last two being most deadly because public health warnings were not adhered to.
“The UK Government’s foresight in being first to secure large stocks of rapid lateral flow antigen test supplies by Innova Medical (USA) and SureScreen Diagnostics (UK) may prove to have been a human and economic lifesaver.”