COVID: Birmingham conducting fewer lateral flow tests than national average

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Exterior photo of the Utilita arena (formerly the NIA)
Walk-in lateral flow tests are being provided at the Utilita Arena (formerly the NIA). Photo credit: Elliot Brown

Fewer lateral flow tests were conducted in the last seven days in Birmingham than in almost all surrounding areas, according to the latest data from Public Health England.

In Wolverhampton, 2.7 tests were conducted using lateral flow devices (LFDs) for every 100 residents. In comparison, only 1.1 per 100 residents were conducted in Birmingham – 29% lower than the national average.

Dr Justin Varney, Birmingham City Council’s Director of Public Health, said the council was expanding lateral flow testing across the city “at pace”, with an additional 35 pharmacies beginning to offer appointments for tests this week.

Varney said that between January 5th and 11th, 1,400 tests were conducted at the walk-in site at the Utilita Arena (formerly the NIA), which has capacity to conduct 4,500 tests per week.

The three mobile community units – at Sheldon Community Centre, Oaklands Youth Centre, and York Street car park in Harbourne – each conducted nearly 800 tests, operating at close to full capacity.

Varney said that Birmingham will have 52 pharmacies providing lateral flow tests by Friday, with the capacity to conduct 5,600 tests each week, and more pharmacies are due to begin offering community testing in the future.

The news comes after the Health Secretary Matt Hancock announced that the regular use of lateral flow tests to identify asymptomatic cases of Covid-19 would be rolled out nationally.

“With roughly a third of people who have coronavirus not showing symptoms, targeted asymptomatic testing and subsequent isolation is highly effective in breaking chains of transmission,” said Hancock. He added that “Lateral flow tests have already been hugely successful in finding positive cases quickly.”

“Asymptomatic testing will keep economy on the move”

Business Secretary Kwasi Kwarteng said the expansion of asymptomatic testing to anyone who could not work from home would “keep the economy on the move” and reassure individuals that their workplaces were safe.

On Monday, Varney told BBC Midlands Today that cases in Birmingham were growing fastest among the working-age population, with the city experiencing an increase in new cases of 140% since Christmas.

Hancock also announced that the Department of Health has ordered an additional two million lateral flow tests. So far, 2.4 million lateral flow tests have been conducted in England, with over one-third occurring in the past seven days.

Birmingham University professor calls for rethink of rollout

But some medical experts have called on the Government to rethink the rollout. Writing in the British Medical Journal, Dr Jon Deeks, a professor at Birmingham University’s Institute of Applied Research, and colleagues said self-administered lateral flow tests were less accurate than the Government claimed, and that the risks of providing infected individuals with an erroneously false test result (a false negative) had been ignored.

“Studies have shown that in symptomless people it misses the SARS-CoV-2 virus in a substantial proportion. In the Liverpool pilot study, 60% of infected symptomless people went undetected, including 33% of those with high viral loads who are at highest risk of infecting others,” said Deeks, Angela Raffle, a lecturer at the Bristol University Medical School and consultant to the national screening programme, and Mike Gill, a former regional director of public health.

“Among students in Birmingham, only 3% of those who would have tested positive on PCR were detected. The Government continues to claim that the test detects 77%—a figure from an unrealistic study using laboratory scientists and experienced nurses running tests on symptomatic people.”

Low test accuracy would be less dangerous if people being tested and the public at large received accurate information about the risks and implications of a false negative result. Instead they are being misled. Results from government studies have been selectively reported and some have not been reported at all.”

Varney said that lateral flow tests are “not perfect”, but to-date, they had identified 166 people in Birmingham who were infectious with Covid-19 but did not have symptoms, enabling them to “take action quickly to protect themselves, their family and their work colleagues to stop the spread of the virus.”

He added that while LFDs are not good at detecting early infections when there are low levels of the virus in the nose and throat, they are good at identifying people who are infectious.

Even if someone has an LFD negative result they have to follow the same social distancing and risk reduction behaviours as before, but this provides additional reassurance in terms of managing the overall risk. This is why we are focusing LFD use in people who don’t have symptoms and are unable to work from home.”

A Department of Health and Social Care spokesperson said asymptomatic testing was essential, and that nationally, LFDs had identified 14,800 carriers of Covid-19.

“Lateral flow devices used by the UK government go through a rigorous evaluation by the country’s leading scientists. LFDs detect cases with high levels of virus, making them effective in finding individuals who are the most likely to transmit the disease, including those not showing symptoms.

Five times more lateral flow tests per person conducted in Liverpool than Birmingham

The five local authorities with the highest lateral flow test rates were in the Liverpool City Region. Across the region, more than six LFD tests were conducted for every 100 people in the past seven days.

Liverpool was also the city that first trialed the use of lateral flow tests in the Autumn. At the time, Hancock told BBC Breakfast that mass testing had helped reduce case levels “remarkably” quickly in the Liverpool City Region, but the area was also subject to strict restrictions during the period and the importance of mass testing to lowering cases is disputed by many health experts.

In the Midlands, the local authorities with the highest lateral flow test rates in the past seven days were South Derbyshire (3.9 per 100 people), Rugby (3.3), Warwick and Wolverhampton (both 2.7).

The local authorities with the lowest LFD test rates were Derbyshire Dales, Broxtowe and Derby (all 0.9 per 100 people).

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Andrew Hillman is a freelance data journalist specialising in health and education. He has written for Birmingham Eastside and the Huffington Post. Follow him on Twitter: @ajhillman_ddj.

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