Squeezing droplets of fluid onto little white cassettes has become a fact of life for most since the mass rollout of lateral flow tests a year ago: 5.8 million were taken last week alone in England, down nine per cent from the week before. But as mandatory self-isolation for those with Covid ends on Thursday, and universally free kits will soon be no more, is it finally game over for at-home tests?
Scientists are hoping the reverse is true: that, now at-home disease diagnosis has gone from unthinkable to de rigueur, we’ll continue to use lateral flow-type technology both at home and in hospital settings.
“The pandemic has really brought into focus how useful [self-testing] can be,” says John Edmunds, an epidemiologist at the London School of Hygiene and Tropical Medicine. Lateral flows, which can correctly identify those with the virus 99 per cent of the time, and those without it 64 per cent of the time, “really have changed” the way people interact with at-home diagnosis, he says: “it’s hard to believe we’ll ever go back to ‘oh well, we’ve just got something wrong with us’, and not try to find out what it might be,” he thinks. Still, minus the legal requirement to do so, time will tell how long these pandemic-formed habits last.
“We know behaviours can be adopted and can be maintained in the long term,” says Susan Michie, director of The Centre for Behaviour Change and a member of SAGE and Independent SAGE. While “it often takes people a little while to get used to a new way of doing things” – like mask-wearing and hand-sanitising – taking tests if feeling unwell, or if asked ahead of a social event, has become “quite normalised.” Michie’s concern is that the removal of the self-isolation mandate “signals that the risk isn’t so great,” prompting a drop-off in would-be testers.
“If people aren’t being expected to self-isolate, why would they be expected to test? It undermines the reason for testing,” she says. Our current “culture of presenteeism” is at fault, she believes, for people willingly spreading the virus. “People should be encouraged, if they think they may be infectious, to stay at home.” Michie, as well as other scientists critical of the abandoning of testing and isolation, is concerned about the impact on hospitals; that if more unwell people require in-patient care as a result of Covid, the current NHS backlog of over six million people – a record high – will be pumped up even more. Disruption at schools is another risk of less testing and isolating, she says, as is the potential numbers of sufferers of long Covid.
