From 11 January in England, people who receive positive LFT results will be required to self-isolate immediately and will not be expected to take a confirmatory PCR test. The government has said this is a ‘temporary measure’ to manage demand at a time when coronavirus cases are at a record high.
Health leaders warned the updated guidance could 'dilute the country’s infection prevention and control response' and limit the UK's ability to track coronavirus and identify potential new variants.
Meanwhile, the UK Health Security Agency (UKHSA) is yet to confirm whether the updated testing and isolation rules will apply for NHS staff, although recent updates to advice for the public have subsequently been rolled out for healthcare workers.
The overhaul of PCR testing rules comes after BMA GP committee chair Dr Farah Jameel warned a shortage of available tests was deepening pressure on GP practices amid huge staff absences.
LFTs are intended for testing people without symptoms - and people who test positive from 11 January are asked to report their result on the gov.uk website and will be contacted by NHS Test and Trace. Those who develop one of the three main COVID-19 symptoms should continue to take a PCR test and self-isolate while they wait for their result - this advice has not changed.
The new approach reflects similar changes made last January when there was also a high rate of COVID infections and PCRs were temporarily paused. They were reintroduced in March 2021 following a reduction in prevalence.
UKHSA chief executive Dr Jenny Harries said: ‘While cases of COVID-19 continue to rise, this tried-and-tested approach means that LFDs can be used confidently to indicate COVID-19 infection without the need for PCR confirmation.
‘It remains really important that anyone who experiences COVID-19 symptoms self-isolates immediately. They should also order a PCR test on gov.uk, or by phoning 119.
‘I’m really grateful to the public and all of our critical workers who continue to test regularly and self-isolate when necessary, along with other practical and important public health behaviours, as this is the most effective way of stopping the spread of the virus and keeping our friends, families and communities safe.’
Boris Johnson announced on 4 January that the government would provide 100,000 critical workers in England with free lateral flow tests to help keep essential services and supply chains running.
Rapid lateral flow tests are most useful at identifying COVID-19 in people without any symptoms, according to the UKHSA, which claims the tests are over 80% effective at finding people with high viral loads who are most infectious and most likely to transmit the virus to others.
Responding to the update rules, chief executive of the NHS Confederation Matthew Taylor said: ‘Staff absences across the NHS are double what they would typically be at this time of year and this is on top of around 93,000 vacancies and so, at a time of extreme pressure any measure that can enable health and care staff to safely return to work will be welcomed by health leaders.
‘However, we need to understand the rationale behind this change as there is a risk it could dilute the country’s infection prevention and control response and limit our ability to both track the prevalence of coronavirus and identify potential new variants. If this is the case, then it needs to be considered as part of a wider strategy that is clearly explained and risk assessed.’
The change of tack could mean that GPs and their staff who test positive for COVID-19 but don’t have any symptoms can start their self-isolation earlier, without needing to get a PCR test and wait for the result - and return to work earlier.
Dr Jameel told GPonline that ongoing problems with access to LFTs and priority PCR testing was adding to issues around staff absences being experienced in general practice and making it more difficult to care for their sickest and most vulnerable patients. Frontline GPs have also warned that staff absences are a major challenge for teams, with some fearing they may have to close surgeries temporarily.