COVID testing rule change muddle

This morning the government announced a change to the rules around COVID 19 testing. Up until now if you have a positive lateral flow test, you are required to take a second “PCR” test. This is to confirm if you have or have not got COVID 19.

Against a background of supply chain problems in getting enough testing kits to the public, the rules have changed. The official line is that whilst levels of COVID-19 are high, people with positive LFD results will most likely have COVID-19. The new rules come into force on Tuesday 11 January.

The new rules

Lateral flow tests are taken by people who do not have COVID-19 symptoms only. Anyone who receives a positive LFD test result should report their result to https://www.gov.uk/report-covid19-result They must then self-isolate immediately. They will not need to take a follow-up PCR test.

After reporting a positive LFD test result, they will be contacted by NHS Test and Trace. This will be to ensure their contacts can be traced and must continue to self-isolate.

Anyone who develops 1 of the 3 main COVID-19 symptoms* should stay at home and self-isolate and take a PCR test. They must self-isolate if they get a positive test result.

Exceptions to the rules

People who are eligible for the £500 Test and Trace Support Payment (TTSP). They will still be asked to take a confirmatory PCR if they receive a positive LFD result. This, government claim, is to enable them to access financial support. As an argument it is frankly threadbare. Clearly government are capable of allowing them to access support whether they take 2 tests or one. It sounds much more like a rule designed to try and delay payments. And to those who need them the most.

People participating in research or surveillance programmes. These people may still be asked to take a follow-up PCR test, according to the research or surveillance protocol. That at least makes sense.

People who are at particular risk of becoming seriously ill from COVID-19. Those who have been identified by the NHS as being potentially eligible for new treatments. They will be receiving a PCR test kit at home by mid-January to use if they develop symptoms. They may be eligible for new treatments if they receive a positive PCR result. This group should use these priority PCR tests when they have symptoms. It will ensure prioritised laboratory handling.

Isolation rules

Anyone who tests positive should self isolate for at least 7 days. They will be able to leave self-isolation 7 days after the date of their initial positive test. That is provided they receive 2 negative LFD results, 24 hours apart, on days 6 and 7.

*Symptoms

Government is still using the symptoms of COVID 19 associated with the first variants. This is problematic and the advice they are giving appears to be out of date. So when they say three symptoms they mean:

a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)

a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

a loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal

Unfortunately these are not the main symptoms associated with the now dominant strain of COVID 19, the omicron variant. The BMJ (British Medical Journal) notes that the three main symptoms of omicron are:

  • Runny nose,
  • headache, and
  • fatigue

In the absence of joined up advice from government, people will have to apply common sense. If you get the any of the symptoms associated with omicron, then take a PCR test and not a lateral flow test.

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