Are free lateral flow tests about to be scrapped?

Could free lateral flow tests be on the way out? The Sunday Times says said so on its front page but Nadhim Zahawi has denied it outright. It’s clear there’s a split in government over this.

Officials quoted in the Sunday Times article say the country needs to realise Covid is here to stay, and to accept that vaccines have blunted most of its force. David Spiegelhalter, one of the most respected statisticians who has been commenting on the pandemic, has said Britain is ‘certainly not going to see a big rise in intensive care admissions and deaths’. Given that deaths are running at 150 a day (and Sage forecast suggested a range of ‘600 to 6,000 deaths a day’) that raises the prospect of the actual death numbers coming nowhere near the range Sage was giving just three weeks ago. In London, the Omicron epicentre, intensive care bed usage has been falling towards normal levels — far behind what was seen this time last year.

  

The mooted plan on tests is that they would still be rolled out in schools, care homes and hospitals, as well as to people with symptoms. But it would end people habitually testing themselves when they feel well, as well as rescinding advice that everyone should test themselves twice a week. When the then Health Secretary Matt Hancock made lateral flows available for free last April, he said that the tests would be 'fundamental in helping us quickly spot positive cases and squash any outbreaks'. But that was then, when Covid was a virus that the government thought it could suppress. Now, with the rise of the more transmissible Omicron variant, as well as 95 per cent of adults having antibodies, more are explicitly accepting that Covid is not going away. Nadhim Zahawi himself has said that we are 'witnessing the transition of the virus from pandemic to endemic'.

Britain has carried out more tests than any other country in Europe. Last month, Brits were carrying out an average of 1.5 million tests a day, the highest figure throughout the pandemic, as the Omicron variant overcame Delta. Two-thirds of those tests were lateral flows. The true figure is likely much higher: the House of Commons’ public accounts committee estimated that only 14 per cent of lateral flows were documented online, so more than four million a day could have been done over December. But if cases will soon be falling fast here there’s less need for that. In the US, where cases are rising, Joe Biden has only just made half a billion tests free to all Americans: this week, the President said people wanting one should ‘Google “Covid test near me”'.

The Sunday Times also reports a financial motive behind the decision: more than £6 billion has been spent on contracts with providers. Yet the cost of lateral flows is dwarfed by other pandemic measures, such as furlough (£69.5 billion), Test and Trace (£28.3 billion), and support for the self-employed (£30.6 billion). Ending free lateral flows would be as much of an epidemiological decision as it is financial. A Whitehall source quoted in the Sunday Times said free testing 'isn’t sustainable or necessary given high vaccination levels'.

The move could also be a tacit admission of defeat in building diagnostic capacity in the UK. The main providers of the tests, Flowflex and Orient Gene, are both Chinese brands. Efforts to bring in British manufacturers have faltered after all bar one company, SureScreen, failed to gain regulatory approval.

Ending free LFTs would mark a turning point in treating Covid like another circulating virus. Yet today’s denial of the plans reveal a disagreement within the heart of government. Zahawi himself prefers a further cut in the isolation period — from seven to five days from symptom onset (as the US has done). This is a sign that ministers now see workforce shortages as a bigger threat than hospitals being overloaded. So self-isolation may well be shortened — or possibly even scrapped — in the next few weeks and months, along with Test and Trace and the practice of publishing daily case numbers.

Omicron seems to have peaked in London at the end of last month and may have peaked nationally (Prof Tim Spector says his Zoe app suggests this). If so then we could now be looking at the beginning of the end. We should know a lot more in the coming days.