The number of people infected with Covid-19 who were missed by lateral flow testing is substantially higher than thought, University of Birmingham researchers say in a report published in the BMJ.
The authors acknowledge that LFTs are an important tool in controlling the coronavirus pandemic, but say claims that the devices can identify the vast majority of cases have been overstated and can give false reassurance.
LFTs have been recommended for widespread use, largely based on predictions made by mathematical models.
While empirical data shows LFTs give a positive result when the virus is present on a swab in high quantities, and therefore can detect people who are likely to be infectious, the proportion missed who are infectious has not been evaluated.
To address this gap, the researchers drew on empirical data from several sources to predict the proportion of LFTs that produce negative results in those with a high risk of Sars-CoV-2 infectiousness.
They then compared these with predictions made by influential mathematical models.
Their focus was to identify the probability that people are likely to be infectious and that they test negative on Innova.
Their results are based on testing in three settings: symptomatic testing at an NHS Test-and-Trace centre; mass testing in Liverpool in residents without symptoms; and in students at the University of Birmingham.
The analysis predicted that of those with a viral culture positive result, Innova would miss 20 per cent attending an NHS Test-and-Trace centre, 29 per cent without symptoms attending municipal mass testing, and 81 per cent attending university screen testing without symptoms, along with 38 per cent, 47 per cent, and 90 per cent of sources of secondary cases.
By comparison, two mathematical models significantly underestimated the numbers of missed infectious people.
One model suggested 8 per cent, 10 per cent, and 32 per cent of cases would be missed in the three settings, while the other assumed no cases would be missed.
Consequences of false negatives is significant
The authors stress that evaluating the accuracy of a test for current infection or infectiousness is challenging owing to the lack of a reference standard, and say there is the potential for error in their estimates.
“The findings in this analysis therefore must be taken as illustrative and not exact,” they say.
But they say that this data is “currently the best available and clearly show that missing people with current infection or who are infectious is possible in all settings".
“Allowing for the uncertainties in the results from our analyses, the proportion of people with current infection missed by the Innova LFT is likely to be of public health importance, particularly in settings with greater proportions of infectious people with lower viral loads, where the tests are often being applied,” said lead author Jon Deeks, professor of biostatics at the University of Birmingham.
“Policymakers need to ensure that the public are aware of the risk of being infectious despite testing negative, and that tests are not used in situations where the consequences of false negative results are considerable."
The UK has spent more than £7bn on lateral flow devices since mid-2020 on the proviso they could reduce Covid transmission by up to 90 per cent. Yet there is lack of hard evidence on this promised impact.
The World Health Organisation has cautioned against mass asymptomatic testing because of this evidence shortfall, as well as the high costs and risk of diverting resources from more important activities.
AIDA%20RETURNS
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Cryopreservation: A timeline
- Keyhole surgery under general anaesthetic
- Ovarian tissue surgically removed
- Tissue processed in a high-tech facility
- Tissue re-implanted at a time of the patient’s choosing
- Full hormone production regained within 4-6 months
The Baghdad Clock
Shahad Al Rawi, Oneworld
Killing of Qassem Suleimani
COMPANY PROFILE
Name: Kumulus Water
Started: 2021
Founders: Iheb Triki and Mohamed Ali Abid
Based: Tunisia
Sector: Water technology
Number of staff: 22
Investment raised: $4 million
More coverage from the Future Forum
Jetour T1 specs
Engine: 2-litre turbocharged
Power: 254hp
Torque: 390Nm
Price: From Dh126,000
Available: Now
Milestones on the road to union
1970
October 26: Bahrain withdraws from a proposal to create a federation of nine with the seven Trucial States and Qatar.
December: Ahmed Al Suwaidi visits New York to discuss potential UN membership.
1971
March 1: Alex Douglas Hume, Conservative foreign secretary confirms that Britain will leave the Gulf and “strongly supports” the creation of a Union of Arab Emirates.
July 12: Historic meeting at which Sheikh Zayed and Sheikh Rashid make a binding agreement to create what will become the UAE.
July 18: It is announced that the UAE will be formed from six emirates, with a proposed constitution signed. RAK is not yet part of the agreement.
August 6: The fifth anniversary of Sheikh Zayed becoming Ruler of Abu Dhabi, with official celebrations deferred until later in the year.
August 15: Bahrain becomes independent.
September 3: Qatar becomes independent.
November 23-25: Meeting with Sheikh Zayed and Sheikh Rashid and senior British officials to fix December 2 as date of creation of the UAE.
November 29: At 5.30pm Iranian forces seize the Greater and Lesser Tunbs by force.
November 30: Despite a power sharing agreement, Tehran takes full control of Abu Musa.
November 31: UK officials visit all six participating Emirates to formally end the Trucial States treaties
December 2: 11am, Dubai. New Supreme Council formally elects Sheikh Zayed as President. Treaty of Friendship signed with the UK. 11.30am. Flag raising ceremony at Union House and Al Manhal Palace in Abu Dhabi witnessed by Sheikh Khalifa, then Crown Prince of Abu Dhabi.
December 6: Arab League formally admits the UAE. The first British Ambassador presents his credentials to Sheikh Zayed.
December 9: UAE joins the United Nations.
UAE SQUAD
Goalkeepers: Ali Khaseif, Fahad Al Dhanhani, Mohammed Al Shamsi, Adel Al Hosani
Defenders: Bandar Al Ahbabi, Shaheen Abdulrahman, Walid Abbas, Mahmoud Khamis, Mohammed Barghash, Khalifa Al Hammadi, Hassan Al Mahrami, Yousef Jaber, Salem Rashid, Mohammed Al Attas, Alhassan Saleh
Midfielders: Ali Salmeen, Abdullah Ramadan, Abdullah Al Naqbi, Majed Hassan, Yahya Nader, Ahmed Barman, Abdullah Hamad, Khalfan Mubarak, Khalil Al Hammadi, Tahnoun Al Zaabi, Harib Abdallah, Mohammed Jumah, Yahya Al Ghassani
Forwards: Fabio De Lima, Caio Canedo, Ali Saleh, Ali Mabkhout, Sebastian Tagliabue, Zayed Al Ameri
CREW
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What sanctions would be reimposed?
Under ‘snapback’, measures imposed on Iran by the UN Security Council in six resolutions would be restored, including:
- An arms embargo
- A ban on uranium enrichment and reprocessing
- A ban on launches and other activities with ballistic missiles capable of delivering nuclear weapons, as well as ballistic missile technology transfer and technical assistance
- A targeted global asset freeze and travel ban on Iranian individuals and entities
- Authorisation for countries to inspect Iran Air Cargo and Islamic Republic of Iran Shipping Lines cargoes for banned goods
Pharaoh's curse
British aristocrat Lord Carnarvon, who funded the expedition to find the Tutankhamun tomb, died in a Cairo hotel four months after the crypt was opened.
He had been in poor health for many years after a car crash, and a mosquito bite made worse by a shaving cut led to blood poisoning and pneumonia.
Reports at the time said Lord Carnarvon suffered from “pain as the inflammation affected the nasal passages and eyes”.
Decades later, scientists contended he had died of aspergillosis after inhaling spores of the fungus aspergillus in the tomb, which can lie dormant for months. The fact several others who entered were also found dead withiin a short time led to the myth of the curse.
Specs
Price, base: Dhs850,000
Engine: 3.9-litre twin-turbo V8
Transmission: Seven-speed automatic
Power: 591bhp @ 7,500rpm
Torque: 760Nm @ 3,000rpm
Fuel economy, combined: 11.3L / 100km
What the law says
Micro-retirement is not a recognised concept or employment status under Federal Decree Law No. 33 of 2021 on the Regulation of Labour Relations (as amended) (UAE Labour Law). As such, it reflects a voluntary work-life balance practice, rather than a recognised legal employment category, according to Dilini Loku, senior associate for law firm Gateley Middle East.
“Some companies may offer formal sabbatical policies or career break programmes; however, beyond such arrangements, there is no automatic right or statutory entitlement to extended breaks,” she explains.
“Any leave taken beyond statutory entitlements, such as annual leave, is typically regarded as unpaid leave in accordance with Article 33 of the UAE Labour Law. While employees may legally take unpaid leave, such requests are subject to the employer’s discretion and require approval.”
If an employee resigns to pursue micro-retirement, the employment contract is terminated, and the employer is under no legal obligation to rehire the employee in the future unless specific contractual agreements are in place (such as return-to-work arrangements), which are generally uncommon, Ms Loku adds.
Specs
Engine: Electric motor generating 54.2kWh (Cooper SE and Aceman SE), 64.6kW (Countryman All4 SE)
Power: 218hp (Cooper and Aceman), 313hp (Countryman)
Torque: 330Nm (Cooper and Aceman), 494Nm (Countryman)
On sale: Now
Price: From Dh158,000 (Cooper), Dh168,000 (Aceman), Dh190,000 (Countryman)
The%20specs
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The biog
Born: High Wycombe, England
Favourite vehicle: One with solid axels
Favourite camping spot: Anywhere I can get to.
Favourite road trip: My first trip to Kazakhstan-Kyrgyzstan. The desert they have over there is different and the language made it a bit more challenging.
Favourite spot in the UAE: Al Dhafra. It’s unique, natural, inaccessible, unspoilt.
UAE currency: the story behind the money in your pockets
UAE currency: the story behind the money in your pockets
From Zero
Artist: Linkin Park
Label: Warner Records
Number of tracks: 11
Rating: 4/5
SPEC%20SHEET%3A%20APPLE%20IPHONE%2015%20PRO%20MAX
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Stan%20Lee
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Company profile: buybackbazaar.com
Name: buybackbazaar.com
Started: January 2018
Founder(s): Pishu Ganglani and Ricky Husaini
Based: Dubai
Sector: FinTech, micro finance
Initial investment: $1 million
Nepotism is the name of the game
Salman Khan’s father, Salim Khan, is one of Bollywood’s most legendary screenwriters. Through his partnership with co-writer Javed Akhtar, Salim is credited with having paved the path for the Indian film industry’s blockbuster format in the 1970s. Something his son now rules the roost of. More importantly, the Salim-Javed duo also created the persona of the “angry young man” for Bollywood megastar Amitabh Bachchan in the 1970s, reflecting the angst of the average Indian. In choosing to be the ordinary man’s “hero” as opposed to a thespian in new Bollywood, Salman Khan remains tightly linked to his father’s oeuvre. Thanks dad.
FA CUP FINAL
Manchester City 6
(D Silva 26', Sterling 38', 81', 87', De Bruyne 61', Jesus 68')
Watford 0
Man of the match: Bernardo Silva (Manchester City)
PROFILE OF HALAN
Started: November 2017
Founders: Mounir Nakhla, Ahmed Mohsen and Mohamed Aboulnaga
Based: Cairo, Egypt
Sector: transport and logistics
Size: 150 employees
Investment: approximately $8 million
Investors include: Singapore’s Battery Road Digital Holdings, Egypt’s Algebra Ventures, Uber co-founder and former CTO Oscar Salazar
