Pupils and teachers in England used to have to self-isolate if they had come into close contact with someone with confirmed covid.
Now those without symptoms can avoid quarantine if they agree to seven daily “lateral flow” tests, which give results in around 30 minutes. They only need to self-isolate if they test positive or develop symptoms as the week progresses.
Schools have already been given official guidance to start the new scheme, called “daily contact testing”, as a way of increasing face-to-face teaching.
But the Department of Health sent FactCheck an email on Tuesday evening which stated: “This programme is still a pilot at this stage and we will only roll this out once it has been deemed clinically safe and approved by the regulator.”
In an “updated” statement issued less than four hours later, this line and any reference to “pilots” were removed – and the Department has not given us an explanation why.
So while the scheme took effect on 4 January, it’s not clear whether the Department got the safety assurances and regulatory approval it said it needed beforehand.
And we don’t know whether the pilots that were carried out answered the vital question of whether the new plan might actually increase the spread of the virus.
‘Increase in transmission risk’
As FactCheck reported last month – and as the government has since confirmed – lateral flow tests only pick up around 60 per cent of cases when carried out by non-experts, though the chances of catching a positive case may improve with repeated tests.
When the possibility of replacing quarantine for contacts of anyone who tests positive with daily lateral flow tests was discussed at SAGE in mid-November, the scientists warned that it carried “a small increase in transmission risk”.
The fear was that even repeated testing might allow some positive cases to slip through, so the policy would not be as effective as making people self-isolate after coming into contact with a confirmed covid case.
The experts from SAGE urged ministers to carry out pilots before changing policy. They said the pilot “should enable evaluation of the potential of the system against different desired outcomes (e.g. reductions in the current quarantine period to enable people to get back to work, reductions in transmission, behavioural outcomes such as adherence to self-isolation), and to understand operational issues”.
The Department of Health and Social Care told FactCheck that it trialled daily contact testing in 12 schools in England and two in Northern Ireland.
It told us that the pilots looked at the practical elements of rolling of the programme.
But despite repeated requests, the government hasn’t provided us with any evidence that the pilots looked at the effect of the scheme on virus transmission.
Has it been ‘deemed clinically safe’?
We first approached the Department on Monday with questions about the evidence for the new policy.
It issued the following statement to FactCheck at 7.30pm on Tuesday night: “Around one in three people with coronavirus have no symptoms meaning they can pass on the disease without knowing it.
“To protect the health of the teaching workforce we are making rapid-result coronavirus tests available to schools and colleges to allow them to test staff and students regularly.
“We are piloting daily contact testing to understand how repeat rapid testing can help find people without symptoms of coronavirus and break the chains of transmission.
“This programme is still a pilot at this stage and we will only roll this out once it has been deemed clinically safe and approved by the regulator.”
At 11pm that evening, we received an updated version of the statement.
Instead of saying that the government was only “piloting” daily contact testing, the new statement said: “We are examining how daily contact testing arrangements and repeat testing can help find people without symptoms of coronavirus and break the chains of transmission”.
The line about the scheme having not yet been “deemed clinically safe” or “approved by the regulator” was missing from the second statement, but despite follow-up questions, the Department has yet to explain why.
It’s possible that in the hours between the two statements, the Department received new information to confirm the safety of the scheme and approval by the regulator – though there was nothing to indicate this in the “background” briefings that accompanied both emails.
Elsewhere, the government seems to have conceded that the evidence base and regulatory sign-off are still missing.
Guidance issued on 11 January on the prospect of using daily contact testing in the wider community (i.e. beyond schools) says: “Daily contact testing is already being evaluated in a number of settings; assuming the evaluations are successful and MHRA approval is obtained we will expand daily contact testing into further institutions.”
We asked the MHRA whether it has in fact signed off the schools policy change but have yet to get an answer.
New guidance that took effect from 4 January allows schools in England to replace self-isolation for pupils and staff who have been in close contact with a confirmed covid case with seven daily tests.
This is likely to help keep more children and teachers in face-to-face learning.
The Department of Health told FactCheck on Tuesday night that the scheme has yet to be “deemed clinically safe”, nor received regulatory approval. In a further statement issued less than four hours later, this line and any reference to the policy still being at “pilot” stage were removed, but the Department has yet to explain why.
We understand that the practicalities of the new programme were piloted in a number of schools, but the Department did not provide any evidence to suggest that the pilots looked at the effect of the policy on virus transmission.