Testing in schools has been finding close to zilch!

Just located the Test and Trace figures for testing in schools.

They are on this webpage
gov.uk/government/pub…

In Table 6 of this downloadable file

1/6
To interpret these results remember all tests give false positives (FP). For Innova DHSC says about 3 per 1000 (0.3%), were FP in Liverpool it was about 1 per 1000 (0.1%). So only event rates above these figures indicate that a test is usefully detecting real cases

2/6
First Primary schools (presume teachers and staff)

2,031,296 tests; 4,232 positives - that is 0.21% - stable for the past month. This is below the 0.3% false positive rate stated for Innova - so many will be false positives.

3/6
Now secondary schools

1,918,823 tests; 2,986 positives - that is 0.16% over two months and has been below 0.1% for the past fortnight. Well below the 0.3% false positive rate stated for Innova - so many will be false positives.

4/6
These data make clear

(1) all LFT positives MUST be verifed by PCR - the Government is risking wrongly putting staff and students unnecessarily in isolation for 10 days.

(2) the case that doing this at all will make a difference to cases and spread is less than wafer thin.

5/6
think about the cost (~£10K-£30K per case detected)

think about the time and effort

think about children who get stressed by tests and swabs

think about what else we could provide to schools

many harms, unlikely there are going to be benefits

why are we doing this?

6/6

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More from @deeksj

24 Feb
Risks of false positives in school testing with Innova

Innova testing of asymptomatics in England has very low rates of test positivity at the moment (0.3%). The lower this figure gets, the more likely a positive result is to be a false positive than a true positive.

1/7
This rate is in health care workers and others getting community testing – you will expect rates in school testing to be lower as children have been locked down.

What are the chances of a positive result being a false positive?

Best data we have are from University testing

2/7
Kudos to @PubHealthScot for looking at this with University students and clearly and fully reporting their findings.

Excellent weekly reports are on their website
beta.isdscotland.org/find-publicati…

Report from 27th Jan shows key data for Uni testing in Nov/Dec.

3/7
Read 7 tweets
21 Feb
What is the evidence supporting the Government’s claims that Innova LFT detects infectious cases?

There are no real studies at all which directly show how well Innova +ve detects infectious people and Innova -ve indicates non-infectious people.

No direct data at all.

1/19
The data come from studies of PCR with inferences made by linking PCR proxy “viral load” Ct values to the viral load levels we know that Innova detects.

Ct values are not standardised and depend on how much biological matter on a swab. They have high measurement error

2/19
Evidence on infectiousness comes from studies linking Ct values with rates of (a) secondary cases and (b) the ability to culture the virus. Neither are perfect – but are the best we can do. They will both most likely underestimate infectiousness.

3/19
Read 20 tweets
21 Jan
@TomChivers has taken on the challenge of trying to understand the disagreements over LFTs. We had a good chat, but unfortunately the final article mispresents some of my views. I explain more below.

What Covid tests can we trust? @UnHerd unherd.com/2021/01/what-c…
Read 7 tweets
18 Jan
Context matters … I am aware that people outside the UK are reading my tweets and papers, and influencing their thinking about lateral flow testing. It’s really important that you understand the context I am writing from, and why it probably is different where you are.

1/11
The situation and issues in the UK (particularly in England), is almost certainly unlike where you are. The UK Government are unique in many ways and that is impacting on how tests are being used. (As a Brit I am also prone to understatement and being overpolite).

2/11
Our Government have staked their reputation on the Moonshot idea “to get our lives back to normal” using LFTs before there was evidence to see whether it would work. It doesn’t make sense to decide policy before evaluating the technology. Decision-making is now politicised.
3/11
Read 11 tweets
16 Jan
Testing in schools saga - again

What is the explanation behind this from @educationgovuk? Why has the @MHRAgovuk said DfE does not need regulatory approval for daily “assisted testing” given it does not approve daily “self testing” of contacts of infected cases in schools?
Daily self-testing of contacts was not approved because MHRA considered that the test misses too many cases, allowing infected and infectious individuals to remain in class. The MHRA would have come to this decision based on a forensic and balanced assessment of the evidence.
Hopefully somebody can help answer why this does not also apply to “assisted testing”. I can think of three different explanations. There may be more.
Read 7 tweets
15 Jan
Great summary and we really need to take the toxicity out of this. Agree with >95% of what is here. Thx for taking time to do this. The big challenge is how we make quick progress without being able to get a ref std for infectiousness. Cluster RCTs great but hard to do.
Part of my 5% disagreement arises in whether we are making a mistake in trying to force “infectiousness” into the test accuracy paradigm, or whether we could do better considering it in a different way. It is a probabilistic rather than binary concept which causes the problem.
We can classify people as more or less likely to infect others, but I don’t think we will ever successfully put people into two groups of those who do or do not infect somebody else from a test. That is unlike our ability to say that people do or not have detectable virus.
Read 9 tweets

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