Lateral flow tests in schools: how do they work and will my child get them?

Schools are going back and some schoolchildren are being offered lateral flow tests twice a week. Will your child get them? Are they accurate? And how do you do the test at home? Our expert family GP has the answers

lateral flow test and schoolchild

Home schooling is almost over! Not long to go until all children in the UK will be back at school and, while all of us are exhaling sighs of relief that teaching fractions is over, we’re hearing that many of you are confused – and perhaps even worried – about the new arrangements for Covid-19 testing in schools.

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Maybe you’ve seen something about the new plans for lateral flow testing but aren’t sure how these tests work? Maybe you’ve heard that lateral flow tests aren’t very accurate? Maybe you’re unsure whether your child will be offered them or not? Or what will it mean it they test positive?

Here’s what you need to know about schools and lateral flow tests…

Are all schoolchildren being offered these new lateral flow tests?

No – although you can request them if your child is not eligible to get them from their school. Here’s what’s currently being offered:

  • If you have a child at secondary school. All secondary school students (and staff) will be offered lateral flow testing. You will be asked to give your consent for your child to be tested (and, if you do not give consent, your child will still be able to attend school). Once you give your consent, your child will be offered 4 tests (spaced a few days apart) on their return to school: 3 of these tests will be done, under supervision, at school; the 4th test will be handed to your child to be done at home (see How to do a lateral flow test, below). After that, your child will be offered twice-weekly tests to be done at home.
  • If you have a child at primary school. There will be no lateral flow tests given to your child at school (although primary-school staff will be offered them). However, anyone who has a schoolchild in their household or childcare bubble (or is in the household or childcare bubble of a member of school staff) can request free twice-weekly lateral flow tests. You can pick these up from your local testing centre or you can order a home test kit online (through your local council’s website).
  • If you have child at nursery. There will be no lateral flow tests given to your child at nursery, although, as with children at primary school, you can request them – see above.
schoolchild with mask

Why are schoolchildren being given lateral flow tests?

We all know that, during lockdown, we’ve been keeping our children at home to help stop coronavirus spreading. And, now that the latest lockdown has reduced the overall rates of infection, children are going back to school because that’s the best place for a (school-age) child to be in terms of their academic development, and also their physical and psychological wellbeing.

But when our children starting mixing again at school, it’s possible – even with careful distancing measures – that some of them will get coronavirus. Luckily, all the evidence shows that children are the demographic who are the least likely to get really ill with it. But, if schoolchildren get the infection, they can spread it to other people – who may be more at risk of complications and haven’t been protected by the vaccine yet.

This is especially true if a child happens to have the infection asymptomatically (without symptoms). And this is quite common: as many as 1 in 3 of us who get coronavirus get it asymptomatically.

The government is introducing lateral flow tests – which are easy to use and give results within 30 minutes – into schools to try to identify schoolchildren who may have the virus but not be aware of it. This way, these children can quickly self-isolate, meaning the virus can't spread within the school as quickly as it otherwise might have
Dr Philippa Kaye, expert family GP and mum of 3

Remember here we are trying to pick up people who have the infection but don’t have the symptoms. If your child has symptoms, they should be isolating at home and requesting a PCR swab (the ‘normal’ test).

But I’ve heard that lateral flow tests aren’t very accurate. Is that true?

There are several kinds of lateral flow tests (LFTs) and they are different, as a group, to the ‘normal’ PCR test. They are quick to use and fast to show results but they all have slightly different sensitivities (the ability to correctly identify all positive cases) and specificities (the ability to correctly identify all negative cases).

What LFTs are good at is picking up a high viral load of coronavirus – and the higher your viral load, the more infectious you are likely to be.

So, while it’s possible an LFT may not pick up a case with a low viral load (typically at the very beginning or very end of the illness), it should still pick up lots of cases at their most infectious stage.

And if you’re doing the testing frequently – which we will be with our twice-weekly tests – it’s likely that any cases that aren’t picked up initially will then be picked up a few days later. This is why LFT tests can be a very useful tool in preventing virus spread in school settings.

What happens if my child tests positive?

If your child’s test is positive and taken at school, they will be isolated in a room and you will be contacted to pick them up.

If the test is positive and taken at home, your child must remain at home.

In both cases, the positive result will need to be confirmed with a viral PCR swab (which can be accessed online or via 119).

Your child’s class bubble will not be asked to isolate unless the PCR swab also comes back at positive.

What happens if my child tests negative?

If your child has a negative LFT result, then they can continue with their school day as normal.

What if my child’s already had Covid?

If your child has had a positive Covid swab in the past 90 days, you should wait until the full 90 days have passed before having lateral flow tests.

What does a lateral flow test look like and how does it work?

lateral flow test kit

The lateral flow test is a test that allows you to do a coronavirus test yourself and see the results quickly. It comes in a little kit that includes a swab stick, some solution to put it in and a test strip that looks a bit like a pregnancy test.

Once you’ve taken your sample (for full instructions, see How to do a lateral flow test, below) and dripped it onto the test strip, you should see the results in within about 30 minutes.

What if my child has symptoms of Covid-19?

If your child has any of these 3 classic symptoms of Covid-19 (you only need to display 1 of them, not all of them):

  • Fever
  • New continuous cough
  • Loss of taste or smell

… then they and the rest of your household will need to isolate and access a viral PCR test – the ‘normal’ test – from a testing centre or by post.

No child who has Covid-19 symptoms should be in school.

How to do a lateral flow test at home

The test is best taken in the morning before school starts. Always read through the instructions which come with the test first. Then…

  • Blow your nose, wash and dry your hands (or use sanitiser) to avoid contaminating the kit.
  • Take the swab. If your kit instructions require a throat swab (most do but some kits only require nasal swabs), rub the swab for about 10 seconds at the back of your throat, around the area where your tonsils are (or would be, if they have been removed).
  • Then (using the same swab), insert it about 2.5cm into one of your nostrils (which is generally the point when you will feel some resistance) and gently roll the swab around for about 10 seconds. It might make your eyes water a little bit!
  • Repeat on the other side, if that’s what your test instructions say (some tests require you to swab both nostrils; some require just the one).
  • Holding the swab carefully away from other surfaces, find the small tube and the bottle of solution. Pour 6 drops of solution into the tube and then insert your swab into the tube, rubbing and squeezing the swab against the side of the tube in the solution for about 10 seconds.
  • Pop the top on the tube and then squeeze a couple of drops from it onto the testing strip. And wait.
  • In about 30 minutes, you should be able read the result – which will be either positive, negative or void (faulty test), see our illustration below.
lateral flow test results chart
Pic: NHS Test and Trace/Health Education England

It sounds like a lot but after –trust me – after doing it a few times, your child will be an expert!

About our expert, Dr Philippa Kaye

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.

Pics: Getty/NHS Test & Trace

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