As plans move ahead to roll out lateral flow tests in Cayman as part of screenings for COVID-19 in local schools, the Compass takes a look at how effective they are and how they work.

While government has yet to formally announce how many tests, and which type, have been acquired, Chief Medical Officer Dr. John Lee said the plan is to have Cayman “flooded” with the tests.

The aim is to have the tests used as part of a COVID-19 ‘catch-and-isolate’ mechanism without disruption to schools and businesses at large. It is still not known when the tests will be distributed and at what cost, if any.

How effective are the tests?

Lee said the effectiveness of the tests depends on the state of infectivity of each person.

“They’re somewhere between 50% and 80% as effective as PCR, sometimes a little bit higher than that. But they’re far, far better than no knowledge at all,” he said on Saturday as he addressed the Cayman Islands Healthcare Conference at the Kimpton Seafire Resort.

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“They’re much better at picking up infections where there is a high viral count, and they’re also better when you use them sequentially.”

How do lateral flow tests work?

Lateral flow tests detect the proteins in coronavirus and are simple and quick to use, according to the UK National Health Service. They are also referred to as rapid tests.

In the below video, Cayman’s chief medical officer demonstrates using a lateral flow test.

Do I have to use a swab for lateral tests?

Yes, the tests do require a swab. According to the NHS, there are two types of lateral flow tests. Based on the instructions that come with the test kit, before you do the test, you would either have to take a throat and nose swab, or a nose swab only.

How long does it take to get the results?

It is unclear which type of lateral flow test will be used in Cayman so it is hard to say;  different test brands have different waiting times. The NHS says the tests requiring throat and nose swabs will have results ready in exactly 30 minutes. The nose-swab-only test (ACON Flowflex – which comes in a blue-and-white box) takes between 15 and 30 minutes, but no longer than 30 minutes. The nose-swab-only test (Orient Gene – green-and-white box) takes 15 minutes, and no longer than 20 minutes, the NHS said.

Steps for taking a lateral flow test

Taking the test begins with reading the instructions and the guidelines to ensure an accurate result.

The NHS outlines a step-by-step process:

Before taking the swab:

  • Wash your hands with soap or use a hand sanitiser
  • Lay out all the items in the test kit on a clean surface
  • If your test does not come with a pre-filled tube, fill the tube with the liquid provided and close the lid
  • Place the tube in the tube holder
  • Blow your nose
  • Wash your hands again

Taking the swab

If your test requires a throat swab:

  • Open your mouth wide and rub the swab over your tonsils (or where they would have been). Avoid the end of the swab touching your teeth, tongue and gums
  • Put the same swab inside your nose (about 2.5 cm up or until you feel some resistance)

If your test requires a nose swab only:

  • Put the swab inside your nose (about 2.5 cm up)

Completing the test:

  • Put the end of the swab into the tube so it’s in the liquid
  • Squeeze the liquid from the tube onto the test strip
  • Check the waiting time in the instructions that came with the test kit
  • Wait for the time shown in the test kit instructions
  • Read the result
  • Do not leave it longer than the waiting time specified in the test kit instructions as this may affect the result

Doing the test on someone else

If you’re doing the test on someone else, it might help to:

  • Talk them through the steps
  • Try to remain calm
  • Get another person to help you

If your test requires you to do a throat swab on someone else:

  • Use a torch to see their tonsils
  • Get them to say “ahhhhhhh” loudly so you can see their tonsils
  • Stop doing the test if the person becomes distressed.

It is important to use a separate test kit for each person. (Source: NHS)

What happens with the results?

Lee said a formal plan for using the tests and reporting results is still being finalised, but noted that every positive test will have to be reported to Public Health.

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