lateral flow test vertical line down middlelateral flow test vertical line down middle

We do not capture any email address. Distilling the complexity and uncertainty surrounding test results is not easy. The NHS says research shows LFTs are 99.9 per cent accurate. A 16 year old girl presents with a cough, fever, headache, and fatigue. If you are currently developing a lateral flow assay device or looking to re-validate a new membrane, request a sample of our FFHP nitrocellulose backed membranes for improved assay consistency and reproducibility. The good news: The surfactant partially denatures proteins dispensed onto the membrane in a buffer and helps them bind to NC fibers. NHS Test & Trace. Coronavirus (COVID-19): testing and contact tracing. Original reporting and incisive analysis, direct from the Guardian every morning. This was supplemented by discussion with colleagues and identifying relevant references cited in the identified papers. My husband and daughter had it and I was having symptoms. 4 0 obj Vertical flow immunoassays rely on the same basic principles as the more commonlateral flow immunoassayformat with some modifications. Those ads you do see are predominantly from local businesses promoting local services. ",#(7),01444'9=82. 2021. I've really mastered the fine art of jabbing swabs up my nose. 8 0 obj For example, people with symptoms or who have been a contact of case will have an elevated risk of covid-19, potentially greater than the background prevalence in the community, and a negative LFD should therefore be treated with caution. endobj I had the same thing last week. For most people being tested who do not have symptoms this is likely to be low or very low. https://gov.wales/get-rapid-lateral-flow-covid-19-tests-if-you-do-not-have-symptoms#section-68475. Close contacts will also have an elevated risk of covid-19. Typically, people who have had a positive result from a recent PCR test are advised not to participate in regular LFD testing for 90 days.1415 People who have been vaccinated are still encouraged to test. Beats me why. Press J to jump to the feed. Simple and rapid detection of ractopamine in pork with comparison of LSPR and LFIA sensors. Figure 1. J Food Drug Anal. Public Health England, University of Oxford. They use the same technology, which has been around for decades. People testing for coronavirus using rapid lateral flow test kits have reported seeing a faint red line in their result but what does it mean? Other LFDs have met minimum standards and are being field tested in the UK.12 This article focuses on interpreting the Innova LFD; the underlying principles will be similar for the interpretation of other tests. It is probably worth doing more lateral flow tests in the days following to see if the result becomes stronger. We pay for videos too. Lateral flow tests have become a lucrative business in the covid-19 pandemic. Strip width is 1 cm, strip length 4.5 cm, with triangular marks at 4 cm strip length. This analysis makes the assumption that LFT test results are independent of each other, which may overestimate the joint specificity and underestimate the joint sensitivity. The surfactant used on the membrane may affect the binding ability of your sample. A summary of the properties of the different Cytiva membranes can be found at the end of this article. Newsquest Media Group Ltd, Loudwater Mill, Station Road, High Wycombe, Buckinghamshire. Zhang T, Ma X, Zhang D, Xu Z, Ma M, Shi F. World J Microbiol Biotechnol. stream Editors' Code of Practice. No other cases have been recorded in the factory. The R code to reproduce this analysis can be found here. <> Challenges of the Nano-Bio Interface in Lateral Flow and Dipstick Immunoassays. Oxford; 2020. Sena-Torralba A, lvarez-Diduk R, Parolo C, Piper A, Merkoi A. Chem Rev. The sensitivity and possibly the specificity may decline if the quality of testing is weaker. 2017 Dec;35(12):1169-1180. doi: 10.1016/j.tibtech.2017.09.001. This is what I assumed. Email us at exclusive@the-sun.co.uk or call 0207 782 4104. 3 . HHS Vulnerability Disclosure, Help But they were less accurate when it came to giving a negative result. When selecting a membrane, you must consider how the various materials and properties will interact with your reagents and sample to meet your test goals for sensitivity, specificity and test duration. These tests differ from polymerase chain reaction (PCR) tests, which look for genetic material from the virus, called RNA (ribonucleic acid) and are more accurate. Their use is well established for home pregnancy testing. As always, the booster vaccine remains the best protection against infection. Greater-Testing-Capacity-Earlier-Would-Have-Reduce-ffffffffc8f79101. It does look funny but Id say its just a funky artifact from manufacturing and not an actual issue. More virus = stronger line. Table 1: Summary of Cytiva membrane properties. All authors reviewed the article and helped with the tables and boxes. eCollection 2022. 2021. This site is part of Newsquest's audited local newspaper network. But as the prevalence of Covid falls, the problem of false positives also becomes pressing. The further a capture reagent is immobilized from the bottom of the membrane, the more time the capture reagent will have to find and bind its target (Fig 2). Nah it means you have alot in your system. This advice has been emphasised by medics including Dr Nathan Hudson-Peacock, an A . NHS Scotland. Complexity of a Lateral Flow Test BIOLOGICAL CHEMICAL PHYSICAL ENGINEERING TROUBLESHOOTING | 25 JUNE 2015. 2019 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim. Click here to upload yours. your test pack does not arrive within 5 days of ordering. Nathan, who goes by @expedition_doctor on Instagram, said he received a positive PCR result following a very faint lateral flow test result. We suggest that when sharing information about LFDs with the public it is best to be open, share uncertainty, and avoiding oversimplifying. Assuming a pre-test probability of 40%, sensitivity of 50% and specificity of 99.6%, the post-test probability would be 25%. Further details of The BMJ policy on financial interests are here: https://www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists/declaration-competing-interests. In theMiriad vertical flow test cartridgesdistributed by Cytodiagnostics Inc., the presence of 4 targets can be evaluated simultaneously in a single sample in 5 minutes or less. contact IPSO here, 2001-2023. Here we show that, at current levels of prevalence in schoolchildren (~0.43%), the chance of a positive test being a true positive (Positive Predictive Value, PPV) is high (88%) and prevalence would need to decrease to below 0.05% in order for the number of false-positive test results to outnumber true positives. commercialization; lateral flow assays; medical testing; point-of-care diagnostics; vertical flow assays. Currently the government is making LFDs freely available to all adults and secondary school children (age 11+) in England, with advice to test twice each week to detect cases in people without symptoms.1 In addition, visitors to care homes in England are also expected to undertake an LFD before their visit. I took the test outside and let it sit for another 10 minutes and then the line under the T became clear showing a clearly positive result with 2 clean lines. Only anecdotally-but as someone on their last day of isolation today and who is still testing ( now faintly) positive, my strongest result was on day 2, when I was illest and at my most contagious I guess. The tests correctly identified all positive samples except one older strain, giving a false negative. On the other hand, a slow flow time allows for a longer interaction time of the targets to be detected at the test line(s), which can enhance the sensitivity and specificity of the test. It's very intriguing. One example being antibody conjugatedgold nanourchins, which will yield a blue coloured dot upon positive detection in the assay. This article was produced at speed. Should coronavirus proteins be detected, a red line will appear, in addition to a second line that indicates the test is working. Please come forward to receive your booster as soon as possible.. A good understanding of the local epidemiology (local UK data are available at https://coronavirus.data.gov.uk/) can improve interpretation. The most apparent difference between the two methods being the vertical and lateral flow of fluid. You no longer have to get a follow-up PCR test if you test positive on a lateral flow with no symptoms. The latter approach enables the developer to exclude clones with obviously unfavorable binding or releasing kinetic properties. In general, used for high viscosity samples, should be blocked in a separate manufacturing step. If the pre-test probability was 20%, the post-test probability of being infectious given a positive LFD test is likely to exceed 96%. FOIA There is currently concern over the possibility of false-positive lateral flow test (LFT) results in the mass asymptomatic testing programme in English schools, with calls for positive LFTs to be confirmed by Polymerase Chain Reaction (PCR) tests. Microfluidic SERS devices: brightening the future of bioanalysis. As with lateral flow, vertical flow immunoassays rely on the immobilization of a capture antibody on a reagent pad to which the sample of interest (with or without antigen to be detected) is applied. Swabbing and waiting for those little lines to come up has become a regular act for many. Assessing the performance of LFDs in identifying people who are infectious depends on having a good measure of infectiousness. As a subscriber, you are shown 80% less display advertising when reading our articles. We have given two scenarios for test performance (boxes 1, 2)in part to reflect ongoing debate about the accuracy of these tests, but also to reflect possible real differences in performance based on the quality of testing. I took the test outside and let it sit for another 10 minutes and then the line under the T became clear showing a clearly positive result with 2 clean lines. If your test comes back positive, you'll see two lines, one next to the control line marked with a letter C and one next to the test line marked with a letter T. If your result comes back . What does a faint line on your lateral flow test mean? Possible issues with respect to lateral flow test requirements and membrane capillary flow time. Also consider the quality of the testing (eg, who did the test, their familiarity with testing, and whether they used a recognised test). stream For easier visualization this multiplexing can also be coupled with nanoparticle probes of different colours, e.g. eCollection 2022 Jun. Click here to get The Sun newspaper delivered for FREE for the next six weeks. An official website of the United States government. 0[@aTEl Competing interests The BMJ has judged that there are no disqualifying financial ties to commercial companies. The views expressed in this article are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. NHS England. In the UK, LFDs are being used primarily to prevent spread of SARS-CoV-2 by finding cases among people who do not have symptoms of covid-19. Smartphones as LFA readers have been transformed into a universal integrated platform for imaging, data processing, and storage, providing quantitative results in low-resource settings. Current guidelines recommend LFDs should not be used to test people with symptoms of covid-19, but widespread availability means these tests are often used by people with symptoms, and some people may develop symptoms shortly after testing. This can potentially destroy the antigen binding sites of some monoclonal antibodies completely, making these reagents unusable in a lateral flow test. I didnt test negative on LFTs until about day 13, was still getting a strong line on day 10 despite the fact my only lingering symptom was fatigue. This is not a big problem when there is lots of Covid about, as the number of false positives will be far lower than the number of true positives. Conversely, rates of infection tend to be lower in older adults who have fewer social contacts and (in the UK) are now mostly immunised. Feels weird and bad though. More generally, when a patient states they have had a negative covid-19 test, the clinician should check whether this was an LFD test or a PCR test and reinforce the need to isolate if symptomatic until the patient has received a PCR test result. I dont believe it indicates an error or a faulty test and I would consider your test negative , I would just take another one, probably invalid but can't hurt to get one that gives a proper result (or non-result hopefully!). The authors declare the following other interests: none. <>>>/BBox[ 0 0 927.35 528.16] /Matrix[ 0.07764 0 0 0.13632 0 0] /Filter/FlateDecode/Length 191>> Everyone in England is now able to take a free Covid-19 lateral flow test (LFT) twice a week, but experts have raised concerns about accuracy. Rapid results. How would you estimate the pre-test probability of a patient being infectious with SARS-CoV-2? Smartphones as LFA readers have been . There is currently concern over the possibility of false-positive lateral flow test (LFT) results in the mass asymptomatic testing programme in English schools, with calls for positive LFTs to be confirmed by Polymerase Chain Reaction (PCR) tests. <>>> It can also be used to estimate other parameters: the negative predictive value (the likelihood that someone with a negative test does not have the infection), as well as the likelihood of having a false positive or a false negative. Despite this, in some circumstances the pre-test probability may be substantially higher, even when disease levels are low. A booster shot is the best protection against Omicron, with early data suggesting it pushes efficacy back up to 75 per cent for infection, and 80 per cent for severe disease. 2021 https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19/test-and-protect/coronavirus-covid-19-get-a-test-if-you-do-not-have-symptoms, Welsh Government. They showed only a little part of the line to show it had tested, not even half of it. Water volume is 100 l. Most people do stop testing positive pretty quickly but some people keep testing positive for months. $.' 1. Our animation shows the inner workings of a multiplex lateral flow immunoassay (LFIA) and explains how it works. Acknowledgments: Patient and public involvement was supported by the National Institute for Health Research (NIHR) Applied Research Collaboration West (NIHR ARC West). 1 0 obj At the lower levels of pre-test probability, the post-test probability will be lower, and false positive results become more likely (box 1). A positive Covid-19 lateral flow test (Photo: Getty) Above this there is a window to the testing strip. Design of Gold Nanoparticle Vertical Flow Assays for Point-of-Care Testing. OM is the guarantor. The positive line may be weak. He said: Essentially, if *any* line appears before the end of the interpretation window (check leaflet, usually this is 30 minutes), then this is a *positive* test and you must isolate. Some of the concern around LFDs relates to their ability to correctly pick up cases of SARS-CoV-2 infection, particularly when deployed in home and community testing. Recent advances in sensitivity, selectivity, and chemical stability enhancement have ensured the foothold of LFAs in commercial POC diagnostics. 0.5-1 ul/cm is usually ok . Rapid vertical flow technique for the highly sensitive detection of Brucella antibodies with Prussian blue nanoparticle labeling and nanozyme-catalyzed signal amplification. 7 0 obj The line went black instantly, before it even had a chance to get up to the control line. Fig 2. I had the exact same pattern as you - went from dark positive to faintly positive back to a strong positive line again. By Dr. Klaus Hochleitner / Global Lead Technology Product Specialist Diagnostics, A summary of the properties of the different, request a sample of our FFHP nitrocellulose backed membranes, Helping you build a smarter diagnostic assay, Compatibility of the test reagents with the membrane surfactant, Kinetic properties of the binding reagents. A lateral flow test must be taken 24 hours apart on day six and seven of the isolation period, and if both tests come back negative, isolation can end on day seven. The positive predictive value of a positive lateral flow device (LFD) test depends on the underlying likelihood of disease. Rapid testing using lateral flow immunoassays (LFIA) has been widely adopted over the past four decades as a means to quickly detect and measure a variety of agents. Information pertaining to COVID-19 in Western PA. Press J to jump to the feed. In a clinical setting this high sensitivity to a low concentration of the virus in the sample may be helpful, by facilitating a diagnosis even if a poor sample is taken or if viral levels are low in the person being tested. He suggested to social distance, hand wash and wear your mask and continue testing with LFTs as per NHS guidance. <> Diagnostics (Basel). It is a simple device intended to detect the presence of a target substance in a liquid sample without the need for specialized and costly equipment. Calls . 2020. Very limited empirical evidence supports or refutes these concerns. Whether the faint line on your lateral flow test means you have tested positive for Covid-19 or not is all down to timing. xQk0 (YdY8 5k7q)e~ei:}w0Q6]@on`NQR8 Department for Health & Social Care. They give results in about 30 minutes compared with around 24 hours for PCR. Demand for the home testing kits has surged in recent weeks, with people eager to check if they have Covid before attending any Christmas or New Year's celebrations. Transmission is also likely to be influenced by other factors (eg, host immunity, social distancing, and mask wearing) as well as how infectious the case is. A string ofhugely positive studiesshow Omicron is milder than other strains for the vaccinated, with the first official UK report revealing the risk of hospitalisation is50 to 70 per cent lower than with Delta. I knew I added 1 too many drops of liquid (4 instead of 3). A test developer may be able to use this fact to improve the test performance. Lateral flow assays (LFAs) have been the pillar of rapid point-of-care (POC) diagnostics due to their simplicity, rapid process, and low cost. The capillary flow time specification can provide an indication of whether the membrane is fast or slow, but you will have to test it with your sample to determine if it can meet your test requirements. Hello. These people will have an elevated risk of covid-19, which might be substantially higher than the background prevalence in the community. Unable to load your collection due to an error, Unable to load your delegates due to an error. endstream Look at it this way: if one in 1,000 tests mistakenly show up positive (a false positive rate of 0.1%), then even if there is no Covid around, 10 people out of every 10,000 tested would receive a positive result. Rapid lateral flow tests give a quick result using a device similar to a pregnancy test. The positive predictive value of a positive lateral flow device (LFD) test depends on the underlying likelihood of disease, When the disease incidence is low, a positive result should be validated by a polymerase chain reaction (PCR) test. doi: 10.1371/journal.pdig.0000064. The announcement about the twice-weekly LFTs was made by the government, not NHS England. Did you take the tests at a different time of day? If you are unable to import citations, please contact }{_K{c2=);(h`_F8dzBu"Q^5,4+wju?1bI*&$MH"AH_lhxnhb9R\WeF`A However, if a line appears *after* the interpretation window then this does NOT count as a positive test. That is because the false positive rate refers to the proportion of erroneous positive tests out of people who are not infected, not the proportion of positive tests that are incorrect. Darkest on day 2 and 3, faded to almost gone by day 6, day 7 (today) its back to super dark. In some circumstances lateral flow tests can. 5 0 obj A Cochrane review synthesised the current evidence for a wide variety of LFDs.19 However, all the studies on the Innova LFD included in the review had not been peer reviewed, and some more recent, relevant evaluations were not included as they were published after the end date of the searches (30 September 2020).2021 The Cochrane review reports a range of estimates for sensitivity and specificity in different contexts of use.18 The sensitivity of LFDs (the proportion of people with disease who have a positive test, or the true positive rate), according to the review, ranged from 28% (when used in an outbreak investigation) to 79% (when used by laboratory scientists), and the specificity (proportion of patients without the disease who have a negative test, or the true negative rate) from 99.5% to 99.9%.19 Recent analysis by Public Health England, not included in the Cochrane review, suggests the specificity may exceed 99.9%.21. If it is the latter, and obviously assuming you are asymptomatic at this point, then you are very unlikely to be a transmission risk anyway and so it is of little significance.. 2021. We need to be mindful of this when assessing data evaluating the accuracy of LFD tests against a PCR reference standard. Read the full report here. Demand for the home testing kits has surged. Lee MJ, Aliya S, Lee ES, Jeon TJ, Oh MH, Huh YS. As long as you stay close to 1 mm it will be ok. 2 mm would be a bit too big and as you continue to increase the size the final line will start to look worse and uneven. He has not travelled abroad recently and lives locally. Clean and dry a flat surface for the test. Assuming a pre-test probability of 0.05% and relatively good testing (sensitivity 67% and specificity 99.9%), the post-test probability for being infectious would be 25%. SARS-CoV-2 lateral flow antigen tests: evaluation of VUI-202012/01. The measured Ct value is only likely to be a proxy for the viral load in the patient, as it will depend on the sample quality.23 Evidence shows a strong correlation between Ct values and in vitro infectiousness24 and some evidence for increased risk of transmission from patients with lower Ct values.25 However, no agreed Ct threshold exists for infectiousness. Multiplexing is easily achieved by spotting capture antibodies against different antigens at pre-determined locations and/or patterns on the membrane. I knew I added 1 too many drops of liquid (4 instead of 3). So does seem to be something to be said for viral load and how strong the line is. Moreover, vertical flow assays (VFAs) have emerged as an alternate paper-based assay due to faster detection time and unique multiplexing capabilities. Read the instructions carefully. A major review found that lateral flow tests used in England were almost always correct when they produced a positive result (99 per cent). Raffle AE. endobj % inaccuracy or intrusion, then please My whole panel turned dark purple instantly! LATERAL flow tests are a quick and easy way to find out if you have Covid. endobj Every nitrocellulose membrane on the market contains a surfactant, usually an anionic surfactant. "If you get a positive result, it means you are currently likely infected with coronavirus and risk infecting others.". The greater the viscosity, the longer the capillary flow time., which results in longer test duration. Before I tested positive for Covid for 7 months but was CURED' using Pfizer vaccine, I put my headaches down to poor vision but it turned out to be a ticking time bomb, The 6 normal sleep problems that are actually a sign you must see your GP, I'm a GP and here's the mistakes so many parents make when it comes to chickenpox, Im Carrie Underwoods PT and here's how her secrets can boost your weight loss too, Shocking images show skin cancer in your EYE - the 7 signs to watch out for, Ease anxiety in minutes with the 54321 mindfulness hack, All over-50s may get extra Covid jab this Autumn as Javid urges Brits who catch virus to 'act like they have flu'. Comparing the membrane capillary flow time specification (for water) with the serum capillary flow time in Figure 2 demonstrates how the viscosity of the sample liquid can affect the test duration. As of last week, overall prevalence in England was 0.12%, while it was 0.04% in London, 0.02% in the south-east and south-west, and 0.08% in the north-east. HP10 9TY. Illustration of the appearance of the Miriad vertical flow cartridge after applying a gold conjugate (A) or a gold nanourchin conjugate (B) when target is present (A, B) and not present (C) in the sample analyzed. Cytiva has developed three membrane families (FFHP, FFHP Plus, and Immunopore). Requires blocking in a separate manufacturing step. One of the first steps in lateral flow rapid test development is the selection of the right materials, especially the nitrocellulose (NC) membrane. Recommendations for use of LFDs are changing rapidly. The Innova Lateral Flow SARS-CoV-2 antigen test failed to detect three in 10 cases with the highest viral loads, in preliminary data . Second, and perhaps even more important, it helps proteins bind to the membrane (Fig 4). On the contrary, a friend just tested positive for 2 days negative for 3 and positive again on the 6th day (although I am inclined to believe it was just bad sample collection). 2021 Mar 5;11(11):5174-5196. doi: 10.7150/thno.56471. However, if the positive line is very faint and appears after a certain amount of time, it could actually mean you are not infected, a doctor has said. This website and associated newspapers adhere to the Independent Press Standards Organisation's Also, looks like 10 days worth of tests, are you still going to continue to isolate after the 10 day isolation period if still testing positive? This example demonstrates a sandwich (non-co. Bookshelf This is too high for the negative result to rule out the diagnosis of covid-19 (ie, two to three out of every 10 children presenting like this would actually have covid-19), and PCR testing would be valuable, ideally undertaken by a healthcare professional to ensure a good sample is taken. The affinity of an antibody is determined by its on-rate, the rate at which an antigen binding site grabs its target, and its off-rate, the rate at which the bound antigen is released again from the binding site. What is a lateral flow test? Get rapid lateral flow COVID-19 tests if you do not have symptoms. Copyright 2023 BMJ Publishing Group Ltd, , professor of population health medicine, , general practitioner and NIHR doctoral research fellow, , associate professor of clinical epidemiology, Covid-19: Government rolls out twice weekly rapid testing to all in England, Put to the test: use of rapid testing technologies for covid-19, Clarifying the evidence on SARS-CoV-2 antigen rapid tests in public health responses to COVID-19, Cochrane COVID-19 Diagnostic Test Accuracy Group, Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection, Lateral flow tests cannot rule out SARS-CoV-2 infection, SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis, Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020, general practitioner and NIHR doctoral research fellow, associate professor of clinical epidemiology, Interpreting a lateral flow SARS-CoV-2 antigen test, https://www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists/declaration-competing-interests, https://www.nidirect.gov.uk/articles/coronavirus-covid-19-testing-and-contact-tracing, https://blogs.bmj.com/bmj/2020/11/09/screening-the-healthy-population-for-covid-19-is-of-unknown-value-but-is-being-introduced-nationwide/, https://www.gov.uk/government/publications/weekly-statistics-for-nhs-test-and-trace-england-13-may-to-19-may-2021/weekly-statistics-for-rapid-asymptomatic-testing-in-england-13-may-to-19-may-2021, https://www.gov.uk/government/news/mhra-issues-exceptional-use-authorisation-for-nhs-test-and-trace-covid-19-self-test-device, https://www.fda.gov/medical-devices/safety-communications/stop-using-innova-sars-cov-2-antigen-rapid-qualitative-test-fda-safety-communication, https://www.gov.uk/government/publications/sars-cov-2-lateral-flow-antigen-tests-evaluation-of-vui-20201201/sars-cov-2-lateral-flow-antigen-tests-evaluation-of-vui-20201201, https://www.gov.uk/government/news/government-reintroduces-confirmatory-pcr-testing, https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/11/C0913-lateral-flow-antien-test-trust-faqs-v3-jan-2021.pdf, https://www.gov.uk/government/publications/covid-19-rapid-point-of-care-near-person-testing-for-service-providers/covid-19-summary-guidance-for-service-providers-on-rapid-point-of-care-near-person-tests-for-diagnosis-and-management, https://khub.net/documents/135939561/390853656/Impact+of+vaccination+on+household+transmission+of+SARS-COV-2+in+England.pdf/35bf4bb1-6ade-d3eb-a39e-9c9b25a8122a?t=1619601878136, https://www.independent.co.uk/news/education/covid-test-quarantine-selfisolation-school-england-b1823194.html, https://www.ox.ac.uk/sites/files/oxford/media_wysiwyg/UK%2520evaluation_PHE%2520Porton%2520Down%2520%252, modmedmicro.nsms.ox.ac.uk/wp-content/uploads/2021/01/infectivity_manuscript_20210119_merged.pdf, https://www.ox.ac.uk/news/2020-11-11-oxford-university-and-phe-confirm-lateral-flow-tests-show-high-specificity-and-are, https://www.liverpool.ac.uk/media/livacuk/coronavirus/Liverpool,Community,Testing,Pilot,Interim,Evaluation.pdf, https://publichealthmatters.blog.gov.uk/2021/03/30/covid-19-reintroducing-confirmatory-pcr-testing/, Birmingham and Solihull Mental Health NHS Foundation Trust: Consultant Psychiatrist General Adult - Orsborn House CMHT, NHS Tayside: Salaried GP with Special Interest in Drug Use, Harm and Reduction, Birmingham and Solihull Mental Health NHS Foundation Trust: Consultant Psychiatrist General Adult - Northcroft CMHT, Brent Area Medical Centre: Salaried GP - Brent Area Medical Centre, Womens, childrens & adolescents health.
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