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Workplace testing for businesses

Symptom-free testing (also known as rapid testing) is a way to identify people who do not have coronavirus symptoms but are infectious.

Around 1 in 3 people with coronavirus do not have symptoms and can therefore spread the virus without knowing.

Workplace surveillance testing (WST) helps businesses provide symptom-free testing in the workplace.

How workplace surveillance testing works

Workplace surveillance testing provides free lateral flow tests (LFTs) and guidance to help businesses manage and carry out employee testing in the workplace.

It includes online training for staff supervising testing, and involves testing employees twice a week. Testing is not compulsory.

Testing does not remove requirements to follow all national government guidance on COVID-safe workplaces, such as social distancing. Anyone who tests positive should self-isolate.

Find out more about workplace surveillance testing.

How to start providing workplace surveillance testing

Businesses with 50 employees or less

Complete our workplace surveillance testing declaration of interest form and we will contact you.

Businesses with 50-250 employees

Visit the GOV.UK website to register to order coronavirus tests for your employees.

Businesses with 250+ employees

Contact the government department that is most relevant to your business:

Frequently asked questions

What are lateral flow tests?

There are two main types of test used to check if people currently have coronavirus.

The first type of test is known as a PCR test, and looks for the virus’s genetic material (Ribonucleic acid or RNA). These tests are currently more commonly used for symptomatic testing. They require a laboratory to be processed.

The second is called a lateral flow antigen test, which detects the coronavirus antigen that is produced when a person is infectious with coronavirus by applying a swab from the nose and throat to a special test kit. These are quicker tests that produce a result within 30 minutes and do not require a laboratory to be processed.

Which lateral flow device is used, and why?

In August 2020, the Department of Health and Social Care commissioned Public Health England and the University of Oxford to rapidly identify the most promising LFDs.

More than 130 types of LFD have been assessed and over 20,000 evaluations completed. These assessments are ongoing, but one LFD has been prioritised for use based on performance, the ‘Innova SARS-CoV-2 Antigen Rapid Qualitative Test’.

Over 8,000 validation tests have been performed to assess the Innova device. This LFD was effective at detecting a high viral load in an individual and registering an appropriate positive result. These are people who are thought to be the most infectious.

How do lateral flow device tests work?

LFDs are effective at detecting a high viral load in an individual and registering an appropriate positive result. These are people who are thought to be the most infectious.

Lateral flow device testing involves the processing of nasal and/or throat swab samples. The device detects a protein (antigen) produced by the virus at its most infectious stage. If present in the person's sample, a coloured line appears on the device. This uses a well- established technique called immunochromatography, which draws the sample along the device in a similar way to a home pregnancy test kit.

The swab sample is added to a fluid in the test kit. This fluid acts as an extraction buffer and is optimised to release viral antigens from the specimen if they are present. During the test analysis, these antigens migrate along the strip in the lateral flow device, binding to anti- SARS-CoV-2 (the virus that causes COVID-19) antibodies located in the strip. The antibodies are linked to coloured particles. The presence of a coloured band in the test region indicates a positive result for the SARS-CoV-2 viral antigens, while its absence indicates a negative result. In general, it takes up to 20 minutes for a positive result to appear. The manufacturer's guidance is to wait a full 30 minutes to confirm that a result is negative.

Does a lateral flow test need a laboratory?

No – as a point of care test, lateral flow devices do not require a lab setting as samples are processed on-site. LFDs can therefore be rapidly deployed across multiple locations without stringent infrastructure requirements.

Can the lateral flow antigen test tell if you have had coronavirus in the past?

No. Lateral flow antigen tests detect the current presence of coronavirus at that moment in time by looking for the presence of antigens or protein parts on the outside of the virus within the swab sample. Antigens are materials that stimulate the body to produce antibodies.

This is unlike an antibody test which tests for the antibodies that your body has produced in response to the virus. A positive antibody test means you have had coronavirus in the past.

Will it replace existing testing technology?

LFD testing technologies are intended to complement, not replace existing testing technology for individuals who have COVID-19 symptoms. The Government is testing a wide range of technologies which we hope can be deployed in time.

Is the test safe?

Lateral flow tests are validated technology, they are safe and the results are trusted. These tests have undergone rigorous testing and evaluation including at Public Health England’s research laboratories to ensure they are verified for use.

Is the test accurate?

Lateral flow tests are highly specific, which means that only a very small proportion of people who do not have coronavirus will receive a positive result (false positive).

Clinical validation has found LFD to have high specificity but slightly lower sensitivity at lower viral loads. Sensitivity measures how likely a test will return a positive result when that person is infected. Therefore twice weekly tests are recommended to pick up any cases which were not detected during the first test and to catch any new infections.

If you test positive on a lateral flow test, it is likely that you are infectious at that moment, whereas people testing positive on a PCR test could be in the less infectious early or late stages of disease. This means that by using the lateral flow test we can identify people with a high viral load who are the most likely to spread the virus further.

What are the test's benefits?

We know that between one in four and one in three people who have coronavirus never show any symptoms, but that does not mean they are not infectious. These devices can help identify people who have high levels of virus who do not have symptoms and would not otherwise be coming forward for a test, ensuring that they can isolate and prevent onwards infection. We may be able to use these tests to help reduce restrictions for those who test negative, in turn supporting the economy and wider society to return to a more normal way of life.

If you test positive on a lateral flow test, it is likely that you are infectious at that moment, whereas people testing positive on the swab test could be in the less infectious early or late stages of disease. This means that by using the lateral flow test we can identify people with a high viral load who are the most likely to spread the virus further.

The benefits of the LFD testing technology are its ability to be used at the point of care and at scale. Lateral flow testing also has: simpler operational requirements, minimal workforce training, and no requirement for laboratory analysis. LFDs deliver a rapid assessment – in 30 minutes – of whether someone is likely to be infectious or not. This is very quick compared to other routinely available testing options and provides the ability to limit infection spread earlier than with PCR testing.

Why are you using LFDs to test asymptomatic people?

Lateral flow antigen tests are a technology that could be used to test a higher proportion of asymptomatic people, better enabling us to identify positive cases and isolate more people who are at high likelihood of spreading virus, and break the chain of transmission.

In doing so we aim to protect those at high risk, find the virus and help enable us to go back to as normal a way of life as possible.

When are you using lateral flow devices instead of other types of test?

Lateral flow devices are being programmed in a number of settings, to see how they can be used for testing at scale, and for testing people who do not currently have symptoms.

What’s the difference between sensitivity and specificity? Why is there so much variation?

Sensitivity is the proportion of people with the disease that have a positive test. Specificity is the proportion of people without the disease that have a negative test.

Our assessment of variation is that some of this is related to training. It is also important that an individual coughs and blows their nose so that an accurate sample is taken.

Why are you using lower sensitivity tests? What does that mean?

When a person has low levels of virus in their system, lateral flow tests are less sensitive than some of the other tests we use (such as PCR tests). However, when levels of virus are at their highest and people are most likely to pass it on to others, they can detect the vast majority of cases.

This also means that if you test positive on a lateral flow test, it is likely that you are infectious at that moment, whereas people testing positive on the PCR test could be in the less infectious early or late stages of disease.

Is 77% sensitivity really enough to tell people to self-isolate?

Absolutely. Sensitivity refers to the proportion of people with Covid-19 that get a positive result. When a person has low levels of virus in their system, lateral flow tests are less sensitive than some of the other tests we use (such as PCR tests). However, when levels of virus are at their highest and people are most likely to pass it on to others, they can detect the vast majority of cases. This means that if you test positive on a lateral flow test, it is likely that you are infectious at that moment.

Specificity is the proportion of people without the disease that have a negative test. The specificity of this test is extremely high – with no more than 5 per 1000 false positives from those tested, and in trained hands lower at 1 to 2 per 1000. This means that there is a very low risk of an individual isolating unnecessarily.

It is of the utmost importance that we all do our bit to stop the spread of the virus and protect other members of society. Participating in the test will help our country fight the pandemic and save lives. Self-isolation, whilst disruptive for those affected, is an essential part of the fight against the virus. 

Should testing continue now that vaccination has started?

Testing should continue and all government guidelines should continue to be followed despite vaccination. The clinical trial evidence demonstrates that vaccine reduces clinically severe infection and severe disease. However, the impact on minor infection, asymptomatic carriage and transmission remains unknown. Therefore, the use of LFD for asymptomatic testing should continue and will continue to be reviewed.

Do lateral flow tests need a professional to perform the test?

The LFD test has been validated for self-swabbing. This means that subjects will be asked to self-administer a swab and provide their own sample. They do not require a qualified person to conduct the test.

Can the test be used on those with nose piercings?

Yes. If you have a nose piercing swab the other nostril. If pierced on both sides, remove the piercing on one side before swabbing.

Does the LFD test kit work in all temperatures?

The LFD devices and reagents should be used at room temperature (between 15˚C and 30˚C). If the kit has been stored in a cool area (less than 15°C), leave it at normal room temperature for 30 minutes before using.

What is the shelf life of the lateral flow test kits?

The shelf life of the Innova LFD test kits is 24 months from the date of manufacture. Expiry date information can be found on the test kit packaging.

Are there any hazardous substances in the device or the test kit ingredients?

No. The products within the Innova lateral flow test kit (including the devices themselves and the extraction buffer fluid) are not hazardous.

The swabbing and processing of a test does not inactivate the virus so caution should be taken when handling the test and when managing spillages as live virus may be present.

If a spillage does occur use a disposable cloth or paper towel, mop up the spillage and dispose of in the bag provided. The area should then be cleaned and disinfected, again the disposable cloth or paper towel should be disposed of in the bag provided.

Can open leftover extraction fluid bottles be stored overnight? If yes, at what temperature?

The extraction fluid bottles may be opened and resealed for each assay. The extraction bottle cap should be firmly sealed after each use. The extraction solution is stable until expiration date if kept at 2-30˚C.

What's the best way to dispose of used LFD tests and associated PPE?

The Department for Environment, Food, & Rural Affairs (DEFRA) have directed that LFD tests and Personal Protective Equipment (PPE) waste used as part of the Workplace Surveillance Testing programme can be disposed of as part of residual waste (‘black bags’). If you already have alternate waste provision for this category of waste (chemical non-hazardous) then please continue to use these means to protect the environment and aid recycling, but if not, it can now go in your “normal” waste.

Are the swabs latex free?

Yes, the Innova swabs are latex free. The swabs are also supplied in sterile packaging, labelled as sterile, to protect from exposure to latex within the external environment. This means that if testing staff handling the test kit are wearing latex gloves there should be no impact on the swab itself. If any part of the swab packaging looks damaged in any way, please do not use the test and report this via the appropriate channel.

Do the tests contain animal products or have they been tested on animals?

The monoclonal antibody technology present in our lateral flow devices are necessarily generated from animal cells. This is in common with other tests of this kind, including commercially available pregnancy tests. The Innova swab itself does not contain animal products.

During development, at no time have any component parts been tested on animals.

The Vegan Society advises vegans avoid using products made from animals as far as is practicable and possible and vegans should never stop taking prescribed medications without first talking to your doctor.

Are the LFD tests halal?

No animal products have been used in the production of the swabs that come into direct contact with the individual using the test.

The thin paper like material inside the LFD is coated with antibodies from animal cells. No direct contact will be made between the person and this material. The monoclonal antibody technology present in our lateral flow devices are necessarily generated from animal cells. This is in common with other tests of this kind, including commercially available pregnancy tests. It is for individuals to make their own decisions based on their religious practises or dietary choices.

If a positive line appears at e.g. 20mins, is it possible it can become negative by 30mins?

No, if the test is read as positive after 20mins no further analysis is needed.

Positive results can be reported at 20 minutes. Negative and void results must be reported at 30 minutes. If a positive signal appears after 30 minutes, it should not be reported as positive. Line C must be coloured to have a valid test result.

Are there any lessons learned about how to avoid void tests?

There are two factors which cause a void or invalid test (i.e. no control line is produced):

  • The inner membrane of the test strip is not coated properly
  • Not enough solution is dripped into the sample well on the device during processing In order to reduce the risk of a void test the guidance for processing a test must be adhered to

Ensure you complete 10 seconds’ worth of extraction of the sample. The lateral flow device cartridge must be on a flat and level surface throughout. Ensure the 2 drops of extracted sample fluid are air-bubble free before releasing them into the sample well of the lateral flow device cartridge. Check that the liquid can be seen seeping through the cartridge. The results should be read within the allocated time (20-30 minutes). Strong positive results can be reported at 20 minutes, however, negative results must be reported at 30 minutes.

What is the typical void rate for lateral flow antigen tests?

According to published lateral flow data, lateral flow tests reported via the existing National Testing Programme infrastructure have a void rate of 0.37%.

What is an IFU?

An IFU is the manufacturer’s Instructions for Use (IFU). This is a step-by-step guide to carrying out a lateral flow test.

What happens if more than two drops of extraction fluid have been dropped on the sample well of the LFD?

For Innova tests, more than two drops (three to four) of extraction solution dripped into the sample well will still give a valid test.

Will the Innova test kits supplied come with control sets provided (positive and negative controls), so that we can validate our environments?

No. Control sets are for batch validation and are not currently available for onsite quality assurance or training. Batch validation for Innova is being completed centrally for the programme by an independent accredited laboratory and therefore there is not a requirement for this to be done locally. The process of batch validation is in line with the Innova process using the prescribed control sets - for every batch, 100 in every 1,000,000 test kits are sent for batch validation. The outcome of the batch validation will not be communicated to the programme unless the failure rate is greater than 3.5% at which point the entire batch will be recalled from the programme.

If your LFD test result is positive

If your LFD test is positive, you must self-isolate immediately. You could be fined if you do not do this. You may be entitled to a one-off payment of £500 through the NHS Test and Trace Support Payment scheme if you are required to self-isolate.

You should take a follow-up PCR test as soon as possible. If you fail to take one within the next 2 days, you and your contacts may need to isolate for the full 10 days whatever the follow-up result.

Whilst waiting for your follow-up PCR test result you and your household members should follow this guidance. If you take the PCR test within 2 days of the LFD and receive a negative result, you and your household can stop self-isolating. However, you and your household must continue to self-isolate if:

  • This PCR test result is positive
  • You choose not to take a follow-up PCR test
  • You receive a negative PCR test result but the test was taken more than 2 days after the LFD

It is important to book your follow-up PCR test as soon as you can following your positive LFD result.

If you have a question that has not been answered above, contact us at c19testing@norfolk.gov.uk.

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