Lateral flow tests: a rapid diagnostic solution for the future

Over the last 12 months, as we collectively sought a way to avoid Covid transmission, the terms ‘lateral flow’ and ‘rapid antigen test’ became an accepted part of the general public’s vocabulary, but the technology is not new. For years these easy-to-use devices have been used widely with success: the pregnancy test being the most well-known.

The market – now projected to reach $10.2bn by 2025 – was growing before the influence of the pandemic, and the latest market growth drivers – the increasing prevalence of infectious disease, ageing populations and the demand for point-of-care testing – that were relevant pre-COVID-19 will remain relevant well into the future.

Gardian, an Australian-based digital health company sees the increased awareness of lateral flow’s patient-centric capabilities as a major factor as to why the technology will be used more widely going forward.

The response to COVID-19

The spread of SARS-CoV-2 was fast, catching most countries off guard. Governments, policymakers, and stakeholders rallied to try and introduce testing strategies that could deliver fast result turnaround times. Throughout the world, organisations mobilised their operations and developed tests in short timeframes; manufacturing capacities were scaled up to meet demand; testing trials and programmes were initiated to quickly assess the state of the COVID-19 situation and formulate response strategies; and vaccine development programmes were initiated across the globe.

During a trial in the UK, nearly 100,000 lateral flow antigen tests were carried out over a two-week period. Although very important in times of crisis, it was not the volume of tests performed that was of interest for future diagnostic strategies – rather, it was the capability to easily test patients across multiple locations and produce results on site in minutes.

And it was not just COVID-19 rapid tests that hit the headlines in 2020. Sky News reported ‘the number of HIV self-testing kits [which included lateral flow] issued in London was 20 per cent higher during the first eight weeks of Covid lockdown than the same period a year before.’

The pandemic has reiterated the value of mass screening and illustrated how getting a broad picture of the status of disease infection as easily and quickly as possible contributes to establishing appropriate and targeted response strategies.

Various diagnostic methods have played their role during the pandemic response. Swab testing at specialised testing centres for a confirmatory result via PCR (Polymerase Chain Reaction) were hailed as the gold standard in Australia until the sheer number of infections overwhelmed the system and the government conceded to the public having access to self-testing.

The global response to the SARS-CoV-2 pandemic suggests however, that laboratory methods may not be the sole solution for infectious disease testing in the future, especially where the need for results is time critical due to a disease’s short incubation or latency period: Ebola being one example.

Accurately producing and reporting results on the same day – for all infectious diseases, irrespective of their incubation period – not only delivers a patient-centric response but could potentially also offer resourcing benefits through reducing the number of people needed to process and interpret a result.

It is also important to understand the dynamics and demographics of global populations, to demonstrate fully why the use of rapid tests is beneficial for future testing programmes. It is projected that throughout the world, the number of people aged 60 or above will be approximately 1.4 billion in 2030 and 2.1 billion in 2050. When infectious disease risks are coupled with the fact that ageing populations, with ever greater numbers of chronic ailments and autoimmune conditions, lead to an increase in demand for primary care, patient care systems will be under greater pressures and will need to be responsive and deliver effective diagnostics quickly.