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On the front line: the students delivering Covid-19 tests

Research Professional News speaks to students working at university coronavirus testing sites

The students working at the hastily assembled Covid testing stations at universities across the UK describe themselves as “Santa’s little helpers”—working for around £600 a week on the front line of the country’s battle to get their peers home safe for Christmas.

According to the government’s latest guidance, universities will be testing students for coronavirus up to 9 December, while the “travel window” for those deemed safe to go home opens on Thursday 3 December.

Research Professional News has been speaking, on condition of anonymity, to final-year undergraduate and postgraduate students who have been testing their peers using lateral flow devices—which can give a result within an hour without the need for a laboratory.

As with any worker in the nation’s many Covid-19 test centres, the students begin their day by testing themselves for the coronavirus. Students in one group said they had been told that if they tested positive, they should self-isolate immediately but would be paid for the rest of the day—although they feel they should be paid for the whole week, having potentially become infected through no fault of their own.

Research Professional News asked if the students had been told to take a more reliable PCR test after a positive lateral flow result—the answer appeared to be no. Lateral flow tests have been described in the British Medical Journal as an “unevaluated, under-designed and costly mess”, with particular concerns raised about the possibility of “false negatives”, meaning students may wrongly believe they are in the clear and could end up infecting others as they travel home.

Training day

While some universities are deploying medical and nursing students to conduct tests, the students that Research Professional News spoke to did not have backgrounds in healthcare.

They told us they were asked to attend a two-hour orientation event the day before the testing centre at their university opened, and were also required to undertake a total of 40 minutes of online training. The digital learning comprised four modules delivered via an NHS Test and Trace website.

The training modules, seen by Research Professional News, comprise short expository segments, including videos, followed by an interactive assessment based on the information that has been provided.

In one video, trainees are shown how to process lateral flow device tests, which involves adding six drops of an extraction fluid to a test tube before collecting a used swab from the person being tested, then rotating and squeezing the swab to release its contents, with the drops to be placed onto the lateral flow device.

Thirty minutes later, the test result should be known. This is unlike a PCR test, in which no staff in the testing centre are in contact with swab samples.

Some of the students Playbook spoke to said the process of the test was fiddly work, and that if they were unable to extract enough sample from the swab, the test was “next to useless”. After a full day’s work at one university facility, the student testers said that no samples had tested positive within the timeframe of 30 minutes.

A University of Oxford study, published last month, said “that when people don’t have suitable training, you are more likely to get false negative or false positive” results from lateral flow testing. 

Ahead of their day’s work, the students were provided with limited personal protective equipment: a plastic apron, a face covering, a plastic visor and pairs of rubber gloves, which should be disposed of after each test.

None of the students that Research Professional News spoke to raised any concerns about their safety or unsafe practices in their university. Some said that now they had experience in the test centre, they hoped they would be first in line to pick up additional testing work in January should a further mass-testing event take place.

There is also no suggestion that the training the student workers received is any different from the training provided to staff working in any of the NHS Test and Trace centres run by private companies on behalf of the NHS. Further, it should be said that not all universities have chosen to employ their own students in their testing centres—however, the practice would seem to be not uncommon.

“The way that over 100 universities have got their testing sites up and running in next to no time is at one with the huge efforts made by professional services staff, academics and students since the crisis began,” said Nick Hillman, director of the Higher Education Policy Institute.

“The fact that institutions and students are working cooperatively together to ensure the success of the government’s testing programme in the run-up to Christmas is great to see. It is true that we must not let this success mask the mixed accuracy of the tests, and we must also ensure that those taking the tests are not misled into thinking they are 100 per cent effective. But we should also not let the best be the enemy of the good.”

In response

Alistair Jarvis, Chief Executive of Universities UK:

“Over the past few weeks university staff across the UK have worked with the government at considerable pace to develop and roll-out enhanced asymptomatic testing for students, as part of the next phase of government pilots for the largest network of diagnostic testing facilities in British history.

“An effective test, track and trace system in higher education—along with other Covid-secure measures already in place—will play an important role in limiting transmission and ensuring universities can continue to offer face-to-face learning and support for student welfare in a low risk and physically-distanced way.

“The government has worked with universities on plans to minimise the risks associated with students travelling home at the end of term by implementing staggered departure dates in the ‘student travel window’, and by increasing opportunities for students across the country to access rapid testing if they choose to do so.

“As well as ensuring students can return home this Christmas, these pilots will enable vital lessons to be learned on the nationwide scaling-up of asymptomatic testing that other industries and society as a whole will substantially benefit from.”

A longer version of this analysis appeared in our 8am Playbook email. Subscribers can access it here. If you wish to sign up for a personal copy, please fill in this form and add 8am Playbook as the subject.