Coronavirus tests that give on-the-spot results in minutes are set to be rolled out across the world, in what is being hailed a landmark in the battle against the disease.
The tests - which take just 15 to 30 minutes to give a diagnosis - work like a pregnancy test and display two blue lines when someone is positive.
The rapid tests look for antigens, or proteins found on the surface of the virus. They are generally considered less accurate - though much faster - than higher-grade genetic tests, known as PCR tests, used by wealthier nations.
US drugs giant Abbott and South Korean manufacturer SD Biosensor - who make the devices - have agreed to supply 133 low-income countries with the tests at the cut- price of £3.80 ($5).
The World Health Organization and the Bill and Melisa Gates Foundations said the £467million project ($600m) could get started as early as next month.
There are fears that outbreaks in Africa, South East Asia and Latin America - which is currently being hit hardest by the pandemic - are being unreported because nations there are struggling with mass shortages of healthcare workers and laboratories needed to do PCR testing.
PCR tests require processing with specialised lab equipment and chemicals and typically that turnaround takes days to deliver results to patients.
Brett Giroir, assistant secretary of Health and Human Services, swabs his nose as he demonstrates a new fast result COVID-19 test
The quick and easy tests will not only help paint a clearer picture of outbreaks in poorer nations, but they will also allow mass screening of health workers, who are dying in disproportionate numbers in low income countries.
WHO director-general Tedros Adhanom Ghebreyesus hailed the programme as 'good news' in the fight against Covid-19.
'These tests provide reliable results in approximately 15 to 30 minutes, rather than hours or days, at a lower price with less sophisticated equipment,' he said.
'This will enable the expansion of testing, particularly in hard-to-reach areas that do not have lab facilities or enough trained health workers to carry out PCR tests.
'We have an agreement, we have seed funding and now we need the full amount of funds to buy these tests.'
Catharina Boehme, chief executive of a non-profit group called the Foundation for Innovative New Diagnostics, said the rollout would be in 20 countries in Africa, and would rely on support of groups including the Clinton Health Access Initiative.
WHO director-general Tedros Adhanom Ghebreyesus hailed the programme as 'good news' in the fight against Covid-19
Peter Sands, executive director of the Global Fund, a partnership that works to end epidemics, said it would make an initial 50 million dollars available from its Covid-19 response mechanism. He said the deployment of the quality antigen rapid diagnostic tests will be a 'significant step' to help contain and combat coronavirus.
'They're not a silver bullet, but hugely valuable as a complement to PCR tests, since although they are less accurate, they're much faster, cheaper and don't require a lab,' he said.
Many rich countries have also faced problems rolling out accurate tests, and testing itself is no panacea - countries like France and the US have all faced backlogs and hiccups at times, and rapid tests in the UK and Spain turned out to be inaccurate.
But rolling out testing in poorer countries aims to help health care workers get a better grip on where the virus is circulating, in hopes of following up with containment and other measures to stop it.
Mr Sands said high-income countries are carrying out 292 tests per day per 100,000 people - while the lowest-income countries were conducting 14 per 100,000 people.
He said the 120 million tests would represent a 'massive increase' in testing, but are still a fraction of what is needed in those countries.Machine that processes 15,000 swabs per day, a 20-second saliva test and £28-a-go nostril sample analyser: How accurate are the tests being lined up for Boris Johnson's 'Operation Moonshot' plan to check 10million people a DAY?
Rapid coronavirus tests that use saliva, work in minutes and cost less than £30 a time could be used to try and hit Prime Minister Boris Johnson's ambition of 10million tests a day in his 'Operation Moonshot'.
The PM earlier this month announced plans for mass testing of people in the UK to allow people to return to normal, but ministers and chief scientists have admitted the technology to do this doesn't yet exist.
There are, however, trials being done all over Britain of innovative swab tests that could see people given a diagnosis or all-clear in minutes, instead of the current days-long waiting time.
Government pilots involving 'lab in a van' tests by the companies Oxford Nanopore (LamPORE technology), Optigene and DNANudge are already underway, but others are being developed and tested all the time.
These are some of the tests that could be involved in Operation Moonshot:
HALO - 'Game-changing' saliva test
HALO saliva test kit: Clients can take the test at home by spitting into a tube (top right, the tube, bottom right, the funnel), and sending the sample off for processing
British biotech company Halo has unveiled a saliva test which it says provides results in under seven hours, delivered through a phone app.
Clients can take the test at home by spitting into a tube, and sending the sample off for processing at the company's lab at Imperial College London.
It is not yet clear how many tests could be processed a day at this lab alone or whether the test could be scaled up for mass use.
But Halo's website says: 'Each testing module is capable of over 250,000 tests per week. Although we have short term limits imposed by equipment, consumables and space, we can rapidly scale up our number of labs to meet any demand.'
Halo's test works similarly to a PCR test used globally for testing people for the coronavirus using a swab.
It purifies the genetic material from saliva and uses polymerase chain reaction to detect the virus in a lab.
The company claims it is '100 per cent specific' to SARS-CoV-2, meaning a person should never get a 'false positive' result if they don't have the virus.
It is 'ten times more sensitive than the PCR test', The Telegraph reported.
Internal tests correctly identified the virus in 100 per cent of tested samples when the viral load was 1,000 times lower than amounts typically found in patient saliva, the company claims, meaning it is able to spot the virus even when it is in low levels.
Jonathan Biles, Halo's chief executive, said: 'Our tests are very, very sensitive. We think we've got something that's game-changing,' The Financial Times reported.
'Saliva is much less intrusive, has a lower impact on the environment and is less labour intensive than other tests.'
Saliva test kits from HALO are sent out to people's homes in an envelope, arranged via an app.
The group's first customer is Exeter University which has bought tens of thousands of tests to conduct on students who display symptoms in a bid to avoid major disruptions from potential Covid-19 outbreaks.
Student's won't even need to leave their accomodation to get a test. They will be sent on through the post.
University of Exeter said: 'Those participants who take tests in the morning will receive same day results, participants in the afternoon will receive results the next day. The test results will then be fed into the national Test and Trace system.
HALO, a team led by Dr Craig Rochford, inventor of the life-saving Epipen, is supported by top medics such as Sir Walter Bodmer and Professor Karol Sikora.
The firm is now in talks with a global airline, a medical research facility, City firms and other businesses, to see how the test can fit in.
'It is designed for large British organisations to test their people conveniently and painlessly and get them back to work safely and cost-effectively,' the company said.
LamPORE – saliva sample testing in 90 minutesSample type: Saliva or nasal swab Turnaround time: 90 minutes Tests per day: 2,000 (small); 15,000 (large) Accuracy: 99% (claimed) Price: Unknown (UK has bought at least 450,000)
Biotech company Oxford Nanopore has developed portable swab-recording devices which use the firm's LamPORE tests
How will it work?
Ministers and health officials are banking on a test that does not need to be processed in a lab to be developed, so that users get their results in a matter of minutes rather than days.
Similar to a pregnancy test, the saliva test would eliminate the need for people to travel – sometimes long distances – to testing centres before returning home to wait for the result. The tests may need to be sent to a laboratory.
How much will it cost?
Operation Moonshot will have a price tag of almost as much as NHS England's £114billion budget in 2018/19, as set out in documents seen by the British Medical Journal.
Last week the Government pledged £500million for a new community-wide repeat testing trial in Salford, Greater Manchester, as part of pilot scheme for a no-swab saliva test.
A number of residents will be invited for a weekly test, with up to 250 carried out each day, while existing trials of tests in Southampton and other parts of Hampshire will also be expanded.
What is the Government hoping for?
The aim of the tests is to start fully reopening society and getting the economy up and running even before a vaccine has been developed.
After imposing stricter social distancing measures limiting groups meeting indoors or outdoors to just six people, with the threat of a fine for non-compliance, the Government is in dire need of some good news.
Previewing the plans, Prime Minister Boris Johnson said the programme would allow Covid-negative people to 'behave in a more normal way in the knowledge they can't infect anyone else with the virus'.
What are the problems with the current testing programme?
There have been numerous reports of people being asked to travel long distances to their nearest testing centre, only to discover that they do not have an appointment.
One man, from Maidstone, Kent, who asked not to be named, revealed to the PA news agency that he was asked to make a 400-mile round trip for a test, only for his results to then be lost.
On Wednesday, Health Secretary Matt Hancock also blamed the shortage of testing slots on symptom-free people attending for a test, despite the fact people can be symptom-free and still spread the virus.
1) Biotech company Oxford Nanopore has developed portable swab-recording devices which use the firm's LamPORE tests and can determine whether a user has Covid in the space of an hour-and-a-half.
The machines take 90 minutes to give a result and can process up to 15,000 samples a day.
It involves taking a sample of saliva, unlike existing methods which require invasive and difficult nose and throat swabs.
The LamPORE device, which also comes in a desktop version which is about the size of a printer, uses electronic means to record and analyse the samples.
Each test is given a barcode which is individually assessed before returning back with the result. This must be done in a laboratory but the labs can be mobile and put into vans or pop-up test sites.
The portable version of the LamPORE device is the same size as a CD player.
Ministers have ordered 450,000 of the tests, which are now being trialled in Salford and Southampton. Millions more are due to be rolled out later in the year if they prove to be effective.
The Salford trial will invite people in the community to come for weekly tests using a new saliva Covid-19 test that produces results in under an hour and a half.
The pilot will begin with a select number of participants and up to 250 tests a day, to be scaled to the whole area.
Initially, the pilot will focus on specific high footfall locations in the city, which includes retail, public services, transport and faith spaces.
Phase two of the no-swab saliva test pilot in Southampton will also start this week.
The second phase of the pilot will trial the weekly testing model in educational settings, with participation from staff and students at the University of Southampton and four Southampton schools.
Over 2,100 pupils and staff across four schools will be invited to have a test as part of the pilot, which is led by a partnership of the University of Southampton, Southampton City Council and the NHS.
The makers of the test have not revealed how accurate it is, and the Government has refused to divulge that information, too.
Mr Hancock said of the tests: 'Oxford Nanopore's new rapid LamPORE tests will benefit thousands of people with fast and accurate test results, removing uncertainty and breaking chains of transmission quickly and safely.
'I am hugely grateful for the fantastic work Oxford Nanopore have done to push forward this important innovation in coronavirus testing.'
OptiGene – swab results in 20 minutes
Sussex-based biomedical company OptiGene has created a nasal and throat swab test that takes just 20 minutes to diagnose people
Sussex-based biomedical company OptiGene has created a nasal and throat swab test that takes just 20 minutes to diagnose people.
Once swabs have been collected from patients, the samples are loaded into the devices, known as the Genie HT, which look for tiny traces of the virus in their DNA.
The machines amplify the DNA billions of times chemically so they can detect the virus with extreme sensitivity. They can also be used with saliva samples.
The device has proven to be just as accurate as PCR swabs, which take days to give results, in clinical trials by Public Health England.
In contrast to the widely used PCR tests, which need be processed at different temperatures, the Genie HT does not require a change in temperature to detect results.
It is currently being trialled by the Government on thousands in A&E departments, GP coronavirus testing hubs and care homes across Hampshire, and will be rolled out in the new testing programmes in Salford and Southampton.
Four thousand people of all ages have been involved in the Hampshire Hospitals NHS Trust trial.
A study done during that trial Hampshire have found the test to be 97 per cent sensitive, meaning it can find 97 out of 100 positive cases, and 99 per cent specific, meaning only one in 100 people would get a false positive result.
DNANudge – 75 minutes to a result from a nostril swabSample type: Nostril Turnaround time: 75 minutes Tests per day: 15 Accuracy: 98% Price: £28 each on average (UK paid £161million for 5.8m tests including 5,000 machines)
The DNANudge test can detect the virus from just a nostril sample - much less invasive than some throat swabs.
Once a swab is taken, it's inserted into a handheld reader that provides results within just 75 minutes.
The DnaNudge has a sensitivity of over 98 per cent - meaning it can pick up on mild and asymptomatic cases - and specificity of 100 per cent.
The 100 per cent specificity means it can tell the difference between a person who doesn't have the disease at all and a sample which wasn't taken properly, meaning there aren't any false negatives.
After successful trials on 500 patients in London hospitals, the 'lab in a cartridge' device was approved for clinical use by the Medicines and Healthcare Products Regulatory Agency (MHRA) at the end of April.
One of the new test kits, made by London-based DNANudge, scours DNA in nose swabs and takes just 75 minute
The Government has purchased at least 5,000 of the DNANudge machines, which can process up to 15 tests a day, to provide six million tests in the coming months.
The test, developed by Imperial College London's Chris Toumazou, is based on the design of a DNA test and can give a result in just over an hour, significantly cutting down on the 48-hour wait for a laboratory diagnosis.
Matt Hancock has previously said about the machines: 'By quickly detecting whether the virus is present in an individual, this new test is an important step forward in point of care testing which means that positive cases can be identified and contained quickly and safely.
'I am hugely grateful to