Have any Questions?

We recognise that the world looks confusing at the moment. Whilst we can’t answer all the unknowns, we’re here to help you understand COVID-19 testing.

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What is a KnowNowᵀᴹ Test?

The KnowNowᵀᴹ Test is the UK's only on-the-spot COVID-19 test that uses just your saliva to tell you if you are currently able to infect someone else with COVID-19.

Unlike other tests, the KnowNowᵀᴹ Test won't give you a positive result if you have been exposed to the SARS-CoV-2 virus in the past, but are no longer able to infect other people.

Who makes the KnowNow Test?

The KnowNowᵀᴹ Test has been invented, developed and manufactured in the UK by Senseutics Limited, trading as Vatic.

Who is Vatic?

Vatic is a predictive health company focused on making medicine more proactive. We deliver on-the-spot tests which detect subtle biomarkers in people’s bodies to predict illness before it becomes acute or infectious.

Our first product is KnowNowᵀᴹ, a rapid turnaround COVID-19 antigen test, that is designed to identify COVID-positive people before they become highly infectious*, based on just a small saliva sample.

When did you start?

Vatic was founded in October 2019 by Alex Sheppard and Dr. Mona Kab Omir.

When the first wave of COVID-19 started in the UK in early 2020, our team immediately saw an opportunity to contribute to global efforts to tackle the pandemic, and leveraged work already underway on antigen testing to quickly start developing the KnowNowᵀᴹ Test.

What's the long term vision for Vatic beyond COVID-19?

We’re focused on developing our predictive health technology and tests so that we can make medicine more proactive and help to predict illness before it becomes acute or infectious. We want to empower people to feel in charge of their own health and wellbeing by making testing more readily accessible and available, allowing for earlier prediction and prevention of acute illnesses.

Why are you called Vatic?

The adjective "vatic" means "describing or predicting what will happen in the future," and derives directly from the Latin word vates, meaning "seer" or "prophet."

We chose this name as it speaks to our mission to make healthcare more proactive and empowering, through predictive screening for acute disease.

How accurate are your tests?

COVID-19 test accuracy is typically determined by ‘specificity’ and ‘sensitivity’.

Specificity is about the extent to which you can eliminate false positives; sensitivity is how much virus needs to be present before a test picks it up. So there is always a need to strike a balance, when testing, between trying to pick up the virus as early as possible, versus accidentally delivering a positive test result for someone who is not actually infected.

The specificity of the KnowNowᵀᴹ Test is 100%. In more than 700 negative patient saliva samples, we haven’t had a single false positive.

What’s important when it comes to sensitivity is how much virus needs to be present in the patient sample for the test to give a positive signal. This is known as the 'Limit of Detection', and we measure this rather than clinical sensitivity as it is much more informative. Our Limit of Detection is between 50,000 and 200,000 viral copies per mL, making our test more sensitive than other rapid antigen tests available. The Abbott BinaxNow test, for example, needs 1,000,000 viral copies per mL in order to get a positive signal. The KnowNowᵀᴹ Test's very low Limit of Detection means it can detect infected people as early as day 3 to 4 of infection. This is before they become highly infectious, and a day or two earlier than most tests available (based on models of viral load in disease progression).

If you'd like to read more about this subject, we recommend this paper. It argues that the "Limit of Detection matters and directly impacts efforts to identify, control, and contain outbreaks during this pandemic" since "higher LoD are likely to miss nonnegligible fractions of infected individuals." It also makes the case that Limit of Detection values for tests using universal standard metrics should be readily available in the public domain to enable like-for-like comparison.

How specific is the KnowNowᵀᴹ Test?

The KnowNowᵀᴹ Test's specificity is 100%. In more than 700 negative patient saliva samples, it hasn’t returned a single false positive result.

This is so important for getting life back to normal. We don't want anyone to be stopped from going to work, heading off on holiday or socialising at events, when actually it would be perfectly safe for them to do these things.

Specificity is particularly important when disease prevalence is low and tests are intended to be used at enormous scale. For example, if a test with just a 3% false positive rate is used on one million people per day, that would result in 30,000 people per day being falsely identified as infectious with COVID-19 and being unnecessarily asked to self-isolate.

How sensitive is the KnowNowᵀᴹ Test?

What’s important when it comes to sensitivity is how much virus needs to be present in the patient sample for the test to give a positive signal. This is known as the 'Limit of Detection', and we measure this rather than clinical sensitivity as it is much more informative.

Our Limit of Detection is between 50,000 and 200,000 viral copies per mL, making our test more sensitive than other rapid antigen tests available. The Abbott BinaxNow test, for example, needs 1,000,000 viral copies per mL in order to get a positive signal.

The KnowNowᵀᴹ Test's low Limit of Detection means it can detect infected people as early as day 3 to 4 of infection. This is before they become highly infectious, and a day or two earlier than most tests available (based on models of viral load in disease progression).

If you'd like to read more about this subject, we recommend reading this paper. It argues that the "Limit of Detection matters and directly impacts efforts to identify, control, and contain outbreaks during this pandemic" since "higher LoD are likely to miss nonnegligible fractions of infected individuals." It also makes the case that Limit of Detection values for tests using universal standard metrics should be readily available in the public domain to enable like-for-like comparison.

What is the limit of detection of the KnowNowᵀᴹ Test?

The Limit of Detection (LoD) is the smallest amount of virus in a sample that a given device can consistently detect.

The Liverpool School of Tropical Medicine carried out an analytical study of the KnowNowᵀᴹ test, which determined that the LoD is 500 plaque-forming units per millilitre (PFU/ml). Based on accepted models of viral load in disease progression, this very low LoD suggests that the KnowNow test can detect infected people as early as day 3 to 4 of infection. This is before they become highly infectious, and a day or two earlier than most tests available.

In the absence of a single study that compares the LoD of KnowNowᵀᴹ to that of other tests, it is not possible to do a like-for-like comparison of the LoDs of different lateral flow tests determined by different studies. This is because there wouldn't be parity across cell cultures and strains of the virus used in the different studies. Additionally, it's important to consider that what the KnowNowᵀᴹ test detects is fundamentally different from other tests. KnowNowᵀᴹ is a true infectivity test which looks exclusively for the spike protein only present on active SARS-CoV-2 viruses. Whereas other lateral flow tests detect the nucleocapsid protein encapsulated in the centre of the virus, which can be present whether the virus is active or not.

The PFU/ml measure, as used in the Liverpool School of Tropical Medicine KnowNowᵀᴹ analytical study, is a measure of only the number of virus particles capable of forming plaques in a given sample - viral particles that are defective or which fail to infect their target cell will not produce a plaque and so are not counted by this measure. No inference can be made about the relationship of PFU to the overall number of viral particles in the sample, since this will differ from sample to sample.

Since the KnowNow test specifically detects infectious viral particles only, an LoD measured in PFU/ml is an informative and appropriate measure. However, for other lateral flow tests which indiscriminately detect active and inactive viral particles, an LoD referencing PFU/ml is not particularly informative or comparable to the KnowNowᵀᴹ LoD. For example, the sample used to determine LoD may have had a very low PFU/ml, but many inactive viral particles which were detected by the test. Ultimately, other lateral flow tests are not true tests for COVID infectivity, they do not detect only infectious virus like the KnowNowᵀᴹ test does.

If you'd like to read more about this subject, we recommend reading this paper. It argues that the "Limit of Detection matters and directly impacts efforts to identify, control, and contain outbreaks during this pandemic" since "higher LoD are likely to miss nonnegligible fractions of infected individuals." It also makes the case that LoD values for tests should be benchmarked against a universal standard and readily available in the public domain to enable like-for-like comparison of SARS-CoV-2 detection methods.

How have you validated the accuracy of your tests?

To date we have conducted three clinical studies. The first was a UK Government-supported National Institute for Health Research (NIHR) study across ten UK hospitals; the second was with Liverpool School of Tropical Medicine, and the third is a community study that we have led ourselves. We have also carried out our own analytical assessments, as well as two Public Health England analytical assessments.

We have worked with over 280 negative patient samples and around 100 COVID-19 positive patients across our studies. We are also currently carrying out a 650+ patient clinical trial with sites in the UK, USA and Brazil to provide us with a higher volume of clinical data, and with a view to additional regulatory approvals to widen the reach of the impact we can have globally in pandemic recovery.

Do you identify infection in people who are asymptomatic?

The KnowNowᵀᴹ test's unique detection mechanism identifies the infectiousness of the people tested. As a result, from our modelling based on accepted and peer-reviewed scientific literature, the KnowNowᵀᴹ test will detect asymptomatic people who are infectious with COVID-19.

The KnowNowᵀᴹ test has an impressively low limit of detection for an on-the-spot equipment-less test, of between 50,000 and 200,000 viral copies per mL, and so it is sensitive enough to identify infectious asymptomatic carriers even if they have low viral loads.

As the KnowNowᵀᴹ Test makes testing quicker, easier and more accessible, more people can get tested on an ongoing basis. Regular testing improves the chances of picking up asymptomatic carriers. Since the KnowNowᵀᴹ Test can detect the virus on day 3 to 4 after infection, based on KnowNow's low limit of detection and accepted models of viral load in disease progression, it identifies these carriers before they’re at a high risk of infecting other people.

Testing to identify asymptomatic carriers is so important, since they make up a large proportion of people who are infectious and enable the virus to keep spreading. This narrative review of 16 clinical studies around the globe concludes that between 40-45% of those infected with SARS-CoV-2 never develop symptoms, and that these asymptomatic carriers can infect others for an extended period, perhaps longer than 14 days.

Does the KnowNow Test identify all COVID-19 mutations?

The mechanism underpinning the KnowNowᵀᴹ test mimics the means through which the virus interacts with the surface of a human cell in order to detect it. As a result, we expect that it will continue to identify the SARS-CoV-2 virus even in the face of further potential mutation in the future, unlike tests based on antibodies.

We have modelled the difference between the Wuhan and 501Y mutations in a recombinant protein model to give us initial analytical evidence that the KnowNow test reacts to these variations of concern. And we are currently carrying out a study on live samples of these and other mutations to gather practical evidence of this.

In fact, we predict that the KnowNowᵀᴹ test may potentially become even more sensitive as the virus mutates to become more infectious. And we will continue to carry out further analyses and studies to support this prediction, and confirm that KnowNow continues to function on newer mutations as they arise.

Is KnowNowᵀᴹ approved and safe?

The KnowNowᵀᴹ test has been developed to Vatic's stringent standards of quality and safety.

It has undergone the necessary clinical trials and performance tests and has been shown to meet the specific requirements published by the UK's Medicines and Healthcare Products Regulatory Agency (MHRA).

The KnowNow test has been CE marked for professional use in a healthcare setting and has been registered for use in the UK and the EU.

How does KnowNowᵀᴹ compare to other COVID-19 lateral flow antigen tests?

The KnowNowᵀᴹ Test is unique to other lateral flow antigen tests in 3 key areas.

The first key difference is that the KnowNow test needs only a saliva sample, which can be taken easily and comfortably from the mouth. Other lateral flow antigen tests usually need a nasopharyngeal, anterior nasal or tonsil sample, all of which are painful and unpleasant for the individual being tested and more challenging to collect effectively for the clinical professional administering the test. No one wants to be made to cry or gag, or make someone else cry or gag, on a regular basis!

The second is that the KnowNowᵀᴹ Test looks specifically for live virus which would cause the individual tested to be able to infect others. Although other lateral flow antigen tests are often said to test whether an individual is infectious, this is because they have a higher Limit of Detection and can only detect the virus when there are more viral particles present in the sample. As a result, they offer a proxy measure for infectivity, rather than directly testing whether there is live virus in the sample. The KnowNowᵀᴹ Test on the other hand is a true infectiousness test, which uses a unique patented mechanism which detects a completely different part of the virus.

Finally, the KnowNowᵀᴹ Test is also more sensitive than other rapid antigen tests available, as it is able to pick up the presence of the virus even when there is much less of it present in the sample. Our Limit of Detection is between 50,000 and 200,000 viral copies per mL, whilst the Abbott BinaxNow test, for example, needs 1,000,000 viral copies per mL in order to get a positive signal.

How does KnowNowᵀᴹ compare to COVID-19 PCR tests?

KnowNowᵀᴹ offers two key benefits over polymerase chain reaction (PCR) tests.

The first benefit is that the KnowNowᵀᴹ test needs only a saliva sample, which can be taken easily and comfortably from the mouth. PCR tests usually need a nasopharyngeal, anterior nasal or tonsil sample, all of which are painful and unpleasant for the individual being tested and more challenging to collect effectively for the clinical professional administering the test. No one wants to be made to cry or gag, or make someone else cry or gag, on a regular basis!

The second benefit is that the KnowNow test uses its unique detection mechanism to determine whether an individual is actually infectious, whereas PCR tests identify whether SARS-CoV-2 viral matter is present in an individual's body, regardless of whether it is already inactive.

Although PCR tests have been seen as the "gold standard" test for the SARS-CoV-2 virus, they do have a number of drawbacks. Laboratory processing is required, meaning that there is a delay before results can be returned, and the associated costs are relatively high. Also the detection mechanism does not specifically identify whether individuals are infectious. In fact, PCR tests detect the virus long after the infectious period, and individuals can continue to test positive for a mean of 17 days after they have stopped being able to infect others (source). This means that people who are not infectious are unnecessarily quarantined as a result of a positive PCR test.

How does KnowNowᵀᴹ compare to COVID-19 antibody tests?

The KnowNowᵀᴹ Test and COVID-19 antibody tests test for completely different things.

Antibody tests identify whether someone has had coronavirus in the past, whereas the KnowNowᵀᴹ Test detects whether an individual is currently infectious.

Antibody testing involves detecting the immune response in the human body to having fought off a virus. These tests look for an antibody created in the bloodstream in response to the presence of a virus in that environment. This is useful when testing the effectiveness of a vaccine, or understanding how far and wide a virus has spread. However, it is of limited usefulness to individuals, as it is only able to identify whether an individual has fought off the SARS-CoV-2 virus in the past. It cannot effectively confirm whether they are currently infected, or infectious.

Where do you make your KnowNowᵀᴹ tests?

KnowNowᵀᴹ Tests have been invented, developed and manufactured in the UK.

How should KnowNowᵀᴹ tests be stored?

KnowNowᵀᴹ Tests should be stored between 2 and 30 degrees celsius, which means it's fine to store it at room temperature in the UK's mild climate.

There's no need to store it inside a fridge, unless you're expecting extremely hot weather. If you do choose to refrigerate the test though, just make sure it comes to room temperature before using it.

The KnowNowᵀᴹ Test device should also be stored still sealed in its foil pouch. Once removed from the foil pouch, it should be used within one hour.

How big is a KnowNowᵀᴹ Test kit?

One box contains 25 tests, and measures 20cm (L) x 21cm (W) x 8cm (H).

How long can unused KnowNowᵀᴹ Tests be kept before they expire?

The expiry date of KnowNowᵀᴹ Tests will be clearly marked on their packaging, and you can expect the shelf-life of each box of tests to be at least four months.

How should used KnowNowᵀᴹ Tests be disposed of?

Used tests, swabs and buffer dropper tubes should be disposed of as potentially hazardous clinical waste.

What does a positive test result look like and mean?

Positive KnowNowᵀᴹ Test result
Positive KnowNowᵀᴹ Test Result

If there is one red line visible next to the "C" in the KnowNowᵀᴹ device test results window, and any line at all, no matter how faint, appears next to the "T", then the test result is positive. This indicates that the SARS-CoV-2 antigen has been detected in the sample.

Following a positive result, current government guidance on matters including self-isolation and reporting the result should be followed.

What does a negative test result look like and mean?

Negative KnowNowᵀᴹ Test Result

If there is one red line visible next to the "C" in the KnowNow device test results window, and no line at all next to the "T", then the test result is negative. This indicates that no SARS-CoV-2 antigen has been detected in the sample.

Is it possible to tell if the test has been carried out incorrectly?

Failed KnowNowᵀᴹ Test Result
Failed KnowNowᵀᴹ Test Result

Yes, it will be very clear if the test has been carried out incorrectly and failed.

If there are no lines at all visible in the KnowNowᵀᴹ device test results window, then the test has failed, and it should be repeated with a new device and a fresh saliva sample.

How soon after exposure would the KnowNowᵀᴹ Test give a positive result?

The KnowNowᵀᴹ test will show a positive result from day 3 or 4 after exposure to the SARS-CoV-2 virus. This is earlier than other rapid antigen tests, which usually start to show positive results around day 5 or later.

This also means that individuals will receive a positive KnowNowᵀᴹ test 1 or 2 days before they are at very high risk of infecting others. So where there is a regular testing programme in place, individuals can quickly be isolated before they become highly infectious and the spread of the virus can be prevented.

The basis for this is our analysis of models of viral load in disease progression, such as the one shown within "Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening" by Dr Michael Mina et al, alongside the low limit of detection of the KnowNowᵀᴹ test of 50,000 to 200,000 viral copies per mL.

How long does a negative test result last for?

Receiving a negative result means that the individual tested does not have any live virus in the sample provided and is not currently infectious to others. However, it's important to be aware that they could still be exposed to the SARS-CoV-2 virus following the test. It could also be possible that the individual tested has already been exposed to the virus 1 or 2 days ago, and they have not yet become infectious to others.

As a result, we recommend that individuals are tested as regularly as possible to keep workplaces and communities safe. Depending on the scenario, we would recommend testing is repeated every 1 to 3 days.

Is it necessary to perform multiple tests to be sure of the result?

It should not be necessary to perform more than one test on a given individual at a single point in time, unless the KnowNowᵀᴹ device test results window displays no lines at all, meaning that the test has failed, or unless it was not possible to read the test results within 15 to 60 minutes of applying the mixed saliva and buffer solution to the KnowNowᵀᴹ device.

However, receiving a negative result does not mean that the individual tested can't be exposed to the SARS-CoV-2 virus following the test. So we do recommend that individuals are tested regularly to keep workplaces and communities safe. Depending on the scenario, we would recommend testing is repeated every 1 to 3 days.

How is a KnowNowᵀᴹ Test administered?

There are just 4 simple steps to the KnowNowᵀᴹ Test.

  1. Swab the mouth: The KnowNowᵀᴹ Test requires just a saliva sample to be taken easily and comfortably from the mouth. We know how uncomfortable and painful other lateral flow antigen tests or polymerase chain reaction (PCR) tests can be, with swabs going high into nostrils and all the way back to tonsils. It was really important to us that people would feel happy to take a KnowNow test on a regular basis.
  2. Shake the tube: The saliva swab is placed into a buffer solution in a small tube, and shaken up to mix it well.
  3. Squeeze on panel: A few drops of the mixed solution is squeezed onto the KnowNowᵀᴹ Test device.
  4. Know in 15 minutes: It takes just 15 minutes for the positive or negative result to appear in the test result window on the KnowNowᵀᴹ Test device. No need to wait 24-48 hours for results, as you would with a PCR test.

Who can administer the KnowNowᵀᴹ Test?

So that the KnowNowᵀᴹ Test is used as effectively as possible, it currently needs to be administered by a trained healthcare professional.

A trained healthcare professional is defined by the Medicines and Healthcare products Regulatory Agency (MHRA) in the Target Product Profile for Point of Care SARS-CoV-2 Detection Tests as a professional belonging to one of the 10 health and social care professional bodies that are overseen by the Professional Standards Authority. You can find a list of these professions here.

However, since the KnowNowᵀᴹ Test needs just a saliva sample, it is much easier to administer effectively than other similar tests, and still return highly sensitive results. So we are investigating whether other specially-trained, competent individuals could be approved to administer KnowNow tests as well.

We are also in the process of trialling and seeking approval for a variation of the KnowNowᵀᴹ Test which could be administered by individuals themselves.

How long does a KnowNowᵀᴹ Test take?

The KnowNowᵀᴹ test will provide a result within 17-18 minutes of an individual arriving for their test.

The process of taking the saliva sample, mixing it with the buffer solution and dropping it onto the KnowNow test device should take a clinical professional no more than 2 to 3 minutes.

It then takes just 15 minutes for the test result to develop in the KnowNow device test results window.

The test result should not be read and interpreted after 60 minutes. If it wasn't possible to read and interpret the results between 15 and 60 minutes after dropping the solution into the sample well, the test should be discarded and the process repeated with another new test and saliva sample.

Is it painful to take the KnowNowᵀᴹ Test?

No, not at all. It was really important to us when inventing this test, that it would be comfortable and easy enough that anyone would be happy to take a test every day if they needed to.

All the KnowNow test needs is a simple saliva sample from the mouth. Unlike alternative antigen tests or most PCR tests, the KnowNow test does not require the clinical professional to insert a swab very high inside the nose to collect a sample from the nasopharynx, nor does it require a tonsil swab. This is one COVID-19 test that won't make people gag or cry.

Are there any health risks to or side effects from taking the KnowNowᵀᴹ Test?ᵀ

There are no health risks associated with using the KnowNow test itself, and it is safe to use on all individuals.

Receiving a negative result means that the individual tested does not have any live virus in the sample provided and is not currently infectious to others. However, it's important to be aware that they could still be exposed to the SARS-CoV-2 virus following the test. It could also be possible that the individual tested has already been exposed to the virus 1 or 2 days ago, and they have not yet become infectious to others.

As a result, we recommend that individuals are tested as regularly as possible to keep workplaces and communities safe. Depending on the scenario, we would recommend testing is repeated every 1 to 3 days.

If this regular testing is combined with mask wearing, hand washing and social distancing, the risk of virus transmission is vastly decreased.

Is there a limit to how frequently I can take your tests?

No, there's no limit at all. KnowNow is specifically designed for frequent testing in order to offer the best chance of identifying infectious individuals as early as possible.

We recommend that individuals are tested as regularly as possible to keep workplaces and communities safe. Depending on the scenario, we would recommend that testing is performed every 2-3 days, or even daily, depending on the scenario.

When do you recommend tests are performed?

We recommend that tests are performed at the earliest opportunity possible, to ensure that individuals in the workplace, venue or community don't come into contact with each other prior to testing.

There's no particular time of day that's best to perform a test. Although it is important that individuals haven't had anything to eat or drink, and haven't smoked, within the 30 minutes prior to taking the test.

Can anyone order KnowNowᵀᴹ Tests?

At the moment, KnowNowᵀᴹ Tests are for professional use only, meaning that they need to be administered by a trained healthcare professional. This means that we can take orders from organisations that have in-house or outsourced healthcare professionals who can perform the tests, or testing service providers.

However, since the KnowNowᵀᴹ Test needs just a saliva sample, it is much easier to administer effectively than other similar tests, and still return highly sensitive results. So we are investigating whether specially-trained, competent individuals could be approved to administer KnowNow tests as well.

We are also in the process of trialling and seeking approval for a variation of the KnowNow test which could be administered by individuals themselves.

How do I order tests?

We're so pleased that you'd like to order our KnowNowᵀᴹ Tests. At the moment we are running some pilots with a few key partners, before distributing our tests more widely.

Please fill in our form and our team will get back to you.

How long will it take a qualified clinician to administer each test?

From our own studies with partners, we estimate that a clinical professional can administer one test every 3.5 to 4 minutes. This assumes that they collect saliva samples from individuals, set the KnowNowᵀᴹ Test devices aside to develop for 15 minutes, and collect samples from further individuals before reading the results from earlier tests.

How frequently should employees or visitors be tested?

We recommend that individuals are tested as regularly as possible to keep workplaces, venues and communities safe.

It is important to remember that individuals can still go on to be exposed to the virus following a negative test result. Additionally, a high proportion of infectious people show no symptoms at all, and so regular testing is key to breaking the chain of transmission.

Depending on the scenario, we would recommend that testing is performed every 2-3 days, or daily, depending on the scenario.

How much space do I need to store the tests?

One box contains 25 tests, and measures 20cm (L) x 21cm (W) x 8cm (H).

The space required depends on how many tests you require at any given time. However, as the KnowNowᵀᴹ Tests can be stored at any temperature between 2 and 30 degrees, special storage facilities should not be required in the UK, unless there is unusually hot weather.

Why test people who don't have symptoms?

SARS-CoV-2 is able to spread from individuals who are pre-symptomatic or asymptomatic. As a result, testing and isolation based on symptoms alone will not be sufficient to stop the spread.

This narrative review of 16 clinical studies around the globe concludes that between 40-45% of those infected with SARS-CoV-2 never develop symptoms, and that these asymptomatic carriers can infect others for an extended period, perhaps longer than 14 days.

Regular community testing with a rapid antigen test like the KnowNowᵀᴹ Test to identify asymptomatic, but infectious, individuals offers one way to break the chain of transmission and enable the re-opening of societies.

Isn't lateral flow testing less good than PCR testing?

There have been questions raised around the sensitivity of rapid lateral flow antigen testing for SARS-CoV-2 as compared to PCR testing. However, these questions have been strongly challenged by the scientific community.

PCR tests identify the presence of the SARS-CoV-2 virus in the body, regardless of whether the virus is actively infectious. The PCR testing process amplifies the genetic code of the virus so that even minuscule amounts of the virus in the sample can be picked up. This makes for a powerful test, but since viral fragments can linger in the body for weeks even after the infection has cleared, infected individuals being tested using PCR will show as positive for a median period of 22–33 days in total. On the other hand, most people infected with SARS-CoV-2 are contagious only for 4–8 days.

So whilst PCR testing for SARS-CoV-2 may have been considered the "gold standard" test up until now, it will by definition show different results when compared to lateral flow tests which aim to identify individuals based on viral loads which suggest they are within their infectious window. This discrepancy between what each test is actually testing for has caused some issues where PCR testing has been used to evaluate the effectiveness of lateral flow tests, such as in the mass testing rolled out in Liverpool in November 2020.

The KnowNowᵀᴹ Test goes a step beyond other lateral flow tests with its unique, patented detection mechanism which only shows a positive result when live infectious virus is identified in the sample. As a result, PCR tests will similarly show different results to the KnowNowᵀᴹ Test in certain cases, since they will show positive results even for individuals outside of their infectious period.

For a much more comprehensive and referenced answer, you may like to read "Clarifying the evidence on SARS-CoV-2 antigen rapid tests in public health responses to COVID-19" from the Lancet.

We have a vaccine now, do we need testing anymore?

Although vaccine rollout is progressing extremely quickly in the UK, the government expects that it will be the end of July 2021 before every adult in the UK has been offered their first dose of a COVID-19 vaccine. Second doses should be received around 12 weeks after the first, and so it is likely to be the end of October 2021 before every adult has received both doses.

In the meantime, whilst we await full vaccine rollout, regular rapid antigen testing offers a way to enable the re-opening of society.

Beyond this, it is also important to consider that no vaccine is 100% effective even after 2 doses, that not everyone will accept or be able to have the vaccine, and that there is uncertainty as to whether the vaccines will work effectively against current or future mutations of the virus. We should also consider the fact that the UK is very much ahead of other countries around the world in progressing its vaccine rollout, and that it will still be some time before the vast majority of people globally will be vaccinated.

With these factors in mind, regular testing is likely to play a role in keeping societies safe and open for some time to come.

Are you taking shortcuts or risks by developing the KnowNowᵀᴹ Test so quickly?

No, we're not taking any shortcuts or risks. The KnowNowᵀᴹ test has been precisely developed, rigorously tested, and approved by the necessary bodies.

As with COVID vaccine development, the speed at which we’ve been able to move has been accelerated by the enhanced support and focus afforded to the sector by all stakeholders, such as the government, the pharmaceuticals industry, academic institutions and so on.

We have conducted two clinical studies. The first was a UK Government-based study across ten UK hospitals; the second was with Liverpool School of Tropical Medicine. We have also carried out our own analytical assessments, as well as two Public Health England analytical assessments.

The KnowNowᵀᴹ Test has been CE marked for professional use within a healthcare context and is approved by the UK's Medicines and Healthcare products Regulatory Agency (MHRA).

What is SARS-CoV-2?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the name given by the International Committee on Taxonomy of Viruses (ICTV) to the virus responsible for causing the disease, COVID-19.

What is a lateral flow test?

A lateral flow test is a simple diagnostic device designed to detect the presence or absence of a target substance in a liquid sample without the need for specialised and costly equipment.

The most commonly recognised type of lateral flow rapid test strip is the pregnancy test.

Why does the KnowNowᵀᴹ test use a saliva sample?

We chose to design our unique KnowNowᵀᴹ test for COVID-19 infectiousness to work with a simple saliva sample, so that it would be comfortable and easy to administer, and to ensure that anyone would be happy to take a test every day if required. We believe that patient comfort and happiness leads to increased participation in routine testing, and ultimately increases the probability that COVID positive patients can be detected before they've had a chance to infect others.

The focus of our first clinical study was to assess the feasibility of using saliva sampling, to refine our saliva collection method, and also to assess the overall usability of the KnowNow test. This was a UK Government-supported National Institute for Health Research (NIHR) study carried out across ten UK hospitals with 100 patients participating. Through this study we determined that saliva sampling was both effective and user-friendly, and identified a specific swab for sampling. We chose not to opt for a spit collection method for our saliva sample, as providing a spit sample can be challenging for some patients, particularly the elderly or those suffering with COVID-19 symptoms.

For other COVID-19 tests, throat and nasopharyngeal swabbing is one of the most common types of sample collection. However, a number of studies have explored various issues with these types of sample collection, including:

  • The sample collection method requires a swab to be inserted into the patient's throat and/or far into their nostril and rotated, causing discomfort to patients due to the procedure’s invasiveness, and even inducing bleeding in their tonsils and posterior pharynx. (1)
  • The discomfort or even pain of the sample collection method has a detrimental impact on compliance for serial testing, as patients are unwilling to subject themselves to the test on a regular basis. (2)
  • Nasopharyngeal sample collection presents a considerable risk to healthcare workers, because it can induce patients to sneeze or cough, expelling virus particles. (2)
  • There are several situations where nasopharyngeal swabs would cause particular harm, such as in patients with coagulopathy, those undergoing anticoagulant therapy, or those with significant nasal septum deviation. (3)
  • These tests are not always successful at the first attempt, even though performed by trained healthcare workers, and shortages of swabs and protective equipment are frequently reported. (3)
  • They show relatively poor sensitivity for SARS-CoV-2 detection in early infection and are inconsistent during serial testing. (2)

Some tests have been designed to work with anterior nasal swabs, as a somewhat less invasive alternative to nasopharyngeal swabs. However, there is some evidence to suggest that nasal swab testing produces less sensitive results and may miss patients with lower viral loads (4).

References:

(1) Exploring salivary diagnostics in COVID-19: a scoping review and research suggestions

(2) Saliva is more sensitive for SARS-CoV-2 detection in COVID-19 patients than nasopharyngeal swabs

(3) Saliva as a Candidate for COVID-19 Diagnostic Testing: A Meta-Analysis

(4) Nasal-Swab Testing Misses Patients with Low SARS-CoV-2 Viral Loads

Still have questions? Email us at info@vatic.health
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