The latest analysis complementing the wider evaluation found that the city’s Covid-SMART pilot was associated with an overall 25% reduction in covid-19 related hospital admissions, including a 43% reduction in the pilot’s first month.
Researchers say that, if causal, the effects of the pilot prevented 6, 829 infections and led to 239 fewer hospital admissions across the city of , before being rolled out to the rest of the UK. Read the full news story.
The analysis of City Region’s Covid-SMART community testing initiative (December 2020 – July 2021) revealed insights thathelped policymakers, public health teams and the public with community approaches to Covid-19 testing.
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On 6 November 2020, City Council, NHS Test and Trace, NHS Clinical Commissioning Group, Cheshire & Merseyside Health & Care Partnership and the University of embarked on a national pilot of community open-access testing for the Covid-19 virus – available to people without symptoms in addition to testing services for those with symptoms. Testing was available to everyone living or working in the City of .
The purpose of the pilot was to reduce or contain transmission of the virus while tackling the mounting harms to health, social and economic wellbeing from Covid-19 restrictions.
This is the full report from an evaluation led by the University of into the COVID-19 community testing pilot. The evaluation was invited by the joint local and national command of the pilot and sponsored by the Department of Health and Social Care (DHSC).
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The report evaluates the data on the biological, behavioural and systems aspects of the pilot and its early public health impacts. It presents findings to help policymakers with community approaches to COVID-19 testing.
The report was led by the University of , alongside researchers from NHS Test and Trace, Joint Biosecurity Centre, Public Health England, and Office for National Statistics.
The evaluation found that a low-cost, rapid, no-lab test of likely infectiousness saves time and extends the reach of health protection measures. The data showed that lateral flow rapid antigen testing meets this need when coordinated by an effective local public health service.
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The end-to-end testing service was found valuable and has been continued beyond the pilot as a core part of ’s Covid-19 response.
Between 6 November 2020 and 30 April 2021, 283, 338 (57%) residents took a test using the Innova SARS-CoV-2 antigen rapid lateral flow test (LFT). Of these, 47% had more than one test (27% of residents). In the same period, 152, 609 residents took a polymerase chain reaction (PCR) test either because they had symptoms or to confirm a positive asymptomaticLFTresult.
Socio-economic inequalities were a substantial challenge. Test uptake was lower and infection rates were higher in deprived areas, in areas with fewer digital resources or lower digital literacy, and among non-white ethnic groups. Fear of income loss from self-isolation was a key barrier to testing.
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The Innova lateral flow device used in the pilot performed as expected, identifying most COVID-19 cases without classical symptoms but with high viral load – those likely to be the most infectious.
There was strong public awareness of, and a largely positive attitude toward community testing, motivated by shared identity, civic pride and a wish to protect others. Misinformation, particularly over test performance, was a substantial problem needing intensive local communications to address.
Multiple national testing initiatives in different contexts from care homes to schools and workplaces made communication too complex and would have been better integrated into a community testing with integrated support from the local authority. TheCIPHA(Combined Intelligence for Population Health Action) integrated data and shared analytics system was essential for coordinating actions between local partners. The role of the director of public health was vital to effective coordination of services and engaging the public.
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Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: A synthetic control study | medRxiv
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Evaluating social and spatial inequalities of large scale rapid lateral flow SARS-CoV-2 antigen testing in COVID-19 management: An observational study of , UK (November 2020 to January 2021) - The Lancet Regional Health – EuropeUp to half a million people in Liverpool are set to be tested for Covid-19 under the UK government’s first attempt to embark on city-wide mass testing and track down every case of the virus.
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The Guardian also understands that the self-isolation period for those who test positive for coronavirus, and their contacts, could be cut from the current 14-day period to seven days as early as this week.
It comes after ministers, who announced a new England-wide lockdown from Thursday amid soaring cases, face pressure to improve the beleaguered £12bn test-and-test trace system to control outbreaks and limit the lockdown to four weeks.
Under the Liverpool mass testing programme, which begins on Friday and will cover everyone living and working in the city, a variety of test types and the logistical help of the army will be deployed in a pilot to see whether mass population screening is feasible across other regions of England, as proposed in Operation Moonshot.
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To be successful, it will need not only to find those who are infected regardless of symptoms, but convince them to self-isolate. Only 20% to 25% of people are estimated to quarantine fully when asked to do so by test and trace.
With that in mind, the government is also pushing forward with plans to cut the self-isolation period. It is understood to be preparing to make changes this week, including potentially halving the 14-day timeframe.
“Those who have been contacted need to self-isolate, ” Johnson told MPs in the Commons on Wednesday. “We’ll be making a big, big push on that. Because, I must be candid with the house, alas the proportion of people who are self-isolating in response to the urges of NHS test and trace is not yet high enough.”
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An all-out effort to get as many people tested as possible in Liverpool – one of the country’s worst-hit areas with weekly Covid cases of 410 in every 100, 000 last week – will depend on people’s willingness to come forward.
Testing of the 500, 000-strong population will be carried out in new and existing sites, using home kits, in hospitals and care home settings, and in schools, universities and workplaces. Some will be invited for tests but walk-up and online bookings will also be possible, and 2, 000 army personnel will be involved.
The tests will include rapid lateral-flow tests that can use nose-and-mouth swabs or saliva and produce results in 15 minutes, as well as the more reliable PCR tests, which are designed to return results within 24 hours – although this turnaround time is often doubled. “LAMP” technology will be used in Liverpool university hospitals NHS foundation trust for testing NHS staff.
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People who test positive will receive a text or email from NHS test-and-trace staff and will be asked to self-isolate and share details of close contacts.
The Department for Health and Social Care says the pilot will help inform a mass testing blueprint and demonstrate how fast and reliable Covid-19 testing can be delivered at scale.
Johnson thanked the people of Liverpool in anticipation of the programme. “These tests will help identify the many thousands of people in the city who don’t have symptoms but can still infect others without knowing. Dependent on their success in Liverpool, we will aim to distribute millions of these new rapid tests between now and Christmas and empower local communities to use them to drive down transmission in their areas, ” he said.
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“It is early days, but this kind of mass testing has the potential to be a powerful new weapon in our fight against Covid-19.”
Liverpool city council will let people know how to access tests this week. Joe Anderson, the Labour mayor of Liverpool, said: “During negotiations with central government, myself and Steve Rotheram [the regional mayor] have always highlighted the need for enhanced public health intervention measures in Liverpool and the wider city region, and we were keen that we should be considered for any new strategies to tackle the worrying rise in Covid-19.”
The first successful example of mass testing was in Vo in Italy. When the country’s northern region was struggling with the earliest deadly outbreak of Covid-19 in Europe, the small town near Venice tested all its 3, 000 inhabitants, whether or not they had symptoms.
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On 6 March, when the programme began, there were no rapid tests. The University of Padua and the Red Cross who jointly carried it out used PCR swab test. They picked up even asymptomatic people and all those with a positive test were quarantined. The first round of testing picked up 89 people with infection. A second round nine days later found six. In 14 days, they had eradicated the virus. The scientists who masterminded it recommended the approach to the UK at the time.
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