Knowledge barriers in a national symptomatic-COVID-19 testing programme

Mark S. Graham, Anna May, Thomas Varsavsky, Carole H. Sudre, Benjamin Murray, Kerstin Kläser, Michela Antonelli, Liane S. Canas, Erika Molteni, Marc Modat, M. Jorge Cardoso, David A. Drew, Long H. Nguyen, Benjamin Rader, Christina Hu, Joan Capdevila, Alexander Hammers, Andrew T. Chan, Jonathan Wolf, John S. BrownsteinTim D. Spector, Sebastien Ourselin, Claire J. Steves, Christina M. Astley

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Symptomatic testing programmes are crucial to the COVID-19 pandemic response. We sought to examine United Kingdom (UK) testing rates amongst individuals with test-qualifying symptoms, and factors associated with not testing. We analysed a cohort of untested symptomatic app users (N = 1,237), nested in the Zoe COVID Symptom Study (Zoe, N = 4,394,948); and symptomatic respondents who wanted, but did not have a test (N = 1,956), drawn from a University of Maryland survey administered to Facebook users (The Global COVID-19 Trends and Impact Survey [CTIS], N = 775,746). The proportion tested among individuals with incident test-qualifying symptoms rose from ∼20% to ∼75% from April to December 2020 in Zoe. Testing was lower with one vs more symptoms (72.9% vs 84.6% p<0.001), or short vs long symptom duration (69.9% vs 85.4% p<0.001). 40.4% of survey respondents did not identify all three test-qualifying symptoms. Symptom identification decreased for every decade older (OR = 0.908 [95% CI 0.883-0.933]). Amongst symptomatic UMD-CTIS respondents who wanted but did not have a test, not knowing where to go was the most cited factor (32.4%); this increased for each decade older (OR = 1.207 [1.129-1.292]) and for every 4- years fewer in education (OR = 0.685 [0.599-0.783]). Despite current UK messaging on COVID-19 testing, there is a knowledge gap about when and where to test, and this may be contributing to the ∼25% testing gap. Risk factors, including older age and less education, highlight potential opportunities to tailor public health messages. The testing gap may be ever larger in countries that do not have extensive, free testing, as the UK does.

Original languageEnglish
Article numbere0000028
JournalPLOS Global Public Health
Volume2
Issue number1
DOIs
StatePublished - 19 Jan 2022
Externally publishedYes

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