Government to launch 40,000 person daily contact testing study
New study to offer daily rapid testing to contacts of positive COVID-19 cases.
- A new study led by Public Health England and NHS Test and Trace will help increase understanding of how effective daily contact testing could be for people who are contacts of positive COVID-19 cases. It is to be used as an alternative to self-isolation.
Daily coronavirus tests will be given to as many as 40,000 people who have been in contact with someone who has tested positive for COVID-19, in a new government-backed study designed to gather evidence on safe alternatives to self-isolation for people who are contacts of positive COVID-19 cases.
If successful, the study – led by the UK Health Security Agency (including Public Health England and NHS Test and Trace) – could provide evidence to help to reduce the length of time people who are contacts of positive COVID-19 cases need to self-isolate, as parts of the economy and society reopen through the roadmap. A reduction in the period of self-isolation from 10 days could help prevent individuals having to miss work, while allowing people to continue to safely participate in society.
The launch of the England-wide exercise builds on the research pilots taking place in businesses, hospitals and schools. Since December over 200 schools, 180 workplaces and over 800 individuals have participated in daily testing pilots, which have proved effective in reducing the need for people to self-isolate, while detecting cases of COVID-19 that would not have otherwise been found. Participants of pilots have been able to safely reduce the length of time spent in self-isolation upon receipt of a negative daily test result.
Currently, anybody who has been notified through NHS Test and Trace as a contact of someone who has tested positive for COVID-19 must self-isolate for 10 days. For those contacts without symptoms, the new study aims to find out if people can replace the need to self-isolate by taking a test every day instead.
Close contacts of people with COVID-19 will be contacted by phone and sent 7 days’ worth of lateral flow tests (LFTs). The contacts are required to test themselves each morning for 7 days. People who test negative and develop no symptoms will be exempt from the legal duty to self-isolate that day and can leave their home to carry out essential activity.
They will need to take another test the next morning to see if they need to self-isolate that day or continue to be exempt. Individuals will still have to adhere to current restrictions, including following the rules on hands, face and space, and only those formally enrolled in the research study will be exempt from usual legal duties.
Health and Social Care Secretary Matt Hancock said:
With around 1 in 3 people not showing any symptoms, regular testing is already playing a critical role in helping us reclaim our lost freedoms – quickly spotting positive cases, helping identify new variants and squashing any outbreaks.
At every stage of this global pandemic, the British public has stepped up and made huge sacrifices – including self-isolating when they are asked. This new pilot could help shift the dial in our favour by offering a viable alternative to self-isolation for people who are contacts of positive COVID-19 cases, and one that would allow people to carry on going to work and living their lives.
Alongside the phenomenal progress of our vaccination rollout – with over 48 million vaccines administered so far – rapid testing is allowing us to get back to doing the things we all love.
When it launches on Sunday 9 May 2021, the study will offer people in England who are identified as a close contact of a positive case the opportunity to take part in the study, providing they do not have COVID-19 symptoms, are above the age of 18 and are not in full-time education.
The aim of the study is to compare 2 approaches to routine testing of contacts in order to determine the potential for onward transmission. The study will take the form of 2 randomly split groups, one of which will be given one PCR test and asked to self-isolate for the full 10-day period. The second group of participants will be given two PCR tests and 7 LFDs to test daily.
Ahead of the formal launch, the study is starting to collect evidence now on the effectiveness of daily contact testing while there is still prevalence of COVID-19 in the community.
Professor Isabel Oliver, National Infection Service Director at Public Health England and study lead, said:
We know that isolating when you have been in contact with someone who has tested positive for COVID-19 is challenging but it remains vitally important to stop the spread of infection. This study will help to determine whether we can deploy daily testing for contacts to potentially reduce the need for self-isolation, while still ensuring that chains of transmission are stopped.
Contacts of cases are at higher risk of infection so testing them is a very effective way of preventing further spread. This study will play an important part of our evaluation of daily contact testing and how the approach to testing might evolve.
With around 1 in 3 people not showing any symptoms of COVID-19, using regular testing, along with vaccines and social-distancing, are helping us keep infection rates low as restrictions are eased. Everyone in England is now able to access free, rapid, twice-weekly testing using LFTs. Since rapid testing was introduced, 145,765 positive cases of COVID-19 have been detected that would not have otherwise been found.
Since the end of February, there has been a robust surveillance programme in place and regular testing is helping us understand the level of virus circulating in the community. This daily testing study is part of the government’s efforts to control the virus and accelerate the return to a safe, secure normality. Only those formally enrolled in the research study will be exempt from usual legal duties.
Background information
Anyone who is identified as a contact by NHS Test and Trace as a contact will be offered to take part in the study. This won’t include people identified as a contact through the NHS COVID-19 app or through an informal channel. A person will be eligible to take part if they:
- do not have COVID-19 symptoms
- live in England
- are not in full-time education
- are aged 18 and over
- are not under the quarantine rules for arriving in England
People will not be able to take part if they have been informed that they have been in contact with someone who’s tested positive with a variant of concern (VOC) or variant under investigation, or within a known workplace or school where a VOC or variant under investigation is circulating.
The MHRA has reviewed and contributed to the study protocol and is in contact with the Principal Investigator. Following the study, the results will be used to seek MHRA exceptional use authorisation to rollout out self-use LFTs nationally for daily contact testing services.
On daily contact testing the Scientific Advisory Group for Emergencies (SAGE) said at its 11 March 2021 meeting, “Daily testing approaches may also offer other benefits in some circumstances (for example, fewer days of education missed if used in schools)”.
Recent analysis by NHS Test and Trace shows lateral flow tests (LFTs) have a specificity of at least 99.9%. This means fewer than 1 false positive in every 1,000 lateral flow tests carried out.
At times of low prevalence, the probability of a positive test result from a rapid LFT being a false positive is higher, so we are mitigating this by asking people to confirm a positive LFT result with a PCR test.
Everyone in England can now access free, twice-weekly rapid testing.
Rapid COVID-19 tests are effective if part of wider strategies, a British Medical Journal (BMJ) analysis paper states.
A BMJ paper analysing rapid testing for COVID-19, co-authored by University of Liverpool academic Professor Iain Buchan, reviews how rapid testing technologies such as PCR and lateral flow tests can be most appropriately used to support different COVID-19 testing strategies.
Please see words from the Chief Medical Adviser for NHS Test and Trace, Susan Hopkins on lateral flow devices:
All testing policy is kept under continuous evaluation.