Research and analysis

COVID-19: general public testing behaviours

Published 19 October 2023

Summary of main findings

COVID-19 lateral flow device tests (LFDs) were made universally available to everyone in England in April 2021 which enabled free access to rapid testing. This was known as the universal testing offer (UTO) and was implemented by what was then NHS Test and Trace (NHSTT).

The UTO paved the way for widespread community based self-testing for COVID-19, allowing all individuals the means to rapidly assess their likelihood of being infectious without needing to use a laboratory process.

The period of the UTO lasted until the end of March 2022. Along with several other COVID-19 policies, it stopped as the UK government introduced the ‘Living with COVID-19’ strategy.

Insights experts, embedded within the Behavioural Science and Insight Unit (BSIU) at the UK Health Security Agency (UKHSA), have been tracking public perceptions of lateral flow device (LFD) testing and self-reported testing behaviours through a combination of ad hoc and more regular fortnightly opinion surveys. The latter fortnightly surveys are collectively referred to in this report as the public perceptions tracker (PPT). The data collected includes self-reporting of LFD testing, why LFD tests were taken and what action was taken after the tests were carried out.

This report draws primarily on the above combination of opinion data collected by NHSTT and UKHSA and explores the drivers behind people’s use of LFD tests and the actions they reportedly took following a test, such as registration of the results to 119 and the GOV.UK website. Registration of results from free LFD tests did not always occur, and the perceptions surveys have helped to estimate and understand the gap between testing and registering of LFD results.

While the main period of interest is the time of the UTO, this report draws on data going back to February 2021 when reliable public perceptions tracking data was first available, to give fuller context. The report also draws on data in the post UTO period up to February 2023 to show how testing behaviours changed after the UTO ended.

Main insights

People used tests to fulfil a wide range of needs throughout the period of UTO and beyond. In February 2023, 1 in 10 adults in England reported continuing to use LFD tests, including many who did so because they felt it was the right thing to do so or because they were seeking reassurance, and not necessarily because guidance suggested they should.

Millions of LFD tests were dispatched before, during and after the UTO period. When compared to the numbers of tests officially registered, this would suggest either an oversupply of LFD tests or severe under-registration of results, or a combination of both.

This discrepancy can be illustrated during the peak period of dispatches in early 2022.

A total 277.86 million LFD tests were distributed in January 2022, yet official data published as part of the weekly NHSTT statistics indicated that only 35,635,100 LFD test results were registered that month (in the weeks starting 3 to 31 January 2022), and only 31,000,374 across February and March 2023 (the registration reference period is the weeks starting 7 February to 28 March 2022).

The perceptions surveys indicated that people were not generally stockpiling tests. At different points during the pandemic, people reported how many tests they had at home and on average, they had less than a full pack of 7 tests in hand.

Using self-reported survey data on levels of testing, it can be estimated that during the peak in January 2022, 91.2 million tests were taken across the population for the first part of January and a further 83.9 million for the second part; this strongly suggests people were using the tests in much larger quantities than the registration rates implied.

Note: as there is a time lag between despatch and usage it is useful to look at estimates of usage from later waves of the PPT survey. They are still high with an estimated 63.9 million for the survey conducted 15 to 16 February 2022 and 59.1 million for the survey conducted 30 March to 4 April 2022.

Consistent themes from the tracking surveys, based on self-report, throughout the period of the UTO and to the last data point in February 2023 were:

• the majority of people who used LFD tests did not officially register test results
• people were more likely to register their result if it was positive or if they were required to for either work or study purposes or because they considered themselves to have a medical need
• those who tested less habitually or tested for reassurance and peace of mind (a commonly cited reason for testing), were less motivated to formally register their result, particularly if it was a negative test result

A majority of those who tested positive reported they engaged in safe behaviours such as staying at home until they obtained a negative result, and reportedly informed others such as shared householders, friends and family and employers or work colleagues of their COVID-19 status.

The analysis in this report indicates that widescale testing was having the public health benefit of changing people’s behaviours even if they did not register their test results officially and that the failure to register test results is not an indication that an individual will not follow the behaviours advised in COVID-19 guidance.

Introduction

The evolution of mass COVID-19 lateral flow testing

In order to break chains of COVID-19 transmission during the pandemic, testing was used to identify new COVID-19 cases as part of a strategy to test, trace and isolate infected individuals.

At the start of the pandemic, polymerase chain reaction (PCR) was the only method to test for SARS-CoV-2. Testing was conducted at dedicated sites and prioritised certain groups such as individuals with specific conditions that made them vulnerable to COVID-19, frontline NHS and care workers and others working with vulnerable groups. PCRs require processing at laboratories and as such can have turnaround times of up to several days due to capacity.

PCR capacity was expanded to make testing of symptomatic individuals more widely available to the general public (in May 2020), and to enable more regular asymptomatic testing in high-risk settings such as care homes ^{[footnote 1]}.

Lateral flow device tests were developed, tested and trialled during 2020, and introduced for use in the national testing programme in late 2020, paving the way for widespread self-testing for COVID-19. These tests gave individuals the means to rapidly self-assess their likelihood of whether they were infectious without needing to use a laboratory process.

Figure 1 below is a simplified timeline chart describing some of the key developments in LFD testing. Most notably in April 2021, the UTO began. Everyone in England was able to access free, regular (twice a week), LFD testing. This was to encourage mass asymptomatic testing to enable case-finding as it was estimated about 25% cases of COVID-19 were asymptomatic (1). The UTO came into being just before the emergence of the new Delta variant in the UK in May 2021.

Figure 1. Main COVID-19 LFD testing events

Text equivalent of main COVID-19 LFD testing events

May 2020: launch of TNHSTT. Tests conducted at test sites for certain groups.

September 2020: launch of COVID-19 app and LFD tests in targeted settings. Tests for those with COVID-19 symptoms.

February and March 2021: Community Testing Programme.

April 2021: universal testing offer begins April 2021 and in the same month people were asked to test twice weekly.

November 2021: autumn-winter plan moves away from twice-weekly tests to ‘testing when you need to during times of high risk’.

December 2021: Daily testing of COVID-19 contacts. Introduction of event certification. Removal of need for confirmatory PCR tests.

February 2022: Test and Trace ends.

March 2022: UTO ends.

During November 2021, the government updated asymptomatic testing guidance and external communications messaging, moving away from recommending twice weekly testing to encourage the use of rapid lateral flow COVID-19 tests to manage periods of high risk.

The COVID-19 autumn and winter plan stated:

People may wish to use regular testing to help manage periods of risk such as after close contact with others in a higher risk environment, or before spending prolonged time with a more vulnerable person.

In December 2021, to minimise the burden of self-isolation on individuals, close contacts of cases with COVID-19 (with some exceptions) could test daily using LFDs rather than self-isolate^{[footnote 2]}.

This public health intervention of daily testing of close contacts was launched as part of the response to the emergence and rapid transmission of the Omicron variant. It involved large-scale diagnostic testing and tracing of close contacts of positive cases which enabled monitoring of the spread of infection at an unprecedented level.

There were several other changes in December 2021 contributing to what became a peak in mass LFD testing that winter. These included the introduction of event certification, earlier removal from self-isolation for those who had tested positive, a removal of the need for confirmatory PCR tests, and increased testing guidance for care homes. This was accompanied by an increase in media coverage to encourage self-testing as well as increased attention from ministers and public health bodies.

The daily testing for close contacts of COVID-19 cases (DTCC) policy ended on 25 February 2022, along with several other COVID-19 policies, as the UK government introduced its ‘Living with COVID-19’ strategy.

The UTO ended in April 2022 which meant free COVID-19 tests were only available for some groups, including those who have a health condition that makes them eligible for COVID-19 treatments. The accompanying guidance issued on 1 April 2022 outlined that members of the public only need test if they were symptomatic and that anyone with a positive COVID-19 test result should try to stay at home and avoid contact with other people for 5 days.

Data analysis and insight within the report

This report presents an analysis of public perceptions survey data first collated on behalf of NHSTT, studies which are now embedded in the public perceptions tracking work conducted by the Behavioural Science and Insights Unit at UKHSA.

General public perceptions data was used to track COVID-19 testing behaviour, producing rapid insight for NHSTT and UKHSA operational teams to:

• help monitor who was testing and why
• gauge compliance with aspects of testing guidance
• identify barriers and enablers to compliance to guidance around testing, registering tests and self-isolation
• understand the experience of accessing testing
• acquire more detail around the public’s engagement with a range of COVID-19 related issues such as vaccination

The analysis in this report focuses on opinion data collected through a combination of ad hoc surveys and PPT data from February 2021 to February 2023.

During that period, testing was changing over time and a PPT survey was set up to run on a regular fortnightly basis to monitor these changes and produce rapid insight for the NHSTT and more latterly the UKHSA operational teams.

In this report, the survey data has been used to examine why there is an observed under-reporting of LFD test results (what we refer to here as registration) when compared to the volume of tests ordered or tests reportedly carried out. This report is structured around the following 3 main topic areas:

• what the public reported about their experiences of LFD test ordering and test usage, including the drivers of their behaviours
• following a test, what people claimed they did, focusing on test result registration and compliance with other guidance around self-isolation
• understanding the gap between the levels of LFD test results being registered according to official operational data, and the amount of testing and registering of results the perceptions surveys suggest was happening

Data sources

While this report draws primarily on a number of NHSTT and UKHSA public perceptions surveys, it also references other sources of public perceptions data that have been gathered through various ad hoc qualitative and quantitative studies, such as:

• studies from the NHSTT/UKHSA Voice of the Customer (VOTC) experience programme
• LFD despatch and testing management information from our operational teams
• tracking studies run jointly by DHSC and CO which go back pre-UTO, as far as February 2020

More details are given in the information sources section.

Main findings for question 1

What did public opinion data reveal about COVID-19 lateral flow device testing and the drivers to test?

When did people test and how often?

Figure 2 below is a timeline chart in which combines data from a number of studies that tracked self-reported LFD testing either in the last 7 days or in the last 2 weeks, depending on the study question used ^{[footnote 3]}.

The data indicate that peaks in mass LFD testing followed the various periods of heightened risk of viral infection, when LFD tests became more easily accessible and when guidance was issued to test more frequently.

Figure 2. Proportion of the public who have taken LFD tests recently

There are 2 data sources for figure 2. The first is from Savanta, DHSC and CO Tracker based on the question ‘To the best of your knowledge, which type of test did you have most recently?’ It draws on a sample of approximately 1,700 adults across England per wave. The second source is from Basis Research drawing on a series of studies such as the Interim COVID-19 survey, LFD demand and fulfilment survey, COVID-19 pilot and the UKHSA PPT. The data is based on the question ‘When did you last take a COVID-19 test?’, drawing on a sample of approximately 1,000 adults per wave.

Detail from early public perceptions surveys of COVID-19 testing conducted by BMG/Savanta for the DHSC and the CO in Figure 3 shows that after the UTO was introduced, a larger proportion of the population started to use LFD tests than were using PCR tests – whereas the reverse was true in March 2021. This switch in kits usage reflected that people could readily access free twice-weekly LFD test kits from April 2021.

Figure 3. Tests taken in the last 7 days, DHSC/CO data

The source for figure 3 is from the Savanta, DHSC and CO COVID-19 tracker based on the question ‘To the best of your knowledge, which type of test did you have most recently?’ It draws on a sample of approximately 1,700 adults across England per wave.

A poll conducted for DHSC and CO in May 2021 (a month after UTO) indicated that the majority of people (59%) (2) had come to see LFDs as easy to take, signalling the perceived convenience of LFDs at that time.

From the launch of the UTO, there was a gradual increase in self-reporting of LFD testing until the noticeable peak during the winter of December 2021 to January 2022 when the Omicron variant was widespread, and the UK government was encouraging daily testing of close contacts among those who were fully vaccinated. The timeline chart in Figure 4 shows that at this point, 3 in 5 people in England (59%) (3) reported in the perceptions surveys that they took an LFD test over a 2-week period, accounting for over 80% of all tests.

Figure 4. LFD tests versus PCR tests taken in the last 2 weeks, UKHSA PPT data

The source for figure 4 is from Basis Research drawing from a series of studies such as the Interim COVID-19 survey, LFD demand and fulfilment survey, COVID-19 pilot and UKHSA PPT. The data is based on the question ‘When did you last take a COVID-19 test?’, drawing on a sample of approximately 1,000 adults across England per wave.

Surveys showed that trust in LFDs had changed over time and that LFDs had increasingly become accepted as sufficient to check for COVID-19. Figure 5 which features 2 bar charts comparing perceptions of PCR tests and LFD tests, shows that by January 2022, 3 in 4 (77%) of the public reported that LFDs provide accurate results, and qualitative insight (4) indicated that LFDs gave users autonomy and control to test where and when they liked.

Figure 5. Perceptions of LFD and PCR test accuracy, UKHSA data

The source for figure 5 is from Basis Research drawing from the interim COVID-19 survey. The data is based on the question ‘How much do you trust that each of these provides an accurate COVID-19 result/diagnosis?’ and draws on a sample of approximately 1,000 adults across England.

Since the December 2021 to January 2022 peak, LFD testing levels have dropped off against a backdrop of COVID-19 guidance changing. For example, on 24 February 2022, all legal restrictions in England were lifted including the need to self-isolate upon a positive COVID-19 test result but those testing positive were advised to stay at home for 5 days. At the same time, there was a drop in recorded infections. According to the ONS Coronavirus Infection Survey data, peak positivity for Omicron BA.1 variant ranged from 5 to 10% across English regions (5).

At the end of March 2022 (the period just before the end of UTO), the percentage of people who had taken an LFD test in the last 2 weeks dropped to 40% (6) from the peak of 59% in January 2022. This drop may have reflected the increasing numbers of people having become fully vaccinated against the virus by that point ^{[footnote 4]} and this may have reduced a sense of personal risk among some, which was highlighted as a barrier to testing in the qualitative research by Kantar Public.

It will also have reflected that in late February the government began to make announcements about the ‘Living with COVID-19’ strategy and plans which were set to take effect in April, sending an early and strong message about the reduced risk of catching COVID-19.

As the end of the UTO took effect in April 2022, decreasing proportions of the public reported they had used a test in the last 2 weeks, and this has settled to about 1 in 10 (9%) in February 2023. Figure 6 translates testing rates into volumes of tests taken and estimates that 4.2 million adults took a test based on perceptions data in the run up to the 2 weeks of 31 January to 13 February 2023 (7), compared to the peak of 26.4 million adults during winter 2021 to 2022.

Figure 6. Estimated LFD test usage, UKHSA PPT data

The source for figure 6 is from Basis Research drawing on a series of studies such as the Interim COVID-19 survey, LFD demand and fulfilment survey, COVID-19 pilot, UKHSA PPT. It is based on the questions ‘When did you last take a COVID-19 test?’ and ‘In the last 2 weeks, how many rapid lateral flow tests, if any, have you personally taken in total?’. It draws on a sample of approximately 1,000 adults across England.

The UKHSA tracker survey data was also used to help understand the average number of tests taken by an individual in the last 2 weeks. This rose to 3.7 tests (or 91.2 million tests across the population) during the Omicron winter peak, but it has since dropped to 2 tests (translating to 8.3 million tests across the population) in February 2023.

Operational data on LFD kits despatched to all settings and the general population in England show how delivery levels fluctuated throughout the period of UTO, but that these reached record levels around the time of winter 2021 to 2022, tipping a monthly high of 277,864,351 for January 2022 (8). The week commencing 10 January was the highest ever week for distribution, coinciding with Omicron and people needing to replenish test kits.

While millions of people had ordered and used tests during the period of the UTO, and especially during the time of Omicron, there is little to suggest in the public perceptions data that many ordered excessively to stock up on tests. The first asymptomatic testing study in April to May 2021 indicated that 44% of the population had unused LFD tests at home, but that more than half of this group had less than 7 tests.

Fast forward to the ‘LFD ordering’ survey from the VOTC programme conducted by UKHSA in February 2023 among people who ordered an LFD in January 2023, the average number of tests in hand was 6.1, again equating to less than one full pack. Figure 7 below shows a simple breakdown of how many tests people reported they had from that survey.

Figure 7. Spare LFD tests at home, UKHSA VOTC data

The source for figure 7 is from Basis Research drawing on a Qualtrics testing journey survey. It is based on the question ‘How many unused rapid lateral flow tests do you have in your home (each box contains 7 tests)?’. It draws on a sample of 14,083 people who had spare or unused LFDs at home.

In the same survey, the vast majority of people who ordered free tests (89%) in January 2023 had already taken a test from that kit. In general, people were using stock as they received it (9).

It appears that many of the free LFD tests sent out by UKHSA operational teams have been used, and that evidence of excessive over-supply of LFD tests (and therefore wastage of tests) is weak.

Analysis of who ordered LFD tests in January 2023 indicates this was higher among those working in the NHS or social care, or those who had regular contact with the virus through work or were asked to test by their employer. Ordering of free LFD tests was also more likely among those in high-risk groups (for example, immunosuppressed), some of whom will have been wanting to access anti-viral treatments. This reflected the policy at that time that such groups were eligible for free LFD tests.

Figure 8 below shows that 16% of the population reported they attempted to order a free LFD test in the 2 weeks running up to 16 January 2023, rising to 60% of those who are paid carers and 35% of those who are frontline NHS or social care workers. Only a small proportion of people attempting to order LFD tests from official sources such as 119 and the GOV.UK website in January 2023, could be described as non-eligible for free tests. It is worth stating not everyone who attempted to order would have successfully received a pack. Official records of actual orders made show that during this period, UKHSA received 105,000 to 157,000 orders per week.

Figure 8. Individuals more likely to order LFD tests

The source for figure 8 is from Basis Research drawing on the UKHSA PPT, wave 10. It is based on the question ‘Have you tried to order / obtain any rapid lateral flow tests from the following sources in the last 2 weeks?’. It draws on a sample of approximately 1,000 adults across England with subgroups consisting of a minimum of 55 respondents.

What were the reasons for testing and who was testing?

The reasons for testing have changed over time and have been plotted in figure 9 below. To make the chart simpler a larger number of reasons have been grouped into fewer categories:

• symptoms: this is comprised of the response ‘I thought I had symptoms and wanted to check if it was COVID-19’
• net ‘testing to enable’: this is comprised of responses ‘So that I could meet up with friends or family’, ‘I was planning to attend or have been to an event’
• net ‘testing because I was asked to’: this is comprised of responses ‘I was asked to test by my employer’ and ‘I was asked to test by my school, college or university’
• testing due to COVID-19 contact: this is comprised of responses “I had been in contact with somebody who tested positive” and “I may have regular contact with virus through work”

A survey conducted in May 2021 (10) showed only 7% carried out symptomatic LFD testing during that period and this reflected advice that LFDs were provided in order to carry out regular asymptomatic testing, that is, precautionary checking. This was at a time of the new Delta variant being discovered in the UK.

There has since been an increase in the proportion of the public reporting they tested because they experienced suspected symptoms, settling at 34% of those testing in the last 2 weeks in February 2023. This partly reflects official advice changing to use LFD tests for symptomatic testing.

As the risk of viral infection has declined and people learned to live with COVID-19, they increasingly used LFDs to meet a variety of other non-functional needs which, in February 2023, included ‘for general reassurance’ or ‘peace of mind’ (35%), and because it felt like the right thing to do (20%). An additional 20% tested when they thought they had contact with a suspected case (20%). Whilst these are not use cases outlined in guidance it is important to note that the public continued to test in the way they felt appropriate, and this has implications on existing measures such as LFD test result registrations.

Figure 9. Reasons for taking an LFD test, UKHSA PPT data

The source for figure 9 is from Basis Research drawing from a series of studies such as the Interim COVID-19 survey, COVID-19 pilot, UKHSA PPT. The questions the data are based on, are variations of ‘Thinking about the most recent rapid lateral flow test that you took, why did you take this test?’

The figure draws on a sample of adults in England who have taken an LFD in the last 2 weeks, with a minimum of 94 per wave.

Another main reason for testing, was to enable people to confidently go about their daily lives such as meeting people and attending events, known as ‘testing to enable’. At the height of the Omicron variant wave in December 2021 to January 2022, there was a peak among those testing who said they were doing so to enable them to go about their business and socially mix (50%).

The qualitative research conducted at the time showed that people did not want another Christmas disrupted by COVID-19. This also coincided with the government actively encouraging daily testing for close contacts to reduce the need for self-isolation.

While the guidance for using LFD tests did not include testing to ‘enable’ social mixing, testing in this way could help to reduce the risk of spread, and indeed in February 2023 (16%), a notable proportion still said they tested for this very reason.

Looking at other reasons for testing, in May 2021, 2 in 5 took an LFD (44%) because they were asked to. In February 2023, around one in 8 reported they were asked to test (13%) by their work or educational establishment. The analysis shows that these reasons were more commonly mentioned by individuals working in settings where there were people vulnerable to COVID-19 such as in the health service and in social care.

In terms of who has been testing, since the beginning of the pandemic, the focus was on priority groups and those who needed to be tested in order to work and this has carried through to the present day. A paper written in the early days of the UTO indicated that increased uptake of LFD tests was associated with a number of characteristics and circumstances such as being female, being a student, and working in a sector that adopted lateral flow testing (health, social care, education, childcare and travel) (11).

The UKHSA public perceptions tracking data indicates that with the withdrawal of the UTO, changes in testing guidance and the reduced risk of infection, fewer people tested.

Figure 10 below shows LFD testing prevalence over time by free LFD test eligibility status. It shows that among the general population, testing was at 9% in the last 2 weeks in February 2023, but that the rate was much higher among health workers, paid carers and individuals with health conditions that make them vulnerable to COVID-19, such as those who are immunosuppressed (IM). These are groups more likely to be eligible for free testing.

Figure 10. Individuals more likely to take an LFD test, UKHSA data (various)

The source for figure 10 is from Basis Research drawing from a series of studies such as the Interim COVID-19 survey, LFD demand and fulfilment survey, COVID-19 pilot and UKHSA PPT. It is based on the question ‘When did you last take a COVID-19 test?’. It draws on a sample of approximately 1,000 adults across England per wave with the following subsamples: All eligible for free LFDs (approximately 200); all paid carers (approximately 60); immunosuppressed (approximately 100); frontline healthcare workers (approximately 80); all not eligible for free tests (approximately 800).

Main findings for Question 2

What did people claim they did after they took an LFD test?

Registering test results

Individuals who had ordered free LFD tests were asked to report the results via official channels such as GOV.UK, 119 and previously NHSTT.

Figure 11 below plots self-reported LFD test registration rates taken from various NHSTT/UKHSA opinion surveys. It is evident that not everybody followed advice to register. At its peak during winter 2021 to 2022, the proportion of people who reported in the surveys that they had taken an LFD test and registered it was 49%, meaning half did not report their results at the peak.

Figure 11. Self-reported LFD test registration over time, UKHSA perceptions data (various)

The source for figure 11 is from Basis Research drawing from a series of studies such as the Interim COVID-19 survey, COVID-19 pilot and the UKHSA PPT. It is based on the question ‘Which, if any, of the following did you do once you’d taken your most recent rapid lateral flow test?’and draws on a sample of approximately 800 adults across England per wave who have taken an LFD and remember when they did.

Over time, as people have learned to live with COVID-19, and as the risk of viral infection and concern about COVID-19 has declined, the registering of LFD results through official channels dropped further. Additionally, since the ‘Living with COVID-19’ strategy and plan started in April 2022, registration of LFD tests was geared towards those testing for work such as NHS and care staff or testing for access to antiviral treatments.

In February 2023, the claimed rate of registration in the surveys settled at 32% of those who took a test. In terms of actual tests on record, according to official registration data 414,238 (12) LFD tests were registered in England during February 2023.

Qualitative research conducted by Kantar Public (13) for UKHSA showed that when it came to reporting, people fell into 3 types. The first type of interest was ‘compliant reporters’. They were individuals who registered all results, irrespective of whether they were positive or negative and who:

• understood reporting as a part of the testing process
• found it easy to do
• felt motivated to report all results
• believed it was the right thing to do

These ‘compliant reporters’ tended to be people working in high-risk occupations or were more likely than average to be students attending their place of education. Importantly, these groups were forming a habit of testing and reporting.

Figure 12 below shows the rate of registering LFD results for the total population as represented by the fine dashed line. From the end of the UTO, the perceptions surveys tracked who was registering and the data shows people eligible for free LFD tests were more likely than those who were not, to do so (42% versus 29% in February 2023).

Looking more closely at that February 2023 data point, the analysis confirms that many of the same groups carried through with their reporting habits; these being key workers and individuals vulnerable to COVID-19 such as those who were immunosuppressed. Again, these were individuals who have got into the routine of testing and registering as one process and who had a strong motivation to register.

Figure 12. Individuals more likely to register an LFD result, UKHSA PPT data

The source of figure 12 is from Basis Research drawing from a series of studies such as the Interim COVID-19 survey, COVID-19 pilot, UKHSA public perceptions pracker. It is based on the question ‘Which, if any, of the following did you do once you’d taken your most recent rapid lateral flow test?’. It draws on a sample of approximately 700 adults across England who have taken an LFD test per wave with the following subsamples: All eligible for free LFDs (approximately 170); all paid carers (approximately 50); immunosuppressed (approximately 90); frontline healthcare workers (approximately 70); all not eligible for free LFD tests (approximately 600).

It is important to know what motivated people to take an LFD test in the first place, in order to understand what they did in relation to registering the result. For instance, where tests were taken to provide reassurance, receiving a result will have serviced that immediate need, and the individual would have been less likely to see a powerful need to register a result. Whereas those who were compelled to test by work or by a medical need were more likely to proceed to the registering stage.

Figure 13 below, based on perceptions tracker data collated in February 2023, shows that the rate of registering went up from 32% among all using an LFD test, to 42% of those who were told to test, but dropped to 25% of those who thought they had symptoms and 24% of those who just wanted peace of mind.

Figure 13. Registering an LFD result by reason for taking a test, UKHSA PPT data

The source of data for figure 13 is from Basis Research drawing on the UKHSA PPT, waves 10 to 12 (3 January to 13 February 2023). The question it is based on is ‘You mentioned that your last lateral flow test was positive/negative. Which, if any, of the following did you do once you’d taken your most recent rapid lateral flow test?’. The data is drawn from a sample of 2,319 adults across England who had taken a test, with the following subgroups: Those checking symptoms or having had contact with a positive case (861); those testing to enable them to go out and have social contact (309); those testing because they were asked to (105); those testing due to contact with COVID-19 (294); those testing for peace of mind (527); those testing because they felt it was the right thing to do (388).

The main reasons for not registering an LFD test result have changed a little over the time NHSTT/UKHSA has been running opinion surveys and are shown in a timeline chart below in figure 14.

The proportions who reported they did not feel the need to register or because their result was negative has remained broadly constant in the period shown. There was a small uplift in the proportion who felt it was no longer a requirement to register results (29%), which would have been true for most unless they were individuals needing to test to access antiviral treatments.

While lack of knowledge appears to be low and constant in figure 13, it is worth noting that not knowing how to register a result was once the top reason given. In an asymptomatic testing study conducted in the early days of the UTO (14), lack of knowledge was mentioned by 38% of those not registering a test result to NHSTT.

Figure 14. Reasons for not registering an LFD test taken over time, UKHSA PPT data

The source for figure 14 is from Basis Research taken from the UKHSA PPT and based on the question ‘Why didn’t you report the result of your most recent rapid lateral flow test via any official channels (for example, the GOV.UK website or 119)?’. The data is drawn from a sample of approximately 470 adults across England who didn’t register their results via official channels.

While it is tempting to feel pessimistic about the under-registration of LFD test results and the reasons for this, it is worth noting that only a very small proportion of people who thought they had COVID-19 or symptoms in February 2023 (5%) said they did not test at all. There is more discussion of the non-compliant reporters in the next chapter.

Furthermore, the perceptions data suggests the millions of tests that were despatched over the pandemic were being used by people to satisfy a number of needs including those who genuinely thought they had symptoms, thought they had come into contact with the virus, plus those who wanted reassurance, thought it was the right thing to do, wanted to mix socially, or were told to test.

Additionally, as discussed below, most people also acted on guidance to stay at home even if they did not report a positive test result.

Staying at home and informing others of test results

Irrespective of whether they registered a test through official channels or not, most people took accountability for their own risks and actions by staying at home, and this appears to have been relatively stable over time. Figure 15 below presents data from the UKHSA tracker surveys which suggests most people stayed at home if they thought they had COVID-19: 92% among those who officially registered a result, and 87% among those who did not register a result.

Furthermore, the majority of those who tested positive continued taking tests until they received a negative result: 87% among those who registered a positive result and 65% among those who did not.

Figure 15. Staying at home and testing until negative by registration status, UKHSA PPT data

The source for figure 15 is from Basis Research taken from the UKHSA PPT and is based on 2 questions. The first is ‘Please think about the last time you (tested positive for/thought you had) COVID-19. Which of the following best describes what you did?’ and ‘You mentioned that your last lateral flow test was positive/negative. Which, if any, of the following did you do once you’d taken your most recent rapid lateral flow test?’ The data is drawn from 2 contrasting sub-samples of adults across England. The first is those who when they last tested positive did not report result to anyone (the base sizes were 96 and 88), and those who when they last tested positive officially registered their results (the base sizes were 154 and 133).

Figure 16 below plots perceptions data over time, and suggests that over a long period, most people irrespective of their registering behaviour stayed at home once they tested positive.

By contrast, testing until getting a negative result seems to have differed by registration status at different moments in time and the lines do not follow those who stayed at home or were isolating. Nevertheless, majorities reported in the surveys that they were compliant with safe behaviours.

Figure 16. Staying at home and testing until negative over time by registration status, UKHSA PPT data

The source for figure 16 is from Basis Research taken from the PPT based on 2 questions ‘Please think about the last time you (tested positive for/thought you had) COVID-19. Which of the following best describes what you did?’ and ‘You mentioned that your last lateral flow test was positive/negative. Which, if any, of the following did you do once you’d taken your most recent rapid lateral flow test?’ The data is drawn from 2 contrasting sub-samples of adults across England who who when they last tested positive did not report result to anyone (with bases sizes approximately 100 per wave) and those who when they last tested positive officially registered their results (with bases approximately 160 per wave).

The survey data indicates that people who tested positive were warning others outside of the official registration channels such as other householders, friends and family and employers of the result – irrespective of whether they officially registered it.

Figure 17 below also shows that for some time now, only 1 in 10 of those testing positive reported they did not register or report their result to anyone, settling at 7% in February 2023.

Figure 17. Reporting to non-official sources over time, UKHSA PPT data

The source for figure 17 is from Basis Research drawing from a series of studies such as the Interim COVID-19 survey, COVID-19 pilot, and the UKHSA PPT based on the question ‘Which, if any, of the following did you do once you’d taken your most recent rapid lateral flow test?’. The data is drawn from samples of adults across England who have taken an LFD and the result was positive (with the base approximately 150 per wave).

Main findings for Question 3

To what extent does official registering of results reflect testing levels?

Official test registration figures below show (15) that only a minority of tests despatched were ever officially registered which could suggest that testing rates were extremely low.

The NHSTT/UKHSA operational data from November 2021 to February 2023 is plotted below in figure 18 to show the volume of LFD tests officially despatched versus officially registered.

The gap between despatches and registration was pronounced in the winter of December 2021 to January 2022. Even taking into account that usage lags behind despatch, as tests go through the supply chain to consumers, and as consumers work through their pack of 7 tests, the gap was considerable.

The gap in the data from official sources between LFD despatches and tests being registered might suggest that tests were over-supplied over a long period of time. However, estimates of how many tests were taken based on perceptions data on LFD testing prevalence helps to show that at points during that December 2021 to January 2022 peak, the number of tests taken matched more closely to despatch data than to the numbers registered to 119 or GOV.UK.

Please note in figure 18 that the equalised fortnightly surveys dates are shown underneath the 2-week rolling despatch and registration periods. They do not perfectly align partly because of the different fieldwork periods and the survey reference period which was ‘in the previous 2 weeks’ of the survey being completed.

Figure 18. Official LFD despatch versus registration of LFD tests over time, UKHSA test management operational data

The source of the perceptions data comes from Basis Research taken from a series of surveys such as the Interim COVID-19 survey, LFD demand and fulfilment survey, COVID-19 pilot and the UKHSA PPT, based on the questions ‘When did you last take a COVID-19 test? and ‘In the last 2 weeks, how many rapid lateral flow tests, if any, have you personally taken in total?’. The data is drawn from samples of approximately 1,000 adults across England per wave.

The official data comes from GOV.UK and LFD distribution records held by UKHSA.

An evaluation of an intervention to encourage the daily testing of close contacts among those who were fully vaccinated during winter 2021 to 2022, noted the observed gap in ordering, testing prevalence and result registration rates. That study showed the number of LFDs taken by the general population during the intervention period was likely to have been at least 6 times greater than the number of results reported to NHSTT ^{[footnote 5]}.

The gap looks to have widened as fewer people have felt compelled to register tests over time. Earlier in figure 6, the estimated volume of tests taken based on the self-report survey data for a year later – the week commencing 13 December 2022 to 2 January 2023 – was in the region of 13.8 million tests. The number of LFDs reported to official sources such as GOV.UK or 119 from the week beginning 9 January to the week beginning 30 January was 425,712.

A wave of tracking data from August 2022 also suggests that tests bought from other sources like chemists, and LFD tests ordered from an earlier period, were being used in addition to those ordered free from official sources. These factors should be considered when using self-reported LFD testing estimates.

As with any public opinion surveys, there are limitations to self-reporting which can lead to under- or over-estimates of certain behaviours such as testing prevalence. In this case, self-reported estimates of testing rates were higher than those estimated by official agencies. While the degree of under- or over-estimation exists in the perceptions data cannot be accurately measured here, it is clear that official registration rates are an underestimate of actual testing that went on during the UTO period.

Figure 19 below shows claimed ordering of free LFD tests, claimed LFD test prevalence and claimed registration rates as a percentage of the total population. This is entirely self-reported data taken from the perception surveys and does not compare against official operational data shown in figure 18 above.

The data indicates a consistently low level of the population claimed to officially register their test results between December 2021 and January 2023 as represented by the bottom dashed line of the chart. However, when looking at the top line, which considers a broader range of people informed about the test result (shared householders, family, work and so on), there was a higher level of ‘informing others’ during this period. These 2 lines remained relatively constant when compared to claimed levels of ordering from official sources, and LFD testing prevalence rates which dropped dramatically after the UTO stopped.

Figure 19. PPT tracker data comparing claimed testing against registering of test results

The source for figure 19 is from Basis Research taken from a series of surveys including the Interim COVID-19 survey, COVID-19 pilot, and the UKHSA PPT. It is based on 3 connected questions which are: ‘Where did you try to order or obtain these rapid lateral flow test kits from?’; ‘Have you tried to order or obtain any rapid lateral flow tests in the last 2 weeks from anywhere else (excluding GOV.UK)?’; and ‘Have you tried to order or obtain any rapid lateral flow tests from the following sources in the last 2 weeks?’

The data is drawn from samples of adults across England who tested and ordered tests from any channel in the last 2 weeks (with a base of approximately 420), those who had taken an LFD in the last 2 weeks (with a base of approximately 500), those who had registered most recent test through official channels (with a base ofapproximately 160), and those who reported their most recent test through official or unofficial channels (with a base of approximately 550).

The public perceptions work is helpful in understanding why, despite testing, people did not register their results officially. As discussed in the previous chapter, many people used and continue to use their test kits to give reassurance, protect others and to enable them to go about their daily lives, which is not contingent on registering a result.

The reporting gap can also be explained by the test result which is examined in more detail below.

Bias towards registering positive tests

As the timeline chart in figure 20 illustrates, those who tested positive have always been more likely to claim they registered their LFD result through an official channel. In February 2023, claimed registration had settled at 44% among those testing positive compared to 29% of those who tested negative.

Figure 20. LFD test registered over time by test result, UKHSA data (various)

The source for figure 20 is from Basis Research taken from a series of surveys including theInterim COVID-19 survey, COVID-19 pilot, the UKHSA PPT, and is based on the question ‘Which, if any, of the following did you do once you’d taken your most recent rapid lateral flow test?’. The data was drawn from a sample of approximately 700 adults across England per wave, who have taken an LFD breaking down into sub-samples of those who have tested positive or negative (with bases of approximately 150 or 550 respectively per wave).

Unless registering was habitual (as seen in the ‘compliant reporters’ group), people will not have always registered every positive test result and it is reasonable to assume these were only a proportion of all positive test results people obtained. As discussed earlier, there was a decreased frequency of testing over shorter confinement periods (after April 2022, the guidance specified a 5-day isolation period) and this will have also contributed towards fewer positive results being registered.

Default to not report negative tests

Individuals who tested negative have always been less likely than those who tested positive to claim they registered their test result, and figure 20 above shows that self-reported registration of negative LFD results through most official channels declined steadily after universal access to free tests stopped.

Research by BMG (16) conducted a few months after the introduction of the UTO in September 2021, pointed to 2 in 5 of those not reporting their result, thinking it is not important to report a negative LFD test result. The research also surfaced a low explicit knowledge of why negative results should be reported and a lack of awareness of the expectation to report a negative result. Furthermore, this claimed lack of knowledge was higher among ethnic minorities, people who lived in the most deprived areas of the country and among students. This is useful to note for future communication on registering all results and should be considered when interpreting who may be represented in official test registration figures.

‘Semi compliant reporters’, according to the qualitative research by Kantar Public (17) were also relevant to explaining the difference in registration by test result. They were individuals who reported positive results but commonly failed or forgot to report negative ones. Kantar found that if they had realised their immediate personal benefit through testing such as they were able to socially mix, they often forgot to officially register their negative result. Equally, they may have taken easier actions (for example, reporting to work or college) which then took precedence over official registering.

The third group identified by Kantar known as ‘non-compliant reporters’ lacked any motivation to report negative tests as they could not understand the benefit of doing so, personally or for health protection systems, and sometimes felt inconvenienced or burdened by this stage of the testing process which they may have regarded as an unnecessary step.

Knowing about these ‘reporting types’ was useful in helping UKHSA to develop communication messaging to explain the importance of registering all results and to encourage people to report results although these may not have gone far enough to address that non-reporting often arose from a lack of alignment between the motivation for doing a test and for reporting the test result.

Tests obtained from other sources such as supermarkets

Another thing to consider about the official registration data is that a proportion of those testing will have bought their LFD tests from supermarkets, chemists and others operating in the private market.

There has not been a requirement to register the results from ‘privately’ purchased LFD tests via official channels. Figure 21 below shows perceptions survey data from January 2023 that indicates about 10% of the sample claimed to have bought and were using tests from the private market.

The data suggests individuals buying from the private market tended to be younger users of LFDs and were more likely to be individuals from minority ethnic groups. While the sample sizes were small for January 2023, this is useful context to consider when reflecting on who is represented in the official registration data.

Figure 21. Individuals more likely to order and LFD from sources other than GOV.UK and 119, UKHSA PPT data

The source for figure 21 is from Basis Research, taken from the UKHSA PPT, Wave 10. It is based on the question ‘Have you tried to order or obtain any rapid lateral flow tests from the following sources in the last 2 weeks?’ and the data is drawn from a sample of approximately 1,000 adults across England and shows subgroups with a minimum base of 30.

Figure 22 examines the reasons for ordering an LFD test by the source of the test. Individuals ordering from the ‘private market’ were more likely than those ordering free tests to say they wanted to test because of COVID-19 symptoms which they wanted to check, and to obtain tests for peace of mind rather than because they are required to do so. Again, this serves to highlight the different motivations for testing among those registering results to official channels.

Figure 22. Reason for ordering LFD tests by source, UKHSA data

The source for figure 22 is from Basis Research taken from the UKHSA PPT, based on the questions ‘Thinking about the most recent rapid lateral flow test that you took, why did you take that test?’ and ‘Have you tried to order or obtain any rapid lateral flow tests from the following sources in the last 2 weeks?’. The data is drawn from samples of adults across England who have taken an LFD in the last 2 weeks and attempted to order via official channels or other sources (where the bases are 221 and 138 respectively).

In conclusion, the official test registrations do not entirely reflect the true level of LFD testing. Many people were testing throughout the period of UTO but chose not to register their results to official sources because they were not motivated to do so.

The official test result data consequently reflects that certain groups were and are required to register their tests or need to (for example, in order to obtain anti-viral treatments) and does not reflect the totality of people who are testing for symptoms, reassurance and peace of mind.

As had been the case for a long time, the official data will reflect a higher proportion of positive than negative results that are occurring.

Also, the official test registration data will not include the 10% obtaining their tests from elsewhere, who were more motivated to test for reassurance purposes rather than because they needed to test and therefore compelled to register a result.

The evidence points towards the vast majority of people who thought they had COVID-19 were testing for it during the pandemic.

The data also suggest that people’s actions were largely compliant with guidance to stay at home or until they tested negative. What is encouraging is that in February 2023, when there were very few rules about what to do when one tests positive, most people appeared to remain at home to stop the spread of the virus and were informing people close to them of their test status.

Limitations of the perceptions research

The sample sizes used here for the analysis are very large and enabled the tracking of trends over time. They also allow for subgroup analysis, for example, comparing those eligible for free lateral flow device tests versus those not eligible. However, participants were recruited to the tracker perceptions surveys and various ad hoc surveys using quota sampling methods based on the latest ONS data, not random pre-selected sampling. In some cases, such as the LFD Ordering Survey (February 2023), data is unweighted and cannot be said to be representative of all those ordering free tests.

In addition to sampling factors and self-selection bias, there may be mode effects to consider which means it is not possible to be certain that the behaviour and beliefs of those completing online surveys are representative of those of the general population or specific target groups like people ordering free tests.

Another limitation is that data was self-reported and may be influenced by social desirability biases, possibly leading to an over-estimation of positive behaviours such as conducting an LFD test and an under-estimation of less positive behaviours such as social mixing during a period of self-isolation.

Sometimes, studies such as these can suffer from recall bias, but this is not likely to be a major consideration as the reference period for each UKHSA tracker survey wave was the previous 2 weeks.

The patterns revealed by the data analysis are not only informative about who was ordering, testing and registering LFD tests, but appear to be in line with earlier studies such as that by Dr Louise Smith and colleagues drawing on CORSAIR data, suggesting a consistency across similar perceptions studies.

The phrasing of some questions and response items may have changed over time or be slightly mismatched between different data sets, making direct comparisons difficult. For instance, in figure 2, the DHSC LFD testing prevalence data is based on tests taken in the last week, whereas UKHSA/NHSTT data is based on tests taken in the last 2 weeks. In figure 18, the dates of the official weekly figures for LFD dispatches and LFD test registrations do not match exactly onto the fortnightly perception survey fieldwork dates, and the survey reference periods used.

Information sources

Details of the studies referenced in this report, are listed in chronological order below:

DHSC and CO PPT survey

The report draws on data that was collated before the introduction of the UTO in April 2021, from a UK nationally representative cross sectional tracking study managed by the DHSC and CO conducted by BMG and then Savanta.

The study was initiated in January 2020 and consisted of weekly or fortnightly online surveys conducted among samples of 2,000 people aged 16 and over. The data quoted in figure 2 was collated between March 2021 and March 2022.

At the time of publication of this report, the full findings from this tracking study had not been published but selected results can be found at The CORSAIR study: Emergency Preparedness and Response from the Health Protection Research Unit.

NHSTT/UKHSA voice surveys

The voice surveys were a continuous experience feedback programme that captured views from the general public at the main stages of the test, trace and isolate journey. The test studies focused on PCR testing at the beginning of the pandemic, and then brought in LFD testing. One of the earliest LFD testing studies from this programme this report draws on is the asymptomatic testing study described below:

Voice: asymptomatic testing study

NHSTT started looking at attitudes and behaviour in relation to LFD testing specifically, in May 2021 with a study of asymptomatic testing. This was comprised of 2 connected surveys conducted by BMG and also drew on complementary qualitative research by Discovery Research and Kantar Public.

Wave 1

Fieldwork took place between 30 April and 10 May 2021 and was conducted using a mix of online and computer assisted telephone interviewing (CATI) methods. The core sample was nationally representative of the adult population in England aged 16 and over and additional targeted boost samples were incorporated to allow better analysis of various groups of interest such as younger age groups (16 to 29), multi-generational households, ethnic minorities, areas of higher deprivation and the offline population. In total, 2,904 interviews were completed.

Wave 2

Fieldwork took place between 9 August and 13 September 2021. Again, the survey was conducted using a mix of online and CATI methods among a core sample who were nationally representative of the adult population aged 16 and over in England and included targeted boost samples to allow better analysis of various groups. In total, 2,359 interviews were completed.

Qualitative research study 1: Kantar Public

This study was carried out for NHSTT in September 2021 by Kantar Public to understand better how to encourage asymptomatic testing, focusing on a segment known to be supportive of testing in principal but which faced barriers to testing. The research aimed to look more deeply at the motivators and barriers to testing and registering and consisted of 17 virtual in-depth interviews and 8 virtual group discussions.

Qualitative research study 2: discovery research

Fieldwork was undertaken in October 2021 by discovery research which comprised 4 group discussions (one conducted face to face and 3 virtual) to understand what messages resonated to encourage people to self-report their LFD test results.

Voice: LFD ordering study

Starting in November 2022, new online survey streams within the voice programme were carried out among those ordering free LFD tests to understand their experience of the ordering service. Some of the experience survey data among people ordering LFD tests is referenced in this report as this data provides an excellent source of information about the self-reported experience of people ordering LFD kits given the very large sample size.

The most recent ordering survey, conducted by Qualtrics, was emailed to people shortly after they placed their order for an LFD kit and the selection window was any order placed in January 2023, which amounted to 244,568 orders (excluding bulk orders). In total, there were 23,383 responses collated between 7 to 23 February 2023, which gave an up-to-date picture of who was ordering LFD test kits and why.

UKHSA interim COVID-19 surveys

UKHSA ran a tracker survey at various intervals between December 2021 and May 2022. The survey had 7 waves. All waves involved a nationally representative online survey with 1,000 people across England. Weights were applied to age and gender, region and social grade to bring the sample more in line with the profile of the English adult population.

UKHSA LFD demand and fulfilment survey

Borrowing many of the questions from the interim COVID-19 surveys, the LFD demand and fulfilment survey was conducted in February 2022. It was a nationally representative online survey with 1,000 people in England with weights applied to age and gender, and region.

UKHSA PPT pilot

Using some questions from the interim COVID-19 tracker, a new questionnaire was developed and tested via an online survey in June 2022. The new survey was designed to test the questions that would be included in what would become the core PPT tracker below. This pilot study was a nationally representative online survey with 1,500 people in England with weights applied to age and gender, region and social grade.

UKHSA PPT

UKHSA has been running a regular PPT with Basis Research which started in August 2022. It took the form of fortnightly online surveys with a nationally representative sample of the adult population aged 16 and over in England. From April 2023, the tracker ran on a monthly cycle. This report draws on tracker data running up to wave 12 which covered the 2-week period of 31 January to 13 February 2023.

At the time of publication of this report, the findings from the PPT have not been published elsewhere other than selected data in the report for the evaluation of daily testing for contacts of COVID-19 cases, December 2022.

LFD testing management information

This report also draws on LFD testing management information from NHSTT and UKHSA operational systems. It has been used in this report to show the pattern of LFD despatches and LFD test result registration in England during the period February 2021 to February 2023. Much of this data can be found by scrolling to the relevant time point at Weekly statistics for NHSTT (England): 2 to 15 June 2022.

Personnel

Project lead: Lee Chan

Public health and clinical oversight: Tom Fowler, Sarah Tunkel, Joanna Cole-Hamilton, Raghavendran Kulasegaran Shylini

Behavioural Science and Insight: Richard Amlôt, Helena Wehling

Specialist policy advice: Robert Jenkins

Operational data and UKHSA statistics: Charmagne Campbell, Callum Edgeley, Carl Masters

References

1. Alene M, Yismaw L, Assemie MA, Ketema DB, Mengist B, Kassie B and others. ‘Magnitude of asymptomatic COVID-19 cases throughout the course of infection: a systematic review and meta-analysis’ PLoS One 2021: 16:e0249090

2. DHSC/CO COVID-19 tracker by Savanta, 17 to 19 May 2021. The full findings of this tracking study are not published but selected results can be found at the CORSAIR website.

3. Basis Research public perceptions tracker 19 December 2021 to 4 January 2022

4. Discovery Research conducted 4 focus groups in October 2022

5. COVID-19 latest insights (Office for National Statistics)

6. Basis Research PPT 30 March to April 4, 2022

7. Basis Research PPT 31 January to 13 February 2023

8. NHSTT lateral flow tests dispatched between September 2020 and February 2022, by use case, published 23 June 2022: Weekly statistics for NHS Test and Trace (England): 2 to 15 June 2022

9. Qualtrics voice of the customer: test ordering survey 7 to 23 February 2023

10. BMG asymptomatic testing survey (Wave 1) for UKHSA, April to May 2021

11. Louise E Smith, Henry WW Potts, Richard Amlot, Nicola T Frear, Susan Michie, G James Rubin. ‘Who is engaging with lateral flow testing for COVID-19 in the UK?’ BMJ Open 2021: 058060, 10 February 2022

12. UKHSA lateral flow tests registration data. LFD tests registered during week 6 February to week 27 February 2023

13. Kantar Public, qualitative study to understand better how to encourage asymptomatic testing, September 2021

14. BMG asymptomatic testing survey (Wave 2) for UKHSA, August to September 2021

15. NHSTT and UKHSA lateral flow test registration data

16. BMG asymptomatic testing survey (Wave 2) for UKHSA, August to September 2021

17. Kantar Public, qualitative study to understand better how to encourage asymptomatic testing, September 2021

Footnotes

1. Asymptomatic testing is testing for those without COVID-19 symptoms, which allows for the identification of more people with transmissible virus who do not know they are infectious. ↩

2. Daily testing of close contacts (DTCC) applied to close contacts who were not legally required to self-isolate and encouraged this group to take daily lateral flow device tests every day for 7 days or until 10 days since their last contact with the person who tested positive for COVID-19. ↩

3. The DHSC/CO data was collated by BMG/Savanta and the data shown is based on approximately 1,700 adults per wave across England. The NHSTT/UKHSA data was collated by Basis across a number of surveys such as the interim COVID-19 survey, LFD Demand and Fulfilment Survey, COVID-19 Pilot, PPT and is based on approximately 1,000 adults in England per wave. Fieldwork dates across the DHSC and NHSTT and UKHSA data do not match exactly but are matched as closely as possible and are shown. ↩

4. DHSC vaccine monitoring statistics stated the number of fully vaccinated (had 3 doses) people in England as of 19 December 2021 was just over 24 million. By 26 February 2023 this had risen to almost 34 million according to Simple summary England – Coronavirus in the UK. ↩

5. The Test and Trace service closed 24 February 2022, ending the tracing service. Tests are now reported to UKHSA via the GOV.UK website, and by ringing 119. ↩