Durham University students’ experiences of asymptomatic COVID-19 testing: a qualitative study

ObjectivesTo evaluate the asymptomatic coronavirus testing programme at Durham University by exploring students’ barriers and facilitators to taking part and provide recommendations to improve the programme.DesignQualitative interviews.SettingOnline.Participants30 students enrolled at Durham University were interviewed in March 2021.Main outcome measuresAttitudes towards testing, experiences of testing and barriers and facilitators to engaging in testing at Durham University.ResultsKey motivations for testing included protecting oneself and others and accessing facilities and events. The process of booking, accessing and doing a test was mostly easy and convenient, although some may prefer home testing. There were concerns about the accuracy of tests and the implications of a positive result. Some highlighted they might be less likely to engage in testing if vaccinated. A negative test result provided confidence to engage in their daily activities, while encouraging some to socialise more.ConclusionsThe findings show that the testing programme at Durham University is convenient and well organised, with testing as a potential requirement to access social events, and self-isolation support being key contributor to uptake. These findings provide insights into young adults’ attitudes towards testing and can inform testing programmes in other universities and settings with asymptomatic testing programmes.

How do we engage people in testing for COVID-19? A rapid qualitative evaluation of a testing programme in schools, GP surgeries and a university

Background The UK Scientific Advisory Group for Emergencies (SAGE) emphasises the need for high levels of engagement with communities and individuals to ensure the effectiveness of any COVID-19 testing programme. A novel pilot health surveillance programme to assess the feasibility of weekly community RT-LAMP testing for the SARS-CoV-2 virus using saliva samples collected at home was developed and piloted by the University of Southampton and Southampton City Council. Methods Rapid qualitative evaluation was conducted to explore experiences of those who took part in the programme, of those who declined and of those in the educational and healthcare organisations involved in the pilot testing who were responsible for roll-out. This included 77 interviews and 20 focus groups with 223 staff, students, pupils and household members from four schools, one university, and one community healthcare NHS trust. The insights generated informed the design and modification of the Southampton COVID-19 Saliva Testing Programme and the next phase of community-testing. Results Conversations revealed that high levels of communication, trust and convenience were necessary to ensure people’s engagement with the programme. This suggests community leaders and stakeholder organisations should be involved throughout programme development and implementation to optimise these features of the testing. Conclusions Participants’ and stakeholders’ motivations, challenges and concerns need to be understood and these insights used to modify the programme in a continuous, real-time process to ensure and sustain engagement with testing over the extended period necessary.

Rapid antigen testing for SARS-CoV-2 infection in a university setting in Ireland: learning from a 6-week pilot study.

Objectives With the ongoing circulation of SARS-CoV-2 in countries across the world it is essential to identify effective ways to reduce the risk of infection while allowing society to function as close to normal as possible. Serial testing using rapid lateral flow antigen tests is a possible way to do this by screening populations in a targeted way, identifying infectious (both symptomatic and asymptomatic) people and removing them from circulation while infectious. To make rapid antigen testing effective, high levels of participation are important. This study was designed to evaluate the establishment of a testing programme in a university setting and assess some of the factors that impact participation in such a study among both staff and students. Study Design Observational, survey Methods A trial period of SARS-CoV-2 rapid testing using the Abbott Panbio rapid antigen test was set up and staff and students based in the University College Dublin Veterinary Hospital were asked to take part voluntarily for 6 weeks. Following the trial period, we used a questionnaire to evaluate satisfaction and to understand some reasons behind participation or lack thereof. Results Overall, almost all respondents to the survey stated that they were happy with having a testing programme present in the workplace and it helped to reduce anxiety associated with COVID-19. Findings indicated that staff and students did not participate equally in the voluntary testing programme. The findings also highlighted that intrinsic motivations and extrinsic motivations for participation differ. For example, participation among staff was much higher than among students, motivational messaging focused on protecting others did not resonate with students as much as staff, convenience was a key factor driving participation in both cohorts and the pressure of being forced to miss class (if positive) close to exam time provided motivation to students to avoid testing. Conclusions Introducing antigen testing into a workplace helped to reduce overall anxiety associated with the potential impact of COVID-19, but achieving good participation was challenging. Participation is key to a successful, campus wide antigen testing programme but reaching high levels of participation is not straightforward and can not be taken for granted. Different motivations drive participation in different cohorts and different messaging/incentivisation is needed to encourage participation in those different cohorts. The findings reported here should inform any SARS-CoV-2 testing programme that will run in these types of settings in the future.

Guiding Organisational Decision-Making About COVID-19 Asymptomatic Testing in Workplaces: Mixed-Method Study to Inform an Ethical Framework

Background: Workplace programmes to test staff for asymptomatic COVID-19 infection have become common, but raise a number of ethical challenges. In this article, we report the findings of a consultation that informed the development of an ethical framework for organisational decision-making about such programmes.Methods: We conducted a mixed-method consultation – a survey and semi-structured interviews – in a case study organisation that had introduced asymptomatic testing for all staff working on-site in its buildings. Analysis of closed-end survey data was conducted descriptively. An analysis approach based on the Framework Method was used for the open-end survey responses and interview data. The analyses were then integrated to facilitate systematic analysis across themes. Inferences were based on the integrated findings and other inputs (literature review, ethical analysis, legal and public health guidance, expert discussions) to develop an ethical framework. Results: The consultation involved 61 staff members from the case study organisation (50 survey respondents and 11 interview participants). There was strong support for the asymptomatic testing programme: 90% of the survey respondents viewed it as helpful or very helpful. Open-ended survey responses and interviews gave insight into participants’ concerns, including those relating to goal drift, risk of false negatives, and potential negative impacts for household members and people whose roles lacked contractual and financial stability. Integration of the consultation findings and the other inputs identified the importance of a whole-system approach with appropriate support for the key control measure of isolation following positive tests. The need to build trust in the testing programme, for example through effective communication from leaders, was also emphasised.Conclusions: This consultation, together with other inputs, informed an ethical framework intended to support employers. The framework may support organisational decision-making in areas ranging from design and operation of the programme through to choices about participation. The framework is likely to benefit from further consultation and refinement in new settings.

National cross-sectional survey of 1.14 million NHS staff SARS-CoV-2 serology tests: a comparison of NHS staff with regional community seroconversion rates

ObjectivesAn initial report of findings from 1.14 million SARS CoV-2 serology tests in National Health Service (NHS) staff to compare NHS staff seroconversion with community seroconversion rates at a regional level.DesignA national cross-sectional survey.SettingA SARS-CoV-2 antibody testing programme offered across all NHS Trusts.Participants1.14 million NHS staff.InterventionSARS-CoV-2 antibody testing.Primary and secondary outcome measuresSARS-CoV-2 antibody testing was used to estimate the seroprevalence of SARS-CoV-2 in NHS staff by region, compared with community seroprevalence as determined by the COVID-19 Infection Survey (Office for National Statistics). We also explored seroprevalence trends by regional COVID-19 activity, using regional death rates as a proxy for COVID-19 ‘activity’.Results1 146 310 tests were undertaken on NHS staff between 26 May and 31 August 2020. 186 897 NHS tests were positive giving a seroconversion rate of 16.3% (95% CI 16.2% to 16.4%), in contrast to the national community seroconversion rate of 5.9% (95% CI 5.3% to 6.6%). There was significant geographical regional variation, which mirrored the trends seen in community prevalence rates. NHS staff were infected at a higher rate than the general population (OR 3.1, 95% CI 2.8 to 3.5). NHS seroconversion by regional death rate suggested a trend towards higher seroconversion rates in the areas with higher COVID-19 ‘activity’.ConclusionsThis is the first cross-sectional survey assessing the risk of COVID-19 disease in healthcare workers at a national level. It is the largest study of its kind. It suggests that NHS staff have a significantly higher rate of COVID-19 seroconversion compared with the general population in England, with regional variation across the country which matches the background population prevalence trends. There was also a trend towards higher seroconversion rates in areas which had experienced high COVID-19 clinical activity. This work has global significance in terms of the value of such a testing programme and contributing to the understanding of healthcare worker seroconversion at a national level.

Experimental Separation Performance of In-Line Piggable Liquid Removal Unit – Pseudo Dry Gas Systems

Pseudo Dry Gas (PDG) technology is proposed as an alternative concept for transporting multiphase fluids (gas, condensate and water) for long deep-water subsea tieback developments (Ref 1 - OTC-28949-MS) (Ref 2 - IPTC-19440-MS). Using PDG technology, subsea pipeline networks can be extended to excess of 200 km total length and considerably reduce the backpressure on the wells. This allows improved recovery of the reserves and the ability to reach currently stranded fields, especially deep-water lower-pressure gas fields. The basis of the PDG system is to remove the liquid of the main pipeline system using Piggable Liquid Removal Units. With the removal of the liquid, the gravitational pressure losses in the system are eliminated allowing the pipeline to operate like a "Pseudo" Dry Gas system. The liquid phase is transported back to shore using a second smaller pipeline running in parallel to the main pipeline by means of subsea liquid pumps (Ref 3 - OTC-29332-MS). After techno-economic reports were completed for a known basin of stranded gas in the West of Shetland, an Oil and Gas Technology Centre (OGTC) experimental project was established to determine the operation performance of the element within the PDG technology with lowest Technology Readiness Level (TRL). Currently the liquid removal unit has a TRL2 and a TRL4 will be achieved after the experimental testing programme has been fully completed. This paper assesses the separation performance (Efficiency) of the Piggable Liquid Units or PDG unit. Previous Flow Assurance and Computational Fluid Dynamics (CFD) established expected efficiencies between 84-99% depending on the gas and liquid flow rates and other factors such as unit orientation, liquid type, operating pressure and temperature. Each PDG unit has two modules which allow for gas-liquid separation of the multiphase fluid in the pipeline. A PDG unit prototype has been built and a testing programme has been developed and undertaken in collaboration with Cranfield University (CU) using the large scale Inclinable Multip hase Flow Loop facilities. The testing programme has two test matrices: Matrix 1 which studies the performance of a single module of the PDG unit and Matrix 2 which investigates the efficienc y of the entire PDG unit (two separation modules). Matrix 1 of the testing programme allows to characterise the system varying the flow conditions (flow regime, liquid and gas flow rates), drop out liquid level and size, effect of sand and the inclination and orientation of the unit as would be expected once installed. This paper focuses on the results obtained from Matrix 1 testing programme and compares them with the initia l PDG unit estimated efficiency values used in previous studies to demonstrate the prove of concept of the PDG technology. The overall conclusion is that the performance of the PDG liquid removal unit is greater than the ones originally used in technology assessment reports.

A novel automated SARS-CoV-2 saliva PCR test protects a global asymptomatic workforce

Regular PCR testing of nasopharyngeal swabs from symptomatic individuals for SARS-CoV-2 virus has become the established method by which health services are managing the COVID-19 pandemic. Businesses such as AstraZeneca have also prioritised voluntary asymptomatic testing to keep workplaces safe and maintain supply of essential medicines to patients. We describe the development of an internal automated SARS-CoV-2 testing programme including the transformative introduction of saliva as an alternative sample type.