In a study from the University of Liverpool, scientists found the first-ever voluntary “mass testing” pilot for people without COVID symptoms was linked to an overall 25% reduction in COVID-19-related hospital admissions.
Assuming this effect was causal, the researchers say the pilot prevented 6,829 infections and led to 239 fewer hospital admissions across the city of Liverpool, before being rolled out to the rest of the UK.
Transmission of the COVID-19 virus by people without symptoms has been a major challenge in controlling the pandemic.
These new findings show that large-scale voluntary community testing for COVID-19 can potentially reduce virus transmission and prevent hospital admissions.
The pilot, known as COVID-SMART, offered supervised voluntary lateral flow testing to all people over the age of 5 years without symptoms who were living or working in Liverpool from November 6, 2020, to January 2, 2021.
The aim was to identify infectious people sooner and disrupt transmission.
The researchers wanted to find out whether large-scale testing was effective at reducing COVID-19-related hospital admissions.
They compared weekly COVID-19-related hospital admissions among the pilot (intervention) population with a control population selected from the rest of England with similar previous COVID-19 hospital admissions and sociodemographic factors to the intervention population.
When the analysis was restricted to the first month of the pilot (November 6 to December 3, 2020), the results show that it was associated with a 43% reduction in COVID-19-related hospital admissions in Liverpool compared with the control population.
In absolute numbers, this is the equivalent of 146 fewer admissions in the period up to December 3, 2020.
However, the researchers stress that this was a time of intensive testing with military assistance when Liverpool was under higher (tier 3) lockdown restrictions than many other areas of the country.
When the analysis was extended across the full intervention period (November 6, 2020, to January 2, 2021), and regional differences in lockdown restrictions were taken into account, a 25% reduction in COVID-19-related hospital admissions was seen (equivalent to 239 fewer admissions) compared with the control population.
The team says it is plausible that the main effect in the analysis is causally related to the COVID-SMART intervention.
They note that large-scale community testing is a complex intervention, where one person’s testing may affect another’s (e.g., family member’s) COVID risk behavior, and therefore the testing effect is not a simple relationship between one test and one chain of virus transmission.
They also emphasize that success relies on high levels of uptake and effective support to enable the isolation of infectious people and their close contacts.
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The study was published in The BMJ.
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