Mild symptoms, poor knowledge of nearby test sites and certain demographic factors have been identified as barriers to COVID-19 testing, according to a new study of more than 4 million adults in the UK published this week in the open journal PLOS Global Public Health by Christina M. Astley from Boston Children’s Hospital, USA, and colleagues from King’s College London. Testing is a crucial component of the COVID-19 response to public health, even when countries introduce vaccination campaigns. In the UK, free PCR COVID-19 tests are offered to people with three symptoms: high temperature, new persistent cough or a change in their sense of smell or taste. However, more than a quarter of people in the UK who report these symptoms are not tested.
In the new study, Astley and colleagues analyzed data on 4.3 million people enrolled in the UK Zoe COVID Symptom Study, which uses a smartphone app to self-report COVID symptoms and test results. They sent follow-up studies in late 2020 to nearly 5,000 people who reported COVID-19 symptoms but no tests. The researchers also examined more than 700,000 responses, received between April 2020 and February 2021, from UK participants from the University of Maryland Global COVID-19 Trends and Impact Survey (UMD-CTIS), an ongoing study partially conducted on Facebook.
The proportion of Zoe participants who report COVID-19 testing among those who report symptoms has increased over time, the study showed, from less than 20% in April 2020 to more than 70% in January 2021. The chances of, that a symptomatic person not tested was higher for those with only one symptom compared to multiple symptoms (27.1% versus 14.6%, s
The authors conclude that greater efforts and improved communications are needed to educate the UK public on test recommendations. The results, they say, support the need for targeted messages to certain demographic risk groups, and an emphasis that even people with mild or transient symptoms may have COVID-19 and should be tested.
The authors add: “Knowing when and where to get a test is crucial to slowing down the COVID-19 transmission, yet one in four people with the UK test qualifying symptoms of fever, cough or odor loss were not tested. Over a third of these individuals did not recognize the three symptoms that would qualify them for a test, and about a third of those who wanted to test did not know where to go, indicating that more is needed. effective training to close the test gap.
These results also have international implications for public health. Test admission in the UK can be relatively high compared to other regions as it has free testing, clear and consistent symptom criteria and a national booking infrastructure. This suggests that even greater efforts may be needed to overcome knowledge barriers in countries with more fragmented test infrastructure or more nuanced test criteria. ”
Researchers urge odor loss to be recognized globally as a symptom of COVID-19
Graham MS, May A, Varsavsky T, Sudre CH, Murray B, Kläser K, et al. (2022) Knowledge barriers in a national symptomatic COVID-19 test program. PLOS Glob Public Health 2 (1): e0000028. doi.org/10.1371/journal.pgph.0000028
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