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Home testing programme planned to track levels of coronavirus

The government has announced a major new programme of home testing which will track the levels of coronavirus present in the community, with a goal of scaling up the project to cover 100,000 people.

Commissioned by the Department of Health and Social Care, the programme is being led by a team of top scientists, clinicians and researchers at Imperial College London, alongside colleagues at Imperial College Healthcare NHS Trust.

The home testing programme would provide self-testing kits to people in the community to determine if they are currently infected, improving understanding of how many coronavirus cases are present across England and potentially how many have been infected and recovered since the beginning of the outbreak.

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Authorities will end up with a far clearer picture of the current spread of the disease and the number of people who have previously caught it with accurate testing, helping identify individuals who may have some immunity to the virus and plan services for those who do not.

Health Minister Lord Bethell said: “Understanding more about the current spread of coronavirus and the prevalence of antibodies is a vital part of our ongoing response to this pandemic.

“This ambitious new testing programme will help us track the rate of the infection now. And, crucially, it will help identify an antibody test that is accurate and easy to use, and which can give us an indication of how many people have already had the infection.

As Lord Darzi explained, "short of a vaccine, testing is the only way out of lockdown"

“This information will inform the future action we take to manage the spread of the virus, including the development of new tests and treatments.”

Self-sampling is widely used in health care for other conditions, such as the management of diabetes and the diagnosis of HIV.

Covid-19 antibody tests are regularly improving in terms of accuracy, though their usability by members of the public remains untested.

Professor the Lord Darzi, FRS, Director of the Institute of Global Health Innovation and the sponsor of the programme at Imperial College London, said: “Short of a vaccine, testing is the only way out of lockdown. But the testing landscape is like the Wild West with no rules, no standards and widely varying reliability.

“Even the most accurate test is useless unless it is usable.

“With this ambitious programme, the biggest in England, we aim to establish a viable testing programme on which the government can rely.”

Professor Paul Elliott, FMedSci, Director of the programme at Imperial College London, added: “Community testing is a vital next step in ongoing efforts to mitigate the pandemic, but to be successful this must be based on robust scientific evidence.

“Through this important programme we will gather the critical knowledge base necessary to underpin community testing programmes and facilitate a greater understanding of the prevalence of Covid-19 in the UK.”

In the first part of the programme (Real-time Assessment of Community Transition or REACT-1), 100,000 randomly selected people from 315 local authorities across England will be invited to provide nose and throat swabs, which will be tested for antigens indicating presence of the virus. This kind of test will look for evidence someone is currently infected with the coronavirus.

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The programme’s second part (REACT-2) will assess a number of different antibody tests for their accuracy and ease of use at home. First, the antibody test will be carried out on volunteers from Imperial College Healthcare NHS Trust who are known to have had the virus to establish the accuracy. Three hundred public volunteers will also be given a sample test to self-administer, which requires them to place a finger prick of blood in a cassette, add a dye and read off the result, to assess its acceptability and whether they understand the guidance on how it is used.

If successful, the test will then be distributed to a larger cohort of up to 10,000 people. The aim is solely to ensure that people can properly self-administer the test rather than provide an accurate assessment of antibody levels.

A further stage will involve up to 5,000 key workers, who will both self-test and have the test administered by a health professional. These results will also be compared with the results of blood samples from participants tested in the laboratory. This will provide more information about the accuracy of the tests.

Provided the antibody self-testing is found to work with a high degree of accuracy, acceptability and usability, it will be rolled out to 100,000 people later this year to provide an indication of the prevalence of Covid-19 based on the presence of coronavirus antibodies.