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The role of regular asymptomatic testing in reducing the impact of a COVID-19 wave

Silva, MEP; Fyles, M; Pi, L; Panovska-Griffiths, J; House, T; Jay, C; Fearon, E; (2023) The role of regular asymptomatic testing in reducing the impact of a COVID-19 wave. Epidemics , 44 , Article 100699. 10.1016/j.epidem.2023.100699. Green open access

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Abstract

Testing for infection with SARS-CoV-2 is an important intervention in reducing onwards transmission of COVID-19, particularly when combined with the isolation and contact-tracing of positive cases. Many countries with the capacity to do so have made use of lab-processed Polymerase Chain Reaction (PCR) testing targeted at individuals with symptoms and the contacts of confirmed cases. Alternatively, Lateral Flow Tests (LFTs) are able to deliver a result quickly, without lab-processing and at a relatively low cost. Their adoption can support regular mass asymptomatic testing, allowing earlier detection of infection and isolation of infectious individuals. In this paper we extend and apply the agent-based epidemic modelling framework Covasim to explore the impact of regular asymptomatic testing on the peak and total number of infections in an emerging COVID-19 wave. We explore testing with LFTs at different frequency levels within a population with high levels of immunity and with background symptomatic PCR testing, case isolation and contact tracing for testing. The effectiveness of regular asymptomatic testing was compared with ‘lockdown’ interventions seeking to reduce the number of non-household contacts across the whole population through measures such as mandating working from home and restrictions on gatherings. Since regular asymptomatic testing requires only those with a positive result to reduce contact, while lockdown measures require the whole population to reduce contact, any policy decision that seeks to trade off harms from infection against other harms will not automatically favour one over the other. Our results demonstrate that, where such a trade off is being made, at moderate rates of early exponential growth regular asymptomatic testing has the potential to achieve significant infection control without the wider harms associated with additional lockdown measures.

Type: Article
Title: The role of regular asymptomatic testing in reducing the impact of a COVID-19 wave
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.epidem.2023.100699
Publisher version: https://doi.org/10.1016/j.epidem.2023.100699
Language: English
Additional information: Copyright © 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Individual based model, Lateral flow device, Polymerase chain reaction, Rapid antigen test, SARS-CoV-2
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10175326
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