1) Sincere thanks to the people of #Liverpool & @LivUniIPH & @lpoolcouncil for important insights into open-access rapid testing for those without #COVID19 symptoms. Useful when led by local #PublicHealth teams giving testing more value than tests alone: gov.uk/government/pub…
2) Don’t assume everyone has a smartphone or can afford to isolate. People with fewer financial or digital resources were less likely to get tested and more likely to get #COVID19. Take tests to people not people to tests. Support isolation properly. gov.uk/government/pub…
3) Accuracy is one part of test utility, timing is another. Use the 1-2 days sooner result from lateral flow vs PCR to maximise 1/time to % appropriate action (quick isolation). Then PCR and viral sequence positives. Testing orchestra > 1 test instrument gov.uk/government/pub…
4) Lateral flow device used in #Liverpool community testing identified most infections in adults reporting no #COVID19 symptoms, particularly those with high viral loads: more likely to infect others. Results reported quickly last year and in depth now at bmj.com/content/374/bm…
5) Police/fire crews asked for daily lateral flow tests as alternative to quarantine for contacts of #COVID19 cases to prevent service outages during alpha variant surge: 3,200 staff days saved with small SMART-release pilot: resumed now for delta wave gov.uk/government/pub…
6) Consider (re)infection at low viral loads with more transmissible variants and part-vaccinated population with different symptom profiles & transmission demographics (bmj.com/content/374/bm…). Avoid single tests for access to high consequence settings. gov.uk/government/pub…
7) 18% increase in case detection & 21% reduction in cases in the 'mass testing' weeks for Liverpool vs 'average' of other areas considering demographic, epidemic (phase & history) and restriction differences. More methodology & Tier effects at medrxiv.org/content/10.110… @Benj_Barr
8) Economic evaluation of community testing was out of scope for this report but the Liverpool pilot team is feeding into a separate, broader economic evaluation for the Testing Initiatives Evaluation Board. gov.uk/government/pub…
9) Community testing needs to adapt to changing community needs, for which it needs timely, system-wide data/intelligence: #Liverpool benefited from @NHSX cipha.nhs.uk to coordinate public health, NHS, local government and research actions. gov.uk/government/pub…
10) Communications teams (outstanding at @lpoolcouncil) were critical to successful public engagement with #LetsGetTested #TestBeforeYouGo and #TestingOurFrontline calls to testing with different restrictions, variants and epidemic phases. gov.uk/government/pub…
11) There was overlap between symptomatic and asymptomatic uses of different testing routes. As symptoms become more varied in the vaccination era (bmj.com/content/bmj/37…) consider using rapid tests with follow-up PCR for those with symptoms gov.uk/government/pub…
12) Local partnership was key to successful community testing: between local authority public health, communications, emergency planning, events, NHS and academic partners as one team. National flexibility and local leadership and agility were essential. gov.uk/government/pub…
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