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Ward H, Atchison C, Whitaker M, Davies B, Ashby D, Darzi A, Chadeau-Hyam M, Riley S, Donnelly CA, Barclay W, Cooke GS, Elliott P. Design and Implementation of a National Program to Monitor the Prevalence of SARS-CoV-2 IgG Antibodies in England Using Self-Testing: The REACT-2 Study. Am J Public Health 2023; 113:1201-1209. [PMID: 37733993 PMCID: PMC10568505 DOI: 10.2105/ajph.2023.307381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 09/23/2023]
Abstract
Data System. The UK Department of Health and Social Care funded the REal-time Assessment of Community Transmission-2 (REACT-2) study to estimate community prevalence of SARS-CoV-2 IgG (immunoglobulin G) antibodies in England. Data Collection/Processing. We obtained random cross-sectional samples of adults from the National Health Service (NHS) patient list (near-universal coverage). We sent participants a lateral flow immunoassay (LFIA) self-test, and they reported the result online. Overall, 905 991 tests were performed (28.9% response) over 6 rounds of data collection (June 2020-May 2021). Data Analysis/Dissemination. We produced weighted estimates of LFIA test positivity (validated against neutralizing antibodies), adjusted for test performance, at local, regional, and national levels and by age, sex, and ethnic group and area-level deprivation score. In each round, fieldwork occurred over 2 weeks, with results reported to policymakers the following week. We disseminated results as preprints and peer-reviewed journal publications. Public Health Implications. REACT-2 estimated the scale and variation in antibody prevalence over time. Community self-testing and -reporting produced rapid insights into the changing course of the pandemic and the impact of vaccine rollout, with implications for future surveillance. (Am J Public Health. 2023;113(11):1201-1209. https://doi.org/10.2105/AJPH.2023.307381).
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Affiliation(s)
- Helen Ward
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Christina Atchison
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Matthew Whitaker
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Bethan Davies
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Deborah Ashby
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Ara Darzi
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Marc Chadeau-Hyam
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Steven Riley
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Christl A Donnelly
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Wendy Barclay
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Graham S Cooke
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
| | - Paul Elliott
- Helen Ward, Christina Atchison, Matthew Whitaker, Bethan Davies, Deborah Ashby, Marc Chadeau-Hyam, Steven Riley, and Paul Elliott are with the School of Public Health, Imperial College London, UK. Ara Darzi is with the Institute of Global Health Innovation, Imperial College London. Christl A. Donnelly is with the Department of Statistics, University of Oxford, Oxford, UK. Wendy Barclay and Graham S. Cooke are with the Department of Infectious Disease, Imperial College London
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