Major home testing programme for coronavirus will track levels of infection in the community

A major new programme of home testing for coronavirus will track the progress of the infection across England, the government announced today.

The programme, commissioned by the Department of Health and Social Care, is being led by a world-class team of scientists, clinicians and researchers at Imperial College London alongside colleagues at Imperial College Healthcare NHS Trust, and supported by Ipsos MORI.

It will help improve understanding of how many people are currently infected with the virus, and potentially how many have been infected and recovered since the outbreak began.

Accurate testing for the virus on a wide scale will provide authorities with a clearer picture of the current spread of the disease and the number of people who have previously caught it. It will help identify individuals who may have some immunity to the virus, and to 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. 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 example in the management of diabetes and the diagnosis of HIV.

The accuracy of COVID-19 antibody tests is still improving and their usability by members of the public is untested.

Professor the Lord Darzi, FRS, Director of the Institute of Global Health Innovation and the sponsor of the programme at Imperial, 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, said:

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 REal-time Assessment of Community Transmission (REACT-1) programme, 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 the presence of the virus. This kind of test looks for evidence that someone is currently infected with the coronavirus.

In the second part of the programme (REACT-2), a number of different antibody tests will be assessed for their accuracy and ease of use at home.

The antibody tests will first be carried out on volunteers from Imperial Healthcare NHS Trust who are known to have had the virus to establish their 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 to be 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 to 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.

If 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.

Professor Tim Orchard, Chief Executive at Imperial College Healthcare NHS Trust, said:

We are delighted to take part in this programme and contribute to efforts to improve COVID-19 testing in the NHS. Community testing will be important in ongoing efforts to tackle the pandemic, potentially easing the burden on health workers and freeing up resources in our health system.

Professor Helen Ward, Professor of Public Health at Imperial College London, said:

As part of this project, we will work with public volunteers and patient advisors to see how easy it is for people to do these tests at home, and co-design the information and packaging that will go out with the tests. We have already had an excellent response from members of the public who are keen to support our research.

Background information

1. The programme is forms part of Pillar 4 of the government’s COVID-19 testing strategy, to conduct UK-wide surveillance testing to learn more about the spread of the disease and inform the development of new tests and treatments. It will add to the data already being collected by Public Health England and the ONS.
2. Antibody tests are a key part of the government’s strategy to boost testing capacity for coronavirus, to protect the vulnerable, support the NHS, and ultimately save lives.
3. Only tests that are accurate will be rolled out, to ensure people are not put at risk. So far, the antibody tests that have gone through the validation process have not proven accurate enough to be rolled out for public use, which is why the government is also backing efforts to develop a home-grown test.
4. The government will continue to work with a variety of international partners to explore testing opportunities and to review new tests as they become available.