Adherence to the test, trace, and isolate system in the UK: results from 37 nationally representative surveys

Article activity feed

1. Version published to 10.1136/bmj.n608

   Mar 31, 2021
2. 

   ScreenIT

   Mar 1, 2021

   SciScore for 10.1101/2020.09.15.20191957: (What is this?)

   Please note, not all rigor criteria are appropriate for all manuscripts.

   Table 1: Rigor

   Institutional Review Board Statement	not detected.
   Randomization	not detected.
   Blinding	not detected.
   Power Analysis	not detected.
   Sex as a biological variable	not detected.

   Table 2: Resources

   No key resources detected.

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   Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

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   Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

   This study also has limitations. First, we used quota sampling to ensure that participant characteristics were representative of the UK adult population. While we cannot be sure that survey respondents are representative of the …

   SciScore for 10.1101/2020.09.15.20191957: (What is this?)

   Please note, not all rigor criteria are appropriate for all manuscripts.

   Table 1: Rigor

   Institutional Review Board Statement	not detected.
   Randomization	not detected.
   Blinding	not detected.
   Power Analysis	not detected.
   Sex as a biological variable	not detected.

   Table 2: Resources

   No key resources detected.

   ---

   Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

   ---

   Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

   This study also has limitations. First, we used quota sampling to ensure that participant characteristics were representative of the UK adult population. While we cannot be sure that survey respondents are representative of the general population,(41, 42) online quota sampling is a pragmatic approach when a large, demographically representative sample must be obtained in a very short time frame during a crisis.(14, 43) Second, data were self-reported, and so could have been influenced by social desirability and recall gaps and bias. Although self-reported adherence to protective measures for COVID-19 such as social distancing is associated with real-world behaviour,(44) it is likely that rates reported here are overestimates of adherence. Third, data are cross-sectional, therefore we cannot infer causality. Fourth, although we asked participants if they had left home at all since developing COVID-19 symptoms, technically it is permissible to leave home under some circumstances, including to attend a medical appointment, get a test or if you receive a negative test result. Given that only 12% of people with symptoms reported requesting a test, we do not believe this explanation accounts for more than a small fraction of the non-adherence that we observed. Fifth, while we had a large overall sample size, numbers of participants included in analyses investigating requesting an antigen test and quarantining after being alerted were smaller, and skewed outcome responses resulted i...

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   Results from TrialIdentifier: No clinical trial numbers were referenced.

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   Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

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   Results from JetFighter: We did not find any issues relating to colormaps.

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   Results from rtransparent:

   • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
   • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
   • No protocol registration statement was detected.

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   Read the original source
3. 

   NCRC

   Oct 13, 2020

   Our take

   Test, trace, and isolate protocols are a crucial part of the UK COVID-19 response. In this large survey, available as a preprint and thus not yet peer reviewed, knowledge of COVID-19 symptoms was fairly poor, and there was a large gap between stated intentions and actual behaviors with respect to test, trace, and isolate guidelines. This gap has remained relatively unchanged from March to August, 2020. Lower adherence was associated with male sex, younger age, lower economic status, and less COVID-19 knowledge, but not with risk perception. The authors suggest that financial assistance might improve outcomes, but this conclusion is speculative.

   Study design

   cross-sectional;other

   Study population and setting

   This study used polling services to conduct a series of nationally representative …

   Our take

   Test, trace, and isolate protocols are a crucial part of the UK COVID-19 response. In this large survey, available as a preprint and thus not yet peer reviewed, knowledge of COVID-19 symptoms was fairly poor, and there was a large gap between stated intentions and actual behaviors with respect to test, trace, and isolate guidelines. This gap has remained relatively unchanged from March to August, 2020. Lower adherence was associated with male sex, younger age, lower economic status, and less COVID-19 knowledge, but not with risk perception. The authors suggest that financial assistance might improve outcomes, but this conclusion is speculative.

   Study design

   cross-sectional;other

   Study population and setting

   This study used polling services to conduct a series of nationally representative surveys regarding COVID-19 knowledge, behaviors, and intentions of 31,787 adults (16 years or older) living in the UK between March 2 and August 5, 2020. Surveys were conducted on a weekly or every other weekly basis, with ~2,000 participants per survey round (21 rounds in all). Some people were surveyed in multiple rounds; there were a total of 42,127 responses. Most questions remained the same throughout the survey, while some questions were added in later survey rounds. Participants were asked to identify the most common COVID-19 symptoms, and were deemed to have done so correctly if they identified fever, cough, and loss of taste or smell. They were also asked whether they had experienced any of those symptoms. Those reporting symptoms within the past 7 days were asked if they had self-quarantined and/or requested an antigen test. In addition to self-reported behaviors, the survey also asked about intentions to self-quarantine, to request an antigen test, and to disclose symptoms to close contacts if participants should become symptomatic. Participants were also asked about their knowledge and beliefs regarding a range of COVID-19 topics, including protective measures, isolation protocols, testing eligibility, government guidance, perceived risk, perceived efficacy of protective measures, and government credibility. Finally, demographic characteristics were obtained via self-report. The study used logistic regression to examine differences in responses by demographic categories (e.g. age, gender, region, employment, etc.).

   Summary of main findings

   Among all respondents, only 49% identified cough, high temperature/fever and loss of sense of smell or taste as the most common symptoms of COVID-19. There was a large gap between intended and self-reported behaviors. While ~70% of people indicated that they intended to self-isolate should they have symptoms in the future, only 18% of people with symptoms within the past 7 days indicated that they had self-isolated. The most common stated reasons for not self-isolating were going to the grocery store or pharmacy (18%), improvement of symptoms (16%), and attending to non-COVID-19 medical needs (15%). There were similar differences between intended and actual behavior for seeking a SARS-CoV-2 test upon experiencing symptoms (~40% vs. 12%) and self-quarantining after being notified by the National Health Service contact tracing program (~65% vs. 11%). Responses to these questions, and the gaps between intended and reported behaviors, remained relatively constant over time. Those who were male, younger, of lower economic status, and less knowledgeable about COVID-19 were, on average, less likely to be adherent to the test, trace, and isolate guidelines. Perceived risk was not associated with adherence behaviors.

   Study strengths

   The study included a large and representative population, using well-established polling services to conduct the research. The main survey methodology was straightforward and well-designed, and data were reported relatively clearly. The repetition over time using the same methodologies allows examination of changing knowledge and behaviors.

   Limitations

   Data were almost entirely self-reported; both self-reported behaviors and intentions may be overestimated due to social desirability and related biases. Response rates were not reported, nor were details of how participants were selected and how they were contacted. Knowledge of COVID-19 symptoms was not disaggregated by individual symptoms, and the binary outcome variable incorporating three common symptoms may not be a good proxy for general awareness of COVID-19 symptoms. Associations between COVID-19 knowledge and behaviors are cross-sectional, and no causality can be inferred. The claim that financial support would improve outcomes is largely speculative and not meaningfully tested in the study itself.

   Value added

   Little evidence has emerged to date about adherence to test, trace, and isolate procedures. This study adds relatively robust, nationally representative data from the UK regarding knowledge, intentions, and behaviors with respect to test, trace, and isolate guidelines over time.

   Read the original source
4. 

   Version published to 10.1101/2020.09.15.20191957v1 on medRxiv

   Sep 18, 2020