A qualitative process analysis of daily contact testing as an alternative to self-isolation following close contact with a confirmed carrier of SARS-CoV-2
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Abstract
Background
In July 2021, a randomised controlled trial was conducted to compare the effect on SARS-CoV-2 transmission of seven days of Daily Contact Testing (DCT) using Lateral Flow Test (LFT) and two Polymerase Chain Reaction (PCR) tests as an alternative to 10 days of standard self-isolation with one PCR, following close contact with a SARS-CoV-2 carrier. In this qualitative study, we used a nested process evaluation to aid interpretation of the trial and provide insight into factors influencing use of tests, understanding of test results, and how tests were used to inform behavioural decisions.
Methods
Interviews were conducted with 60 participants (42 randomised to DCT and 18 randomised to self-isolation) who had been in close contact with a confirmed SARS-CoV-2 carrier and had consented to take part in the trial.
Results
Data were organised into three overarching themes: (1) assessing the risks and benefits of DCT (2) use of testing during the study period and (3) future use of testing. Attitudes toward DCT as an alternative to self-isolation and behaviour during the testing period appeared to be informed by an assessment of the associated risks and benefits. Participants reported how important it was for them to avoid isolation, how necessary self-isolation was considered to be, and the ability of LFTs to detect infection. Behaviour during the testing period was modified to reduce risks and harms as much as possible. Testing was considered a potential compromise, reducing both risk of transmission and the negative impact of self-isolation, and was regarded as a way to return to normal.
Conclusion
Participants in this study viewed DCT as a sensible, feasible, and welcome means of avoiding unnecessary self-isolation. Although negative LFTs provided reassurance, most people still restricted their activity as recommended. DCT was also highly valued by those in vulnerable households as a means of providing reassurance of the absence of infection and as an important means of detecting infection and prompting self-isolation when necessary.
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SciScore for 10.1101/2022.01.14.21267257: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: All participants provided verbal consent prior to taking part in the interview. Sex as a biological variable Of the total participants, 33 (55%) were women, and 30 (50%) were from an ethnic minority background. Randomization Results: A total of 60 participants took part in an interview, including 42 (70%) participants randomized to DCT (DCT group), and 18 (30%) who were randomized to 10 days self-isolation with a single PCR (SI group). Blinding not detected. Power Analysis 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).
R…SciScore for 10.1101/2022.01.14.21267257: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: All participants provided verbal consent prior to taking part in the interview. Sex as a biological variable Of the total participants, 33 (55%) were women, and 30 (50%) were from an ethnic minority background. Randomization Results: A total of 60 participants took part in an interview, including 42 (70%) participants randomized to DCT (DCT group), and 18 (30%) who were randomized to 10 days self-isolation with a single PCR (SI group). Blinding not detected. Power Analysis 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:Limitations of this work: Despite our best efforts to recruit a diverse sample of participants, the main potential limitation of this work is that relevant voices may have been missed. It is possible that more vulnerable populations, or those with greater concerns about the role of DCT as an alternative to self-isolation did not consent to take part in the trial and were therefore not invited to take part in an interview. It should also be noted that this work was conducted during a period when cases of COVID-19 were declining and restrictions were easing. This may have influenced perceptions of testing and isolation, and our results should be interpreted with this in mind. Implications for policy: This work has a number of implications regarding the use of testing in the future. As we negotiate a return to a ‘new normal’ it is essential that strategies and policies are introduced that maximise safety whilst reducing the negative impact of unnecessary isolation. DCT as an alternative to self-isolation has the potential to reduce the negative impact of self-isolation among those who are still required to do so. However, it may also provide additional reassurance, both inside and outside the home, for those who are not. At the time of writing, LFTs were freely available to members of the public in the UK, but this is not guaranteed to continue [17]. Our results suggest that there may be value in continuing to make tests freely available to people who have been in contact with a...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
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.
Results from scite Reference Check: We found no unreliable references.
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