Impact of baseline cases of cough and fever on UK COVID-19 diagnostic testing rates: estimates from the Bug Watch community cohort study
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Abstract
Background: Diagnostic testing forms a major part of the UK’s response to the current coronavirus disease 2019 (COVID-19) pandemic with tests offered to anyone with a continuous cough, high temperature or anosmia. Testing capacity must be sufficient during the winter respiratory season when levels of cough and fever are high due to non-COVID-19 causes. This study aims to make predictions about the contribution of baseline cough or fever to future testing demand in the UK.
Methods: In this analysis of the Bug Watch community cohort study, we estimated the incidence of cough or fever in England in 2018-2019. We then estimated the COVID-19 diagnostic testing rates required in the UK for baseline cough or fever cases for the period July 2020-June 2021. This was explored for different rates of the population requesting tests, four COVID-19 second wave scenarios and high and low baseline cough or fever incidence scenarios.
Results: Under the high baseline cough or fever scenario, incidence in the UK is expected to rise rapidly from 250,708 (95%CI 181,095 - 347,080) cases per day in September to a peak of 444,660 (95%CI 353,084 - 559,988) in December. If 80% of these cases request tests, testing demand would exceed 1.4 million tests per week for five consecutive months. Demand was significantly lower in the low cough or fever incidence scenario, with 129,115 (95%CI 111,596 - 151,679) tests per day in January 2021, compared to 340,921 (95%CI 276,039 - 424,491) tests per day in the higher incidence scenario.
Conclusions: Our results show that national COVID-19 testing demand is highly dependent on background cough or fever incidence. This study highlights that the UK’s response to the COVID-19 pandemic must ensure that a high proportion of people with symptoms request tests, and that testing capacity is sufficient to meet the high predicted demand.
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SciScore for 10.1101/2020.09.03.20187377: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Data collected consisted of an online consent form and a baseline survey followed by weekly surveys sent by email to be completed by each participant.
IRB: This study was given ethical approval by the UCL Research Ethics Committee (ID 11813/001).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: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:A limitation of our study was that participants were more likely to be older, female, …
SciScore for 10.1101/2020.09.03.20187377: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Data collected consisted of an online consent form and a baseline survey followed by weekly surveys sent by email to be completed by each participant.
IRB: This study was given ethical approval by the UCL Research Ethics Committee (ID 11813/001).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: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:A limitation of our study was that participants were more likely to be older, female, healthier and living in less deprived areas than the general population of England. To account for age and sex, we adjusted for these variables in our incidence estimates. There were also a disproportionately low number of Black, Asian and other Minority Ethnic (BAME) participants included in the study – communities that are known to have been particularly adversely affected by COVID-19 [21]. Consequently, our results do not account for possible differences in the incidence of baseline cough and fever in these underrepresented groups. Another possible limitation of this study is that a cough was defined as ‘incident’ rather than ‘continuous’ (lasting more than one hour or three or more coughing episodes in 24 hours), therefore potentially differing from the UK’s COVID-19 diagnostic symptomatology. We may consequently overestimate the number of cough cases who would require a test under current NHS guidance. We also note that our estimates of testing demand were largely driven by cough symptoms, as fever was comparatively less common. Data was not collected on altered or lost sense of smell or taste, but we expect this to be rare in comparison to symptoms of cough or fever. In conclusion, our study provides estimates of the baseline incidence of cough or fever in the general population in the UK. Our calculations indicate that the UK’s current COVID-19 testing capacity is insufficient for hig...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).
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.
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