Mass Testing With Contact Tracing Compared to Test and Trace for the Effective Suppression of COVID-19 in the United Kingdom: Systematic Review
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Abstract
Making testing available to everyone and tracing contacts might be the gold standard to control COVID-19. Many countries including the United Kingdom have relied on the symptom-based test and trace strategy in bringing the COVID-19 pandemic under control. The effectiveness of a test and trace strategy based on symptoms has been questionable and has failed to meet testing and tracing needs. This is further exacerbated by it not being delivered at the point of care, leading to rising cases and deaths. Increases in COVID-19 cases and deaths in the United Kingdom despite performing the highest number of tests in Europe suggest that symptom-based testing and contact tracing might not be effective as a control strategy. An alternative strategy is making testing available to all.
Objective
The primary objective of this review was to compare mass testing and contact tracing with the conventional test and trace method in the suppression of SARS-CoV-2 infections. The secondary objective was to determine the proportion of asymptomatic COVID-19 cases reported during mass testing interventions.
Methods
Literature in English was searched from September through December 2020 in Google Scholar, ScienceDirect, Mendeley, and PubMed. Search terms included “mass testing,” “test and trace,” “contact tracing,” “COVID-19,” “SARS-CoV-2,” “effectiveness,” “asymptomatic,” “symptomatic,” “community screening,” “UK,” and “2020.” Search results were synthesized without meta-analysis using the direction of effect as the standardized metric and vote counting as the synthesis metric. A statistical synthesis was performed using Stata 14.2. Tabular and graphical methods were used to present findings.
Results
The literature search yielded 286 articles from Google Scholar, 20 from ScienceDirect, 14 from Mendeley, 27 from PubMed, and 15 through manual search. A total of 35 articles were included in the review, with a sample size of nearly 1 million participants. We found a 76.9% (10/13, 95% CI 46.2%-95.0%; P=.09) majority vote in favor of the intervention under the primary objective. The overall proportion of asymptomatic cases among those who tested positive and in the tested sample populations under the secondary objective was 40.7% (1084/2661, 95% CI 38.9%-42.6%) and 0.0% (1084/9,942,878, 95% CI 0.0%-0.0%), respectively.
Conclusions
There was low-level but promising evidence that mass testing and contact tracing could be more effective in bringing the virus under control and even more effective if combined with social distancing and face coverings. The conventional test and trace method should be superseded by decentralized and regular mass rapid testing and contact tracing, championed by general practitioner surgeries and low-cost community services.
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SciScore for 10.1101/2021.01.13.21249749: (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
Software and Algorithms Sentences Resources Search terms in Google Scholar included “[UK] Google Scholarsuggested: (Google Scholar, RRID:SCR_008878)A search in PubMed included “((((((((Mass testing for COVID-19 and “Contact tracing”) OR (Mass testing for SARS-CoV-2 and “Contact tracing”)) OR (”Test and trace”)) OR (”Mass testing” and “symptom-based testing”)) NOT (Animals)) NOT (HIV)) NOT (Influenza)) NOT (Ebola)) NOT (Cancer)”. PubMedsuggested: (PubMed, RRID:SCR_004846)Finally, a search for “Mass testing for COVID-19” … SciScore for 10.1101/2021.01.13.21249749: (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
Software and Algorithms Sentences Resources Search terms in Google Scholar included “[UK] Google Scholarsuggested: (Google Scholar, RRID:SCR_008878)A search in PubMed included “((((((((Mass testing for COVID-19 and “Contact tracing”) OR (Mass testing for SARS-CoV-2 and “Contact tracing”)) OR (”Test and trace”)) OR (”Mass testing” and “symptom-based testing”)) NOT (Animals)) NOT (HIV)) NOT (Influenza)) NOT (Ebola)) NOT (Cancer)”. PubMedsuggested: (PubMed, RRID:SCR_004846)Finally, a search for “Mass testing for COVID-19” AND “contact tracing for COVID-19” OR “mass testing for SARS-CoV-2” AND “contact tracing for SARS-CoV-2” was done in Mendeley. Mendeleysuggested: (Mendeley Data, RRID:SCR_002750)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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.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.
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