Adherence to the test, trace, and isolate system in the UK: results from 37 nationally representative surveys
Findings from 37 nationally representative surveys in the UK, 2 March 2020 to 27 January 2021 (74 697 responses from 53 880 people) suggest levels of adherence to test, trace, and isolate are low, although some improvement has occurred over time.
Source:
British Medical Journal
SPS commentary:
Only 51.5% of participants identified the main symptoms of covid-19; the corresponding values in the most recent wave of data collection were 50.8% Across all waves, duration adjusted adherence to full self-isolation was 42.5%; in the most recent wave of data, it was 51.8%. Across all waves, requesting a test for covid-19 was 18.0%), increasing to 22.2% from 25 to 27 January. Across all waves, intention to share details of close contacts was 79.1%, increasing to 81.9% from 25 to 27 January. Non-adherence was associated with being male, younger age, having a dependent child in the household, lower socioeconomic grade, greater financial hardship during the pandemic, and working in a key sector.
According to an editorial, the true impact of a test, trace, and isolate programme is probably even lower than that suggested by current study given the extent of pre-symptomatic and asymptomatic transmission of covid-19 and the potential for attrition along the full cascade of test, trace, and isolate efforts. It suggests that ultimately, symptom based and case based interventions alone are highly unlikely to contain the covid-19 pandemic, and a more realistic expectation is that an effective test, trace, and isolate programme can be one component of a more comprehensive strategy. It adds that population based measures such as physical distancing, use of face masks, and possibly mass testing are needed to complement case based interventions to reduce the reproduction number to below unity—as has been observed in Singapore and Taiwan. It notes that even now, vaccines are not anticipated to bring life back to normal quickly, and concerns about vaccine safety and viral variants pose ongoing challenges for vaccination programmes globally. Therefore, combined use of vaccination, case based interventions, and population based interventions provide the best chance for sustained control of covid-19. It concludes that this study is an important reminder of the gaps and vulnerabilities associated with test, trace, and isolate programmes.