Covid-19 international comparative research and rapid knowledge exchange hub on diagnostic testing systems

Lead Research Organisation: University of Sussex
Department Name: University of Sussex Business School

Abstract

The proposed research asks how leading countries such as Germany and South Korea configure and use their national diagnostic testing systems for Covid-19 ('testing systems') in order to have relatively low rates of Covid-19 mortality per capita in their populations, to avoid or shorten 'lock-downs', and reduce economic impacts. We will identify the key elements of testing systems that have contributed to effective performance, including measures taken that have facilitated preparedness and resilience before the crisis, as well as those rapid innovations that have helped countries to deal with a fast evolving pandemic. We will explain how testing systems have been used, and how challenges related to testing have been overcome. The research will include the four nations of the UK and five further countries. Additionally, the role of transnational organisations such as the WHO, EU and large diagnostics companies will be studied to understand how tensions have been managed between increasing the quantity of new tests for Covid-19 and maintaining their quality.

The project will establish a UK research and knowledge exchange hub to will facilitate dialogue between the international research team and policy makers so that relevant questions are rapidly addressed and lessons are disseminated to policy makers and public audiences, in the UK, and beyond. In order to support COVID-19 responses deliverables will be shared from the early stages of this 12 month project. Additionally to inform preparations for future outbreaks, we will contribute to national and international fora seeking to learn lessons from the current crisis.

Publications

10 25 50
 
Description The ongoing spread of SARS-CoV-2, as well as the risk of future pandemics, make it imperative for countries to learn from one another, particularly around the organisation of testing systems. Results from this study of the national testing systems in six countries (hereafter referred to as 'the study countries.') reveals flaws in UK Coronavirus testing compared with other countries. The analysis uses the framework outlined by the UK's Independent Scientific Advisory Group for Emergencies - Find, Test, Trace, Isolate, Support ('FTTIS') - which presents five key components of a 'test and trace' system that is equipped to effectively control the spread of SARS-CoV-2. Study countries include Ireland, Germany, South Africa, South Korea Spain, and the UK. Findings show considerable variation in FTTIS systems across countries, and suggest three lessons for control
of SARS-CoV-2:

1. As no country has a fully optimised testing system, all study countries can benefit from sharing lessons.

2. For most countries, key areas of focus should be on maintaining isolation and quarantine of individuals and providing support measures to ensure adherence
to guidelines and wellbeing.

3. A full FTTIS system requires an additional evaluation component to enable learning, to address the changing challenges of Covid-19 response and share best practice internationally.

Key lessons have been reported to key stakeholders and the general public:

UK lessons
• Of the study countries, the UK has the highest proven test capacity with 12,985 tests recorded per week per million capita in July (and rising). However, this capacity is not being used efficiently.
• Coronavirus testing in the community in the UK is being delivered outside of the usual NHS structures, with access to testing and sample collection undertaken without the high levels of medical supervision seen in other countries.
• Unlike other studied countries, testing in the UK has been undertaken outside accredited laboratories with experience of clinical testing for infectious diseases, raising quality concerns.
• In the UK there appears to be no systematic follow-up of isolating or quarantining individuals, except for travelers returning from designated countries. This is against World Health Organisation (WHO) advice.
• Low levels of sick pay may not be enough to prevent the financially insecure from continuing to work, even when unwell. The daily maximum levels of sick pay for isolating employees in Germany are equivalent to the UK's weekly rate.

General lessons

• Find: Combining active and passive case-finding approaches, identifying high-risk groups and using effective, tailored communication strategies are all imperative.
• Test: The accuracy, utility, and reliability of tests depends on the procedures used for sample collection, handling, and processing. Leveraging existing laboratory networks enables rapid scale up of quality-assured tests.
• Trace: Centralised, decentralised and digital contact tracing may be complementary, with careful consideration of how data can be shared across the FTTIS systems while protecting privacy.
• Isolate: FTTIS systems should include some form of monitoring of individuals in isolation and quarantine to promote adherence to guidelines and wellbeing.
• Support: Offering practical, financial, and material support to individuals in isolation and quarantine promotes adherence and wellbeing.
• These components are interrelated and rely upon one another.
• Openness and evaluation are integral to the FTTIS system, to support continual assessment, learning, evolution and international sharing of good practice
Exploitation Route The project has gathered substantial data in real time across countries, in particular collecting a large volume of documents and compiling detailed country-level chronologies comparing the development of testing systems. These resources may be useful for future research.
Sectors Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice,Pharmaceuticals and Medical Biotechnology

URL https://www.octs.info/
 
Description Several members of the project team have worked extensively with national and international TV, radio, newspaper and online journalists, from a wide range of organisations, in order to disseminate key findings of the project as well as to support accurate and detailed reporting of Covid-19 testing-related news stories. Collectively the team has had several hundred global media news mentions during the project, ranging from substantial dedicated features on the project's research, to supporting quotes providing news analysis, technical advice and comment for journalists.
First Year Of Impact 2020
Sector Other
Impact Types Societal

 
Description Collaboration with the International Comparators Joint Unit (ICJU) 
Organisation Cabinet Office
Country United Kingdom 
Sector Public 
PI Contribution The research team has established a link with the ICJU as part of the co-development and dissemination activities of the project. This has involved discussing emerging areas of research interest for government and seeking to address these through our research. Our research has been combined with other streams of data available to ICJU in order to assist them in producing reports for policy makers in government.
Collaborator Contribution The ICJU has provided a regular point of contact and regular meetings for the research team to discuss emerging areas of mutual research interest and facilitated discussions with relevant staff. These discussions are particularly helpful for the research team to understand how their research can best be delivered at a time and in a form that is most useful for policy makers.
Impact An outcome from the collaboration has been the rapid sharing of research findings with ICJU, and the incorporation of these into relevant internal reports. The collaboration covers subject matter that is inherently interdisciplinary, spanning the social sciences (especially Science Policy), and the life sciences, including medicine.
Start Year 2020
 
Description Advice provided to TV documentary team (Dispatches, Channel 4) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Michael Hopkins was interviewed by the Dispatches documentary team, for a programme on NHS Test and Trace. The interview was not used in the final broadcast.
Year(s) Of Engagement Activity 2020
 
Description Appearance on Channel 4 News 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Michael Hopkins was interviewed and appeared briefly on the Channel 4 News weekend edition, on the topic of the September return to work/ school and the threat this posed in terms of increasing Covid-19 cases.
Year(s) Of Engagement Activity 2020
URL https://www.channel4.com/news/coronavirus-police-warn-people-not-to-party-this-weekend
 
Description Collaboration to produce BBC Radio 4 Programme 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Michael Hopkins was approached by the BBC Radio 4 Science Unit to collaborate in producing a 20+ minute feature for the series 'Inside Science'. The feature provided an opportunity to explore the findings of the project's research in detail, for a general audience. The broadcast was highly effective, with several further approaches from other media outlets being attracted to the research as a result.
Year(s) Of Engagement Activity 2020
URL https://www.bbc.co.uk/programmes/m000ncp8
 
Description Collaboration to produce BBC World Service (Radio) 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The team was approached to contribute to a programme on Covid 'test and trace' systems by the BBC Radio Science Unit. The programme used the structure of our team's paper as a framework for a panel debate, with project team member Prof. Gail Davey also invited to join the panel and discuss our research. The programme was broadcast to a global audience estimated to be in the hundreds of millions.
Year(s) Of Engagement Activity 2020
URL https://www.bbc.co.uk/programmes/w3ct0xk2
 
Description Feature on project research in Guardian Newspaper article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Michael Hopkins collaborated with a Guardian journalist to facilitate a production of synopsis of the project's research in a dedicated newspaper article.
Year(s) Of Engagement Activity 2020
URL https://www.theguardian.com/politics/2020/sep/24/uk-failing-to-use-its-high-covid-test-capacity-effi...
 
Description Interview for Bloomberg on NHS Test and Trace 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Michael Hopkins was interviewed by a Bloomberg reporter on the topic of NHS Test and Trace.
Year(s) Of Engagement Activity 2020
URL https://www.bloomberg.com/amp/news/articles/2020-09-12/johnson-pledges-millions-of-covid-tests-but-u...
 
Description Interview on Moonshot Testing in The Independent 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact This interview on the UK's planned 'Operation Moonshot' for a functional antibody test led to a series of questions from other journalists that appeared as small comments in other pieces.
Year(s) Of Engagement Activity 2020
URL https://www.independent.co.uk/news/health/coronavirus-test-operation-moonshot-boris-johnson-covid-b4...
 
Description Invited Speech at Westminster Health Forum Policy Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Michael Hopkins was invited to present key results from the project to an audience of politicians, policy makers, and professionals, and engage in debate around Covid-19 testing systems. The talk was apparently well received with questions and discussion.
Year(s) Of Engagement Activity 2020
 
Description Radio Interview on BBC Radio 5 Live 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interviewed on BBC Radio 5 Live with an approximate reach of 2.3 million people.
Year(s) Of Engagement Activity 2020
 
Description Radio Interview on LBC 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interview about Operation Moonshot on LBC morning news
Year(s) Of Engagement Activity 2020
 
Description Radio interview for LBC 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Michael Hopkins was invited to discuss Covid testing on Heart Radio, also broadcast on LBC.
Year(s) Of Engagement Activity 2020
 
Description Radio interview for RTE (Ireland) 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Two members of the team (Jim Ryan and Michael Hopkins) were interviewed for RTI (Ireland) in an item comparing the UK's and Ireland's Covid-19 testing strategies.
Year(s) Of Engagement Activity 2020
URL https://www.rte.ie/radio/radioplayer/html5/#/radio1/21868759
 
Description Submission of evidence to Parliamentary enquiry 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The team wrote a summary of early findings from their research and provided this as an evidence submission to the House of Lords Science and Technology Committee, addressing issues that had been published as of interest to the committee. The full text of the submission is available at the URL provided.
Year(s) Of Engagement Activity 2020
URL https://committees.parliament.uk/writtenevidence/8378/pdf/
 
Description Submission of evidence to Parliamentary enquiry 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The project team provided substantial input into the preparation of an evidence submission to the House of Commons Parliamentary Science and Technology Committee on behalf of the Science Policy Research Unit, addressing a number of questions that had been published as being of interest to the committee. The full text of the submission is available at the URL provided.
Year(s) Of Engagement Activity 2020
URL https://committees.parliament.uk/writtenevidence/9525/pdf/
 
Description Two team members being interviewed by the Financial Times in featuring good international practices of self-isolation support systems 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Two team members (Michael Hopkins and Choon Key Chekar) were interviewed by the Financial Times in featuring self-isolation support systems. Dr Chekar summarised South Korean self-isolation support systems as an example of good practice and Prof Hopkins provided an overview from the study countries and pointed to the recommendations for the UK.
Year(s) Of Engagement Activity 2020
URL https://www.ft.com/content/22544fbf-a5dd-4b3c-99c7-1341cb2b0eb5