Virus Watch: Understanding community incidence, symptom profiles, and transmission of COVID-19 in relation to population movement and behaviour.

The novel strain of Coronavirus (COVID-19) has caused large numbers of deaths and
severe societal disruption in China and is predicted to become a global pandemic. To
prepare and respond we need to know how many people become infected, how many of
them become ill, what their symptoms are, how many seek health care, how commonly
they transmit to household contacts, what proportion need hospitalisation and what
proportion die. We need to understand how the population responds e.g. hand washing,
behaviours during and after coughing, sneezing or nose wiping, and whether people
restrict their movements and social contacts. Since many of those infected will have
relatively mild symptoms and not seek medical advice the only way to accurately obtain
this information is to conduct large scale community studies. We will follow up members of
the public and contacts of cases using regular online surveys of symptoms and
behaviours, secure tracking of participant movements, and testing for COVID-19 and other
respiratory infections to build a detailed picture of how the virus spreads and the
population responds. We will share this data with participants, health service and public
health planners and the general public to help minimise the impact of the virus.

This COVID-19 Rapid Response award is jointly funded (50:50) between the Medical Research Council and the National Institute for Health Research. The figure displayed is the total award amount of the two funders combined, with each partner contributing equally towards the project.

COVID-19 is set to become a global pandemic. Near real time information is needed to
inform NHS planning and public health response. This includes community incidence
(regardless of seeking care), risk factors for disease, clinical symptoms, case
hospitalisation and mortality ratios, asymptomatic viral shedding, asymptomatic infection,
household transmission risk and population behaviours during periods of wellness and
illness (including social contact and movement, respiratory hygiene and health seeking
behaviours). This information can only be gathered accurately through large scale
community studies.
Our experience of the MRC/Wellcome FluWatch study and ESRC BugWatch study allows
us to rapidly establish two six-month national household cohorts (April-September 2020)
and (October 2020-March 2021) of 25,000 individuals each (2,500 in each region of
England and Wales) for online symptom and behaviour reporting and optional use of an
app allowing their mobile phones to be used as GPS trackers enabling secure transfer
and analysis of detailed movement patterns. Two sub-cohorts (10,000 individuals each)
will also self-swab when ill for detection of COVID-19 and other circulating viruses. We will
also conduct a London based study (200 households) following household contacts of
COVID-19 cases for 28 days with daily symptom reporting, regular swabbing and baseline
and follow up serology to investigate household transmission and asymptomatic infection
and virus shedding. We will use data from Virus Watch to train whole population prediction
models based on social media and search engine data and develop spatiotemporal
models. Findings will be rapidly disseminated via online dashboards informing the public
and decision makers.