Design and implementation of a national program to monitor the prevalence of SARS-CoV-2 IgG antibodies in England using self-testing: the REACT-2 study

<p><strong>Data System.</strong> The UK Department of Health and Social Care funded the REal-time Assessment of Community Transmission-2 (REACT-2) study to estimate community prevalence of SARS-CoV-2 IgG (immunoglobulin G) antibodies in England.</p> <p><strong>Da...

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Bibliographic Details
Main Authors: Ward, H, Atchison, C, Whitaker, M, Davies, B, Ashby, D, Darzi, A, Chadeau-Hyam, M, Riley, S, Donnelly, CA, Barclay, W, Cooke, GS, Elliott, P
Format: Journal article
Language:English
Published: American Public Health Association 2023
Description
Summary:<p><strong>Data System.</strong> The UK Department of Health and Social Care funded the REal-time Assessment of Community Transmission-2 (REACT-2) study to estimate community prevalence of SARS-CoV-2 IgG (immunoglobulin G) antibodies in England.</p> <p><strong>Data Collection/Processing.</strong> We obtained random cross-sectional samples of adults from the National Health Service (NHS) patient list (near-universal coverage). We sent participants a lateral flow immunoassay (LFIA) self-test, and they reported the result online. Overall, 905 991 tests were performed (28.9% response) over 6 rounds of data collection (June 2020–May 2021).</p> <p><strong>Data Analysis/Dissemination.</strong> We produced weighted estimates of LFIA test positivity (validated against neutralizing antibodies), adjusted for test performance, at local, regional, and national levels and by age, sex, and ethnic group and area-level deprivation score. In each round, fieldwork occurred over 2 weeks, with results reported to policymakers the following week. We disseminated results as preprints and peer-reviewed journal publications.</p> <p><strong>Public Health Implications.</strong> REACT-2 estimated the scale and variation in antibody prevalence over time. Community self-testing and -reporting produced rapid insights into the changing course of the pandemic and the impact of vaccine rollout, with implications for future surveillance.</p>