Community prevalence of SARS-CoV-2 in England during April to November 2020: Results from the ONS Coronavirus Infection Survey
Background Decisions about the continued need for control measures to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rely on accurate and up-to-date information about the number of people testing positive for SARS-CoV-2 and risk factors for testing positive. Exist...
| Glavni autori: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Jezik: | English |
| Izdano: |
Elsevier
2020
|
| _version_ | 1826300241117184000 |
|---|---|
| author | Pouwels, K House, T Pritchard, E Robotham, JV Birrell, PJ Gelman, A Vihta, K-D Bowers, N Boreham, I Thomas, H Lewis, J Bell, I Bell, JI Newton, J Farrar, J Diamon, I Benton, P Walker, AS |
| author_facet | Pouwels, K House, T Pritchard, E Robotham, JV Birrell, PJ Gelman, A Vihta, K-D Bowers, N Boreham, I Thomas, H Lewis, J Bell, I Bell, JI Newton, J Farrar, J Diamon, I Benton, P Walker, AS |
| author_sort | Pouwels, K |
| collection | OXFORD |
| description | Background
Decisions about the continued need for control measures to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rely on accurate and up-to-date information about the number of people testing positive for SARS-CoV-2 and risk factors for testing positive. Existing surveillance systems are generally not based on population samples and are not longitudinal in design.
Methods
Samples were collected from individuals aged 2 years and older living in private households in England that were randomly selected from address lists and previous Office for National Statistics surveys in repeated cross-sectional household surveys with additional serial sampling and longitudinal follow-up. Participants completed a questionnaire and did nose and throat self-swabs. The percentage of individuals testing positive for SARS-CoV-2 RNA was estimated over time by use of dynamic multilevel regression and poststratification, to account for potential residual non-representativeness. Potential changes in risk factors for testing positive over time were also assessed. The study is registered with the ISRCTN Registry, ISRCTN21086382.
Findings
Between April 26 and Nov 1, 2020, results were available from 1 191 170 samples from 280 327 individuals; 5231 samples were positive overall, from 3923 individuals. The percentage of people testing positive for SARS-CoV-2 changed substantially over time, with an initial decrease between April 26 and June 28, 2020, from 0·40% (95% credible interval 0·29–0·54) to 0·06% (0·04–0·07), followed by low levels during July and August, 2020, before substantial increases at the end of August, 2020, with percentages testing positive above 1% from the end of October, 2020. Having a patient-facing role and working outside your home were important risk factors for testing positive for SARS-CoV-2 at the end of the first wave (April 26 to June 28, 2020), but not in the second wave (from the end of August to Nov 1, 2020). Age (young adults, particularly those aged 17–24 years) was an important initial driver of increased positivity rates in the second wave. For example, the estimated percentage of individuals testing positive was more than six times higher in those aged 17–24 years than in those aged 70 years or older at the end of September, 2020. A substantial proportion of infections were in individuals not reporting symptoms around their positive test (45–68%, dependent on calendar time.
Interpretation
Important risk factors for testing positive for SARS-CoV-2 varied substantially between the part of the first wave that was captured by the study (April to June, 2020) and the first part of the second wave of increased positivity rates (end of August to Nov 1, 2020), and a substantial proportion of infections were in individuals not reporting symptoms, indicating that continued monitoring for SARS-CoV-2 in the community will be important for managing the COVID-19 pandemic moving forwards.
|
| first_indexed | 2024-03-07T05:14:11Z |
| format | Journal article |
| id | oxford-uuid:dc942ce8-e68e-44e1-a33e-0a8ef1ad89f3 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:14:11Z |
| publishDate | 2020 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:dc942ce8-e68e-44e1-a33e-0a8ef1ad89f32022-03-27T09:18:52ZCommunity prevalence of SARS-CoV-2 in England during April to November 2020: Results from the ONS Coronavirus Infection SurveyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:dc942ce8-e68e-44e1-a33e-0a8ef1ad89f3EnglishSymplectic ElementsElsevier2020Pouwels, KHouse, TPritchard, ERobotham, JVBirrell, PJGelman, AVihta, K-DBowers, NBoreham, IThomas, HLewis, JBell, IBell, JINewton, JFarrar, JDiamon, IBenton, PWalker, ASBackground Decisions about the continued need for control measures to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rely on accurate and up-to-date information about the number of people testing positive for SARS-CoV-2 and risk factors for testing positive. Existing surveillance systems are generally not based on population samples and are not longitudinal in design. Methods Samples were collected from individuals aged 2 years and older living in private households in England that were randomly selected from address lists and previous Office for National Statistics surveys in repeated cross-sectional household surveys with additional serial sampling and longitudinal follow-up. Participants completed a questionnaire and did nose and throat self-swabs. The percentage of individuals testing positive for SARS-CoV-2 RNA was estimated over time by use of dynamic multilevel regression and poststratification, to account for potential residual non-representativeness. Potential changes in risk factors for testing positive over time were also assessed. The study is registered with the ISRCTN Registry, ISRCTN21086382. Findings Between April 26 and Nov 1, 2020, results were available from 1 191 170 samples from 280 327 individuals; 5231 samples were positive overall, from 3923 individuals. The percentage of people testing positive for SARS-CoV-2 changed substantially over time, with an initial decrease between April 26 and June 28, 2020, from 0·40% (95% credible interval 0·29–0·54) to 0·06% (0·04–0·07), followed by low levels during July and August, 2020, before substantial increases at the end of August, 2020, with percentages testing positive above 1% from the end of October, 2020. Having a patient-facing role and working outside your home were important risk factors for testing positive for SARS-CoV-2 at the end of the first wave (April 26 to June 28, 2020), but not in the second wave (from the end of August to Nov 1, 2020). Age (young adults, particularly those aged 17–24 years) was an important initial driver of increased positivity rates in the second wave. For example, the estimated percentage of individuals testing positive was more than six times higher in those aged 17–24 years than in those aged 70 years or older at the end of September, 2020. A substantial proportion of infections were in individuals not reporting symptoms around their positive test (45–68%, dependent on calendar time. Interpretation Important risk factors for testing positive for SARS-CoV-2 varied substantially between the part of the first wave that was captured by the study (April to June, 2020) and the first part of the second wave of increased positivity rates (end of August to Nov 1, 2020), and a substantial proportion of infections were in individuals not reporting symptoms, indicating that continued monitoring for SARS-CoV-2 in the community will be important for managing the COVID-19 pandemic moving forwards. |
| spellingShingle | Pouwels, K House, T Pritchard, E Robotham, JV Birrell, PJ Gelman, A Vihta, K-D Bowers, N Boreham, I Thomas, H Lewis, J Bell, I Bell, JI Newton, J Farrar, J Diamon, I Benton, P Walker, AS Community prevalence of SARS-CoV-2 in England during April to November 2020: Results from the ONS Coronavirus Infection Survey |
| title | Community prevalence of SARS-CoV-2 in England during April to November 2020: Results from the ONS Coronavirus Infection Survey |
| title_full | Community prevalence of SARS-CoV-2 in England during April to November 2020: Results from the ONS Coronavirus Infection Survey |
| title_fullStr | Community prevalence of SARS-CoV-2 in England during April to November 2020: Results from the ONS Coronavirus Infection Survey |
| title_full_unstemmed | Community prevalence of SARS-CoV-2 in England during April to November 2020: Results from the ONS Coronavirus Infection Survey |
| title_short | Community prevalence of SARS-CoV-2 in England during April to November 2020: Results from the ONS Coronavirus Infection Survey |
| title_sort | community prevalence of sars cov 2 in england during april to november 2020 results from the ons coronavirus infection survey |
| work_keys_str_mv | AT pouwelsk communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT houset communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT pritcharde communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT robothamjv communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT birrellpj communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT gelmana communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT vihtakd communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT bowersn communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT borehami communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT thomash communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT lewisj communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT belli communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT bellji communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT newtonj communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT farrarj communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT diamoni communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT bentonp communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey AT walkeras communityprevalenceofsarscov2inenglandduringapriltonovember2020resultsfromtheonscoronavirusinfectionsurvey |