COVID testing pilot in Liverpool reduced cases by a fifth

A new study's found that the community testing program that was trialled in Liverpool led to a significant reduction in case numbers.

Last November, the city became the first in the world to have a voluntary mass testing programme for people without coronavirus symptoms.

More than 50 sites across the city delivered rapid tests during the peak of the surge testing period, with army personnel supporting the city’s response.

Now, a study by the University of Liverpool and the Department for Health and Social Care (DHSC) has concluded that community testing led to an 18% increase in case detection and a 21% reduction in cases compared with other areas up to mid-December.

After December, due to a surge in the new Kent variant of the virus the data couldn't be accurately compared.

During the evaluation period (6 November 2020 to 30 April 2021), 283,338 (57%) Liverpool residents took a test using a lateral flow device (LFT).

The study found the devices worked as expected, identifying most cases with high viral load, which were likely to be the most infectious.

Over 6,000 asymptomatic cases were identified...

Of those tests that were taken a total of 6,300 individuals declaring no symptoms tested positive by LFT (case positivity: 2.1%), with 22,567 individuals declaring symptoms tested positive by PCR (case positivity: 14.8%).

Researchers found that:

• Testing saved around a day in the time it takes to identify someone as likely to pass on the virus, and by being able to test more people.

• There was strong public awareness of, and a largely positive attitude toward community testing, motivated by shared identity, civic pride and a wish to protect others.

• Co-ordination of testing with timely data integrated across NHS and public health organisations was critical to success.

However, people living in more deprived areas were less likely to take up testing and more likely to test positive. Fear of loss of income in self-isolation was a significant factor in this inequity in testing

Professor Iain Buchan, Dean of the Institute of Population Health and lead for the evaluation of Liverpool community testing pilot, said: “Introducing rapid antigen testing for people without symptoms of COVID-19, living or working in the City of Liverpool in November 2020, saw cases fall by a fifth, while the ability of the public health service to detect new cases – with or without symptoms – rose by a fifth.

“No other city or region was exactly like Liverpool at the time in terms of the pandemic or its restrictions, but with careful analysis of data from across England, we have shown that rapid antigen testing was a useful addition to other public health measures.”

“The city-wide teamwork and data integration needed to deliver community testing in Liverpool are assets likely to outlast the pandemic. A national grid of intelligence-led local public health systems is needed to resist the next pandemic and to recover from this one – an important conclusion of our evaluation – a bigger picture than testing for virus antigen.”

Liverpool’s Director of Public Health, Matthew Ashton, said: “The Covid-19 testing pilot was cutting edge public health work in action and a substantial number of people in the city embraced it.

“It helped cement regular testing as a way of identifying those with the virus who would have been unknowingly spreading it to others, and contributed to the fall in the infection rate we saw in Liverpool over the course of the pilot. It proved to be hugely valuable at a point in time when the vaccines had not yet been rolled out.

“It also reinforced challenges we face across all areas of public health, such as how to reach those in deprived areas, and helped us to work together with partners to address them.

“We hope our learning can be used by Governments here and abroad, not just in managing Covid-19 but also in future pandemics.”

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