REal-time Assessment of Community Transmission (REACT) of SARS-CoV-2 virus: Study protocol

Steven Riley; Christina Atchison; Deborah Ashby; Christl A Donnelly; Wendy Barclay; Graham S Cooke; Helen Ward; Ara Darzi; Paul Elliott; REACT study group

doi:10.12688/wellcomeopenres.16228.2

REal-time Assessment of Community Transmission (REACT) of SARS-CoV-2 virus: Study protocol

Wellcome Open Res. 2021 Apr 21:5:200. doi: 10.12688/wellcomeopenres.16228.2. eCollection 2020.

Authors

Steven Riley^{1

2}, Christina Atchison^{1

3

4}, Deborah Ashby¹, Christl A Donnelly^{1

2

5}, Wendy Barclay⁵, Graham S Cooke^{4

6

7}, Helen Ward^{1

3

4

7}, Ara Darzi^{4

7

8}, Paul Elliott^{1

4

7

9}; REACT study group

Affiliations

¹ School of Public Health, Imperial College London, London, UK.
² MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
³ Patient Experience Research Centre, School of Public Health, Imperial College London, London, UK.
⁴ Imperial College Healthcare NHS Trust, London, UK.
⁵ Department of Statistics, University of Oxford, Oxford, UK.
⁶ Department of Infectious Disease, Imperial College London, London, UK.
⁷ National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK.
⁸ Institute of Global Health Innovation, Imperial College London, London, UK.
⁹ MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.

Abstract

Background: England, UK has one of the highest rates of confirmed COVID-19 mortality globally. Until recently, testing for the SARS-CoV-2 virus focused mainly on healthcare and care home settings. As such, there is far less understanding of community transmission. Protocol: The REal-time Assessment of Community Transmission (REACT) programme is a major programme of home testing for COVID-19 to track progress of the infection in the community. REACT-1 involves cross-sectional surveys of viral detection (virological swab for RT-PCR) tests in repeated samples of 100,000 to 150,000 randomly selected individuals across England. This examines how widely the virus has spread and how many people are currently infected. The age range is 5 years and above. Individuals are sampled from the England NHS patient list. REACT-2 is a series of five sub-studies towards establishing the seroprevalence of antibodies to SARS-CoV-2 in England as an indicator of historical infection. The main study (study 5) uses the same design and sampling approach as REACT-1 using a self-administered lateral flow immunoassay (LFIA) test for IgG antibodies in repeated samples of 100,000 to 200,000 adults aged 18 years and above. To inform study 5, studies 1-4 evaluate performance characteristics of SARS-CoV-2 LFIAs (study 1) and different aspects of feasibility, usability and application of LFIAs for home-based testing in different populations (studies 2-4). Ethics and dissemination: The study has ethical approval. Results are reported using STROBE guidelines and disseminated through reports to public health bodies, presentations at scientific meetings and open access publications. Conclusions: This study provides robust estimates of the prevalence of both virus (RT-PCR, REACT-1) and seroprevalence (antibody, REACT-2) in the general population in England. We also explore acceptability and usability of LFIAs for self-administered testing for SARS-CoV-2 antibody in a home-based setting, not done before at such scale in the general population.

Keywords: COVID-19; PCR; SARS-CoV-2; antibody; lateral flow immunoassay; point-of-care diagnostics; prevalence; virus.

Abstract

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