Abstract
Background: Diagnostic testing forms a major part of the UK’s response to the current coronavirus disease 2019 (COVID-19) pandemic with tests offered to anyone with a continuous cough, high temperature or anosmia. Testing capacity must be sufficient during the winter respiratory season when levels of cough and fever are high due to non-COVID-19 causes. This study aims to make predictions about the contribution of baseline cough or fever to future testing demand in the UK. Methods: In this analysis of the Bug Watch prospective community cohort study, we estimated the incidence of cough or fever in England in 2018-2019. We then estimated the COVID-19 diagnostic testing rates required in the UK for baseline cough or fever cases for the period July 2020-June 2021. This was explored for different rates of the population requesting tests and four COVID-19 second wave scenarios. Estimates were then compared to current national capacity. Results: The baseline incidence of cough or fever in the UK is expected to rise rapidly from 154,554 (95%CI 103,083 - 231,725) cases per day in August 2020 to 250,708 (95%CI 181,095 - 347,080) in September, peaking at 444,660 (95%CI 353,084 - 559,988) in December. If 80% of baseline cough or fever cases request tests, average daily UK testing demand would exceed current capacity for five consecutive months (October 2020 to February 2021), with a peak demand of 147,240 (95%CI 73,978 - 239,502) tests per day above capacity in December 2020. Conclusions: Our results show that current national COVID-19 testing capacity is likely to be exceeded by demand due to baseline cough and fever alone. This study highlights that the UK’s response to the COVID-19 pandemic must ensure that a high proportion of people with symptoms request tests, and that testing capacity is immediately scaled up to meet this high predicted demand.
Highlights
In response to the spread of novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the United Kingdom (UK) has implemented large-scale public health measures that aim to reduce transmission and contact rates in the population
In this study, we estimate the baseline incidence of cough or fever cases and their potential impact on COVID-19 diagnostic testing services in the UK in July 2020 – June 2021
Our results show that a high baseline incidence of cough and fever between September 2020 and February 2021 will place a significant strain on UK testing capacity
Summary
In response to the spread of novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the United Kingdom (UK) has implemented large-scale public health measures that aim to reduce transmission and contact rates in the population. The importance of COVID-19 testing in the UK’s response to the current pandemic is apparent in the five-pillar testing strategy, described by the UK Government in April 2020. Diagnostic testing forms a major part of the UK’s response to the current coronavirus disease 2019 (COVID-19) pandemic with tests offered to anyone with a continuous cough, high temperature or anosmia. We estimated the COVID-19 diagnostic testing rates required in the UK for baseline cough or fever cases for the period July 2020-June 2021. This was explored for different rates of the population requesting tests and four COVID-19 second wave scenarios. Results: The baseline incidence of cough or fever in the UK is expected to rise rapidly from 154,554 (95%CI 103,083 - 231,725) cases version 2 (revision)
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