Understanding public responses to UK's COVID test, trace and isolate measures

In a recent study published on the medRxiv* preprint server, researchers investigate the public behaviors in response to the United Kingdom test, trace, and isolate (TTI) policy in July 2021.

Study: Public perceptions and interactions with UK COVID-19 Test, Trace and Isolate policies, and implications for pandemic infectious disease modelling. Image Credit: Stokkete / Shutterstock.com

Background

As of February 3, 2022, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which is the etiologic agent of coronavirus disease 2019 (COVID-19), has infected more than 386 million people worldwide and caused over 5.7 million deaths. The devastation inflicted by the COVID-19 pandemic is multi-fold, from straining public health care systems to disrupting normal life.

The implementation of a TTI policy has been used to control viral transmission in many nations. As per the TTI policy in the U.K., infected people and their contacts who are likely to develop infection are required to isolate within their residences to prevent the further spread of SARS-CoV-2.

Individuals with symptoms such as fever, continuous cough, as well as loss of smell and taste were required to take a reverse transcription-polymerase chain reaction (RT-PCR) test and quarantine with family members until a negative result was obtained. If the test was positive, the infected person's contacts from two days before the positive test were traced and notified. The family members and contacts of the infected person were required to self-isolate at home for 10 days.

About the study

In the present study, a team of researchers conducted an analysis that was part of a 12-month rapid response academic TTI epidemiological modeling research project. This analysis was conducted at the end of the research project when several COVID-19-related restrictions were eased in the U.K.

Thematic analysis map: Factors of behavioral response to pandemic and TTI guidance. The “Attitudes… ” theme was quite distinct from the other themes, and items arising as e.g. “Perceived risk” or “Mental health” were commonly not related to “Trust”

The objective of the current study was to investigate the public behavior in response to the TTI policy, assess their pragmatic interaction and approach to TTI policies, as well as assess how this information would reflect in TTI intervention modeling by the pandemic response modelers. The researchers invited participants through social media posts and offered a £50 store voucher to participate in the online interview to share feedback on the TTI process.

A data-driven, thematic analysis was used to study the interview data in a realistic approach. The data were then refined and presented to pandemic response modelers from nine academic institutions for review, comments, and revisions.

Study findings

The participants of the study noted the lack of official guidance on SARS-CoV-2 and reported that most people considered COVID-19 to be similar to seasonal flu or allergies. Fully vaccinated people, as well as those with a history of COVID-19, believed they would not contract SARS-CoV-2 anymore and thus avoided COVID-19 testing.

The public trust in the government and its competence to guide COVID-19-related strategies was undermined due to the non-adherence of officials to the rules, cronyism, corruption, profit-generation by private organizations and confusion due to constant changes in COVID-19-related guidance.

According to reports, the National Health Service (NHS) COVID-19 app showed defective performance in reporting or pinging notifications. The app reportedly provided multiple non-specific notifications and failed to notify individuals when they were in close contact with an infected person.

The authors observed that participants feared losing their jobs if they were home-quarantined for long periods and/or multiple times. Several participants complained of being pressured to continue working despite testing positive and were asked to remove the NHS app to stop notifications.

People were more inclined to trust RT-PCR results over those of lateral flow devices (LFDs) and wanted to verify a positive LFD result with an RT-PCR test. COVID-19 contacts were less likely to adhere to isolation guidelines after a negative LFD result and all of them felt that quarantine was not needed after they had received a negative RT-PCR test.

The study observed that quarantine requirements, testing measures, and missing social interactions were the primary reasons for the participants’ open frustration with continued COVID-19 restrictions after several years into this pandemic. Multiple lockdowns had mental implications on people living in small apartments without gardens and they felt that it is mentally challenging to quarantine again when traced as contacts.

Although some people were skeptical about LFD results, others valued LFD results and believed that they were useful when traced as contacts to check their infection status and reduce anxiety. Many people also perceived that they have a moral duty to verify their infection status before visiting or meeting vulnerable individuals.

Conclusions

The present work is a qualitative interview of about 20 participants and its results could be generalized across a larger population. Several findings of this study were consistent with those of earlier studies conducted in different phases of the COVID-19 pandemic. The lack of appropriate official guidance on COVID-19 and changing policies were found to reduce trust in the government.

Some parents believed that testing on children was unethical and coercive. Adherence to quarantine measures was poor in asymptomatic cases, while symptomatic cases complied with TTI measures.

The study findings should be considered when designing and implementing better TTI measures to effectively control SARS-CoV-2 transmission and ensure public trust in COVID-19-related interventions.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information

Written by

Tarun Sai Lomte

Tarun is a writer based in Hyderabad, India. He has a Master’s degree in Biotechnology from the University of Hyderabad and is enthusiastic about scientific research. He enjoys reading research papers and literature reviews and is passionate about writing.