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Study finds low level of adherence to the UK Test, Trace and Isolate system

The success of a test, trace and isolate system is highly dependent upon individuals using the system correctly but a study has found that self-reported adherence to the system is low.

The use of a national test, trace and isolate (TTI) system allows countries to separate those infected with COVID-19 as a means of helping to prevent the spread of the virus. In the UK, the TTI system has focused on the requirement for individuals who develop the classic COVID-19 symptoms to isolate themselves for at least seven days, request a test for the virus and to provide details of close contacts. However, the success of the system is highly dependent upon individuals being able to recognise the relevant COVID-19 symptoms and some research has shown that knowledge of symptoms is poor. Now research led by a team from the Department of Psychological Medicine, Kings College, London, UK, has analysed data obtained from 37 online surveys conducted across the UK from January 2020 to 2021 and which tracked adherence to the key components of the TTI system over time. The researchers were interested in identifying the personal and clinical characteristics that were related to full adherence to the system. The team set the outcome measures of interest as the correct identification of COVID-19 symptoms, levels of self-reported self-isolation, requests for a test and finally sharing contact details.

Data were obtained from 53,880 participants across the four nations of the UK. Between May 2020 and January 2021, only 51.5% of respondents were able to correctly identify the symptoms of COVID-19. Furthermore, while in the early surveys during 2020, only 20.2% said that they had not left home since developing symptoms. However, the overall level of adherence to full self-isolation increased to 42.5% over later months. The desire to request a COVID-19 test was also initially low (18%) but increased slightly to 22.2% in January 2021. Key reasons cited for not requesting a test were not thinking symptoms were COVID-19-related (20.9%) and that symptoms had improved (16.9%). Finally, across all surveys, the proportion willing to share close contact details was 79.1% but this increased to 81.9% in January 2021. Overall, factors associated with non-adherence to the TTI system included being male, younger age, having a dependent younger child in the household and lower socioeconomic grade.

The authors noted that the low self-reported rates of adherence to the TTI system were probably linked to an apparent lack of awareness of COVID-19 symptoms. They concluded that the effectiveness of the system in its current form is limited and called for policies that supported people financially and better communication about the TTI system for it to become more effective.

Smith LE et al. Adherence to the test, trace and isolate system in the UK: results from 37 nationally representative surveys. BMJ 2021