Impact of community asymptomatic rapid antigen testing on covid-19 related hospital admissions: synthetic control study

Zhang, Xingna ORCID: 0000-0002-8849-2112, Barr, Ben ORCID: 0000-0002-4208-9475, Green, Mark, Hughes, David ORCID: 0000-0002-1287-9994, Ashton, Matthew, Charalampopoulos, Dimitrios ORCID: 0000-0002-3763-3130, Garcia-Finana, Marta ORCID: 0000-0003-4939-0575 and Buchan, Iain ORCID: 0000-0003-3392-1650 (2022) Impact of community asymptomatic rapid antigen testing on covid-19 related hospital admissions: synthetic control study. BMJ-BRITISH MEDICAL JOURNAL, 379. e071374-.

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Abstract

<h4>Objective</h4>To analyse the impact of voluntary rapid testing for SARS-CoV-2 antigen in Liverpool city on covid-19 related hospital admissions.<h4>Design</h4>Synthetic control analysis comparing hospital admissions for small areas in the intervention population with a group of control areas weighted to be similar for past covid-19 related hospital admission rates and sociodemographic factors.<h4>Setting</h4>Liverpool city, UK, 6 November 2020 to 2 January 2021, under the intervention of Covid-SMART (systematic meaningful asymptomatic repeated testing) voluntary, open access supervised self-testing with lateral flow devices, compared with control areas selected from the rest of England.<h4>Population</h4>General population of Liverpool (n=498 042) and a synthetic control population from the rest of England.<h4>Main outcome measure</h4>Weekly covid-19 related hospital admissions for neighbourhoods in England.<h4>Results</h4>The introduction of community testing was associated with a 43% (95% confidence interval 29% to 57%) reduction (146 (96 to 192) in total) in covid-19 related hospital admissions in Liverpool compared with the synthetic control population (non-adjacent set of neighbourhoods with aggregate trends in covid-19 hospital admissions similar to Liverpool) for the initial period of intensive testing with military assistance in national lockdown from 6 November to 3 December 2020. A 25% (11% to 35%) reduction (239 (104 to 333) in total) was estimated across the overall intervention period (6 November 2020 to 2 January 2021), involving fewer testing centres, before England's national roll-out of community testing, after adjusting for regional differences in tiers of covid-19 restrictions from 3 December 2020 to 2 January 2021.<h4>Conclusions</h4>The city-wide pilot of community based asymptomatic testing for SARS-CoV-2 was associated with substantially reduced covid-19 related hospital admissions. Large scale asymptomatic rapid testing for SARS-CoV-2 could help reduce transmission and prevent hospital admissions.

Item Type:	Article
Uncontrolled Keywords:	Humans, Hospitalization, Communicable Disease Control, Hospitals, COVID-19, SARS-CoV-2
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	28 Nov 2022 10:02
Last Modified:	18 Jan 2023 19:43
DOI:	10.1136/bmj-2022-071374
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3166389