Adherence to behaviours associated with the test, trace, and isolate system: An analysis using the Theoretical Domains Framework

Background: The UK’s test, trace, and isolate system are key measures to reduce the impact and spread of the COVID-19. However, engagement with and adherence to guidance on testing, self-isolation, and providing details of contacts can be low and interventions are needed. This qualitative study aimed to identify the key factors affecting adherence to test, trace, and isolate behaviours using the Theoretical Domains Framework (TDF). Methods: We conducted six online focus groups between October 2020 and February 2021 with people living in Sheffield who came into close contact with others in work or social settings (N = 30). The focus groups explored capability, opportunity, and motivational barriers to adherence to test, trace, and isolate behaviours. Framework analysis was used to code the data into TDF domains. Results: There is a complex relationship between the factors affecting COVID-19 symptom identification, testing, and self-isolation. People who perceived significant barriers to testing and self-isolation were less likely to interpret potential symptoms as COVID-19, and perceiving barriers to self-isolation reduced the likelihood of requesting a test. Concerns about the negative consequences of self-isolation for themselves and others were common and also influenced willingness to pass on details of contacts. There was a lack of trust in the Test and Trace system, with people wanting further evidence of being at risk of infection. Conclusions: Communications and interventions to increase adherence to test, trace, and isolate strategies need to consider the interplay of these behaviours and their influences and target them collectively. Efforts to promote testing should focus on the range of barriers to self-isolation, especially increasing financial and practical support, and include new messaging to promote symptom identification.

Modelling the effect of an improved trace and isolate system in the wake of a highly transmissible Covid-19 variant with potential vaccine escape

Objective: How helpful would a properly functioning find, test, trace, isolate and support (FTTIS) system be now in the UK with new Covid19 infections at a low level and half the adult population immunised but with a highly transmissible variant becoming predominant? Design: a dynamic causal model of Covid-19 supplied with the latest available empirical data is used to assess the impact of a new highly transmissible variant. Setting: the United Kingdom. Participants: a population based study. Interventions: scenarios are used to explore a Covid-19 transmission rate 50% more and twice the current rate with or without a more effective FTTIS system. Main outcome measures: incidence, death rate and reproductive ratio Results: a small short third wave of infections occurs which does not occur if FTTIS effectiveness is improved from 25% to 30%. Conclusion: a modest improvement in FTTIS would prevent a third wave caused by a highly transmissible virus.

Adherence to the test, trace, and isolate system in the UK: results from 37 nationally representative surveys

Objective To investigate rates of adherence to the UK’s test, trace, and isolate system over the initial 11 months of the covid-19 pandemic. Design Series of cross sectional online surveys. Setting 37 nationally representative surveys in the UK, 2 March 2020 to 27 January 2021. Participants 74 697 responses from 53 880 people living in the UK, aged 16 years or older (37 survey waves, about 2000 participants in each wave). Main outcome measures Identification of the main symptoms of covid-19 (cough, high temperature or fever, and loss of sense of smell or taste), self-reported adherence to self-isolation if symptoms were present and intention to self-isolate if symptoms were to develop, requesting a test for covid-19 if symptoms were present and intention to request a test if symptoms were to develop, and intention to share details of close contacts. Results Only 51.5% of participants (95% confidence interval 51.0% to 51.9%, n=26 030/50 570) identified the main symptoms of covid-19; the corresponding values in the most recent wave of data collection (25-27 January 2021) were 50.8% (48.6% to 53.0%, n=1019/2007). Across all waves, duration adjusted adherence to full self-isolation was 42.5% (95% confidence interval 39.7% to 45.2%, n=515/1213); in the most recent wave of data collection (25-27 January 2021), it was 51.8% (40.8% to 62.8%, n=43/83). Across all waves, requesting a test for covid-19 was 18.0% (95% confidence interval 16.6% to 19.3%, n=552/3068), increasing to 22.2% (14.6% to 29.9%, n=26/117) from 25 to 27 January. Across all waves, intention to share details of close contacts was 79.1% (95% confidence interval 78.8% to 79.5%, n=36 145/45 680), increasing to 81.9% (80.1% to 83.6%, n=1547/1890) from 25 to 27 January. Non-adherence was associated with being male, younger age, having a dependent child in the household, lower socioeconomic grade, greater financial hardship during the pandemic, and working in a key sector. Conclusions Levels of adherence to test, trace, and isolate are low, although some improvement has occurred over time. Practical support and financial reimbursement are likely to improve adherence. Targeting messaging and policies to men, younger age groups, and key workers might also be necessary.

Leveraging industrial-technological innovation to achieve sustainable development: A systems thinking perspective

Industrial-technological innovation (ITI) has become an important requirement for the sustainable development of China. ITI development requires a comprehensive understanding of the dynamic complexity associated with ITI systems. Previous research into ITI systems is based primarily on static methods that isolate system components, and ignore feedback on adjustments made. Based on systems thinking, this paper develop six archetypes (“Limit to Growth,” “Success to the Successful,” “Tragedy of the Commons,” “Fixes that Fail,” “Accidental Adversaries,” and “Shifting the Burden”) and an ITI system integration model. The model visualizes the ITI system as a whole and identifies bottlenecks that may affect ITI development. This conceptual model provides a more effective method of judgment, which can better explain the operational mechanism of the ITI system and improve the system’s operational characteristics. Finally, we evaluate the ITI system and propose that self-organization is a key lever of a systemic intervention framework for ITI.

Adherence to the test, trace and isolate system: results from a time series of 21 nationally representative surveys in the UK (the COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] study)

Objectives: To investigate rates of adherence to the UKs test, trace and isolate system over time. Design: Time series of cross-sectional online surveys. Setting: Data were collected between 2 March and 5 August 2020. Participants: 42,127 responses from 31,787 people living in the UK, aged 16 years or over, are presented (21 survey waves, n≈2,000 per wave). Main outcome measures: Identification of the key symptoms of COVID-19 (cough, high temperature / fever, and loss of sense of smell or taste), self-reported adherence to self-isolation if symptomatic, requesting an antigen test if symptomatic, intention to share details of close contacts, self-reported adherence to quarantine if alerted that you had been in contact with a confirmed COVID-19 case. Results: Only 48.9% of participants (95% CI 48.2% to 49.7%) identified key symptoms of COVID-19. Self-reported adherence to test, trace and isolate behaviours was low (self-isolation 18.2%, 95% CI 16.4% to 19.9%; requesting an antigen test 11.9%, 95% CI 10.1% to 13.8%; intention to share details of close contacts 76.1%, 95% CI 75.4% to 76.8%; quarantining 10.9%, 95% CI 7.8% to 13.9%) and largely stable over time. By contrast, intention to adhere to protective measures was much higher. Non-adherence was associated with: men, younger age groups, having a dependent child in the household, lower socio-economic grade, greater hardship during the pandemic, and working in a key sector. Conclusions: Practical support and financial reimbursement is likely to improve adherence. Targeting messaging and policies to men, younger age groups, and key workers may also be necessary.

Government response to COVID-19 in the Czech Republic: February–July 2020

The Czech Republic initially managed the outbreak of the novel coronavirus remarkably, with relatively few cases and low death rate. Its public health response was characterized by swift implementation of public health measures driven by an implicit precautionary principle, but also chaotic communication of measures and a lack of transparency in justifying individual policies. June and July 2020 have seen a rise in COVID-19 cases linked to two regional clusters but later associated with community transmission, which exposed weaknesses in the country’s test-trace-isolate system.

Framework for Unifying Model-based and Data-driven Fault Diagnosis

Model-based diagnosis methods rely on a model that defines nominal behavior of a dynamic system to detect abnormal behaviors and isolate faults. On the other hand, data-driven diagnosis algorithms detect and isolate system faults by operating exclusively on system measurements and using very little knowledge about the system. Recently, several researchers have combined model-based diagnosis techniques with datadriven approaches to propose hybrid1solutions for fault diagnosis. Many researchers have proposed methods to integrate specific approaches. In this paper, we demonstrate that data-driven and model-based diagnosis methods follow a similar procedure and can be represented by a general unifying framework. This unifying framework for fault detection and isolation can be used to integrate different methodologies developed by two communities. As a case study, we use the proposed framework to build a crossover solution for fault diagnosis in a wind turbine benchmark. In this case study, we show that it is possible to achieve a better diagnosis performance by using a hybrid method that follows the proposed framework.

ISO 9001 aspects related to performance and their level of implementation

Purpose: In the last three decades, thousands of companies around the world have embraced the ISO 9001 standard in their quest to improve company performance and customer satisfaction. In recent literature, a number of authors have identified different “levels” of ISO 9001 implementation. This study aims to analyse these implementation levels in companies from the point of view of the customer, and provide guidelines for future improvement.Design/methodology/approach: Research was conducted based on the results of the second-party audits (SPAs) of 90 suppliers, (including component suppliers, assemblers, and wind farm operation and maintenance services), to one of the wind power industry’s largest wind turbine manufacturers. The audits were carried out within the ISO 9001:2008 framework and conducted by one of this study’s authors in his role as the wind turbine company’s Director of Global Quality.Findings: Auditing suppliers plays a unique role in helping to isolate system weaknesses, identify opportunities and suggest areas for improvement. This study shows that, in terms of management commitment and culture and the good practices of an organization, ISO 9001 certified companies implement differing degrees of the standard. From the results of this research, a "road map" towards improvement can be established; one that allows companies in the sector to go beyond simply being accredited with the standard and instead to take advantage of ISO 9001 certification as a catalyst for change.Research limitations/implications: This article focuses only on the wind power sector, although its findings could be extrapolated to similar sectors of high technology and high levels of customization.Originality/value: While quality audits are a customary topic for academics and researchers, few contributions are related to SPAs and their impact on the quality control process of company suppliers. Primary data from the SPAs of suppliers (objective data collected by one of the paper’s authors), was used here and is one of the most valuable aspects of this paper’s contribution.