Public Attitudes and Factors of COVID-19 Testing Hesitancy in the United Kingdom and China: Comparative Infodemiology Study

Background Massive community-wide testing has become the cornerstone of management strategies for the COVID-19 pandemic. Objective This study was a comparative analysis between the United Kingdom and China, which aimed to assess public attitudes and uptake regarding COVID-19 testing, with a focus on factors of COVID-19 testing hesitancy, including effectiveness, access, risk perception, and communication. Methods We collected and manually coded 3856 UK tweets and 9299 Chinese Sina Weibo posts mentioning COVID-19 testing from June 1 to July 15, 2020. Adapted from the World Health Organization’s 3C Model of Vaccine Hesitancy, we employed social listening analysis examining key factors of COVID-19 testing hesitancy (confidence, complacency, convenience, and communication). Descriptive analysis, time trends, geographical mapping, and chi-squared tests were performed to assess the temporal, spatial, and sociodemographic characteristics that determine the difference in attitudes or uptake of COVID-19 tests. Results The UK tweets demonstrated a higher percentage of support toward COVID-19 testing than the posts from China. There were much wider reports of public uptake of COVID-19 tests in mainland China than in the United Kingdom; however, uncomfortable experiences and logistical barriers to testing were more expressed in China. The driving forces for undergoing COVID-19 testing were personal health needs, community-wide testing, and mandatory testing policies for travel, with major differences in the ranking order between the two countries. Rumors and information inquiries about COVID-19 testing were also identified. Conclusions Public attitudes and acceptance toward COVID-19 testing constantly evolve with local epidemic situations. Policies and information campaigns that emphasize the importance of timely testing and rapid communication responses to inquiries and rumors, and provide a supportive environment for accessing tests are key to tackling COVID-19 testing hesitancy and increasing uptake.

Rapid detection of neutralizing antibodies to SARS-CoV-2 variants in post-vaccination sera

The uncontrolled spread of the COVID-19 pandemic has led to the emergence of different SARS-CoV-2 variants across the globe. The ongoing global vaccination strategy to curtail the COVID-19 juggernaut, is threatened by the rapidly spreading Variants of Concern (VOC) and other regional mutants, which are less responsive to neutralization by infection or vaccine derived antibodies. We have previously developed the hiVNT system which detects SARS-CoV-2 neutralizing antibodies in sera in less than three hours. In this study, we modify the hiVNT for rapid qualitative screening of neutralizing antibodies (nAb) to multiple VOC of SARS-CoV-2, and assess the neutralizing efficacy of the BNT162b2 mRNA vaccine on seven epidemiologically relevant SARS-CoV-2 variants. Here we show that the BNT162b2 mRNA vaccine can activate humoral immunity against the major SARS-CoV-2 mutants that are currently in circulation. Albeit a small sample size, we observed that one dose of vaccine was sufficient to elicit a protective humoral response in previously infected people. Using a panel of seven SARS-CoV-2 variants and a single prototype virus, our modified hiVNT would be useful for large-scale community wide testing to detect protective immunity that may confer vaccine/immune passport in the ongoing COVID-19 pandemic.

Body mass index and risk of COVID-19 diagnosis, hospitalisation, and death: a cohort study of 2 524 926 Catalans

Context A comprehensive understanding of the association between body mass index (BMI) and COVID-19 is still lacking. Objective To investigate associations between BMI and risk of COVID-19 diagnosis, hospitalisation with COVID-19, and death after a COVID-19 diagnosis or hospitalisation (subsequent death), accounting for potential effect modification by age and sex. Design Population-based cohort study. Setting Primary care records covering >80% of the Catalan population, linked to region-wide testing, hospital, and mortality records from March to May 2020. Participants Adults (≥18 years) with at least one measurement of weight and height. Main outcome measures Hazard ratios (HR) for each outcome. Results We included 2 524 926 participants. After 67 days of follow-up, 57 443 individuals were diagnosed with COVID-19, 10 862 were hospitalised with COVID-19, and 2467 had a subsequent death. BMI was positively associated with being diagnosed and hospitalised with COVID-19. Compared to a BMI of 22kg/m 2, the HR (95%CI) of a BMI of 31kg/m 2 was 1.22 (1.19-1.24) for diagnosis, and 1.88 (1.75-2.03) and 2.01 (1.86-2.18) for hospitalisation without and with a prior outpatient diagnosis, respectively. The association between BMI and subsequent death was J-shaped, with a modestly higher risk of death among individuals with BMIs ≤19kg/m 2 and a more pronounced increasing risk for BMIs ≥40kg/m 2. The increase in risk for COVID-19 outcomes was particularly pronounced among younger patients. Conclusions There is a monotonic association between BMI and COVID-19 diagnosis and hospitalisation risks, but a J-shaped one with mortality. More research is needed to unravel the mechanisms underlying these relationships.

Rapid detection of neutralizing antibodies to SARS-CoV-2 variants in post-vaccination sera

The uncontrolled spread of the COVID-19 pandemic has led to the emergence of different SARS-CoV-2 variants across the globe. The ongoing global vaccination strategy to curtail the COVID-19 juggernaut, is threatened by the rapidly spreading Variants of Concern (VOC) and other regional mutants, which are less responsive to neutralization by infection or vaccine derived antibodies. We have previously developed the hiVNT system which detects SARS-CoV-2 neutralizing antibodies in sera in less than three hours. In this study, we modify the hiVNT for rapid qualitative screening of neutralizing antibodies (nAb) to multiple variants of concern (VOC) of SARS-CoV-2, and assess the neutralizing efficacy of the BNT162b2 mRNA vaccine on seven epidemiologically relevant SARS-CoV-2 variants. Here we show that the BNT162b2 mRNA vaccine can activate humoral immunity against the major SARS-CoV-2 mutants that are currently in circulation. Albeit a small sample size, we observed that one dose of vaccine was sufficient to elicit a protective humoral response in previously infected people. Using a panel of seven SARS-CoV-2 variants and a single prototype virus, our modified hiVNT would be useful for large-scale community wide testing to detect protective immunity that may confer vaccine/immune passport in the ongoing COVID-19 pandemic.

Infection Testing at Scale: An Examination of Pooled Testing Diagnostics

Executive Summary In pandemics or epidemics, public health authorities need to rapidly test a large number of individuals without adequate testing kits. We propose a testing protocol to accelerate infection diagnostics by combining multiple samples, and in case of positive results, re-test individual samples. The key insight is that a negative result in the first stage implies negative infection for all individuals. Thus, a single test could rule out infection in multiple individuals. Using simulations, we show that this protocol reduces the required number of testing kits, especially when the infection rate is low, alleviating a key bottleneck for public health authorities in times of pandemics and epidemics such as COVID-19. Our proposed protocol is expected to be more effective when the infection rate is low, which suggests that it is better suited for early stage and large-scale, population-wide testing. However, the managerial trade-off is that the protocol has costs in additional time for returning test results and an increased number of false negatives. We discuss applications of pooled testing in understanding population-wide testing to understand infection prevalence, to diagnose infections in high-risk groups of individuals, and to identify disease cold spots.

Can Genomics Remove Uncertainty from Adoption? Social Workers’ and Medical Advisors’ Accounts of Genetic Testing

Genetic testing is controversial in adoption with professionals taking different positions on whether children should be protected from genetic information or whether it can be used to assist adoption. In this article, we argue that advances in ‘genome-wide’ testing add further complications to these debates. Although next-generation sequencing (NGS) and microarray-based technologies can offer high-quality molecular diagnoses for a variety of conditions, they also increase the burden of interpretation. For these reasons, adoption professionals will need to understand the relevance and complexity of biomedical information. Our study explores the accounts of social workers’ and medical advisors’ knowledge and reasoning about genetic testing in adoption. Twenty participants, including social workers, managers, medical advisors and paediatricians, were recruited from adoption services in England and Wales. A key finding revealed that medical professionals reported increasing pressure to test children prior to adoption, whilst social workers justified testing on the basis that it reduced uncertainty and therefore assisted adoption. Professionals’ accounts of genetic testing suggest that social workers may not be aware of the potential indeterminacy of microarray and NGS technologies. This has important implications for adoption because increases in genomic uncertainty can stigmatise children and disadvantage their prospects for adoption.

Assessment of public attitude and uptake experience of COVID-19 tests in the United Kingdom and China: a comparative infodemiology study (Preprint)

BACKGROUND Background: Massive community-wide testing has become a cornerstone of management strategies for the COVID-19 pandemic. This study aimed to assess public attitudes, risk perception, information needs, perceived access, and uptake experience about COVID-19 testing in the UK and China. OBJECTIVE This study aimed to assess public attitudes, risk perception, information needs, perceived access, and uptake experience about COVID-19 testing in the UK and China. METHODS Methods We collected and manually coded 3856 UK tweets and 9299 Chinese Sina Weibo posts mentioning COVID-19 testing from June to July, 2020. We adopted a grounded theory framework to conduct content analysis. Descriptive analysis, time trends, geographical mapping, and chi-squared test were performed to assess the temporal, spatial, and socio-demographic characteristics that determine the difference of attitudes or uptake of COVID-19 tests. RESULTS Results Social media users in the UK demonstrated a higher percentage of support towards COVID-19 testing than those in China; comparatively, there were much wider reports of public uptake of COVID-19 tests in mainland China than the UK, and uncomfortable experiences and logistical barriers to testing were more expressed in China. The top reasons for taking COVID-19 tests were personal health needs, community-wide testing, and mandatory testing policies for travel, with major differences in the ranking order between two countries. Rumours and information need about COVID-19 testing were also identified. CONCLUSIONS Conclusion The local epidemic situation influenced public attitudes towards individual COVID-19 testing and mass community-wide testing. Policies and information campaigns that emphasise the importance of timely testing and provide a supporting environment for accessing a test are key to normalise COVID-19 testing as a part of life during the pandemic and to increase uptake.