Antibody testing on adults
1 May 2020
Zoom call with members of the public: intro slides, snap poll & breakout room discussions
Helen Ward, Christina Atchison, Philippa Pristerà
Breakout room hosts / facilitators (A-Z):
Anna Lawrence-Jones, Maria Piggin, Philippa Pristerà, Rozlyn Redd / Christina Atchison, Emily Cooper, Helen Ward, Jane Bruton, Vasiliki Papageorgiou
Insight Report authors:
Emily Cooper, Philippa Pristerà
The REACT study, which stands for REal-time Assessment of Community Transmission, is a complex research programme looking at community transmission of SARS-COV-2, the virus that causes COVID-19. One arm of the study, REACT-2, aims to better understand how many people have already had COVID-19 through home-based antibody testing. However, an important part of this includes confirming how accurate, easy to use and acceptable these self-testing antibody kits are before sending them to larger numbers of the general public. PERC are supporting this study by carrying out community involvement to gain early insight on people's thoughts about antibody testing in general, as well as their questions, concerns and suggestions to inform piloting of the self-testing kits in the community.
On Friday 1st May 2020, we held a community involvement zoom call (12–1pm), which was attended by 37 members of the public from across the UK. The majority were relatively experienced with public involvement in research, but for some this was their first time engaging with us in this way.
The agenda for the call included:
- Context for the call and an introduction to the project team
- A quick introduction to antibody testing and immunity
- Our plans for the REACT studies and community involvement
- Q&A and PreDiscussion Poll
- Breakout room discussions (4 rooms; 9–10 members of the public per room) covering broad topics including (i) Understanding/Concerns/Acceptability (ii) Logistics (iii) Public material
- Next Steps and Further Questions.
Overall the REACT study was well received, and at-home antibody testing was viewed to be appropriate. However, some felt an alternative approach to testing (beyond just at-home/self-testing) would be needed for certain groups who might struggle with the test due to perceived usability/accessibility challenges. Comments raised during the breakout room discussions have been themed and summarized in our Insight Report, which is available to download. Key messages are highlighted below.
- Overall support for the at-home antibody test with most feeling they would want to take part.
➢ 97% (n=34) of respondents to our anonymous snap poll said they would be likely or very likely to take an at-home antibody test based on what they had heard during the call
➢ Participants also suggested they would be happy for the test to be available to their family members with some attendees also feeling that it would acceptable and desirable to test children with parental consent although this is something we would want to explore further with parent groups.
- Perceived usability challenges of the test may exclude certain members of the population.
➢ In general, the test was seen to present usability/accessibility challenges for those with physical or mental impairments, or those for whom English is not their first language.
➢ Several parts of the testing kit were viewed as being difficult to use or needing improvement. For example, people found the pipette difficult to use or did not understand where to deposit the blood on the cassette.
- Instruction video and booklet considered to be clear and well designed
➢ The sharing of testing instructions via a combination of video and instruction booklet was received positively, with both parts thought to be well designed.
➢ Some changes were suggested to improve their comprehensibility. For example, making the video shorter or in two parts and adding more detail to the booklet.
➢ Although call participants understood the REACT2 study is focused on the usability of the test (and that individual results could not be relied on as an indicator of immunity), there were still a number of comments regarding the accuracy of the results, including: (1) Concern around how people might interpret and feel about their test results and whether it would cause people to change their behaviour; and (2) Suggestions around how the accuracy of the test and purpose of study could be conveyed more clearly in the information booklet and what the limitations would mean for people’s perceptions of the test.
- Attendees identified several ways that the REACT2 study could be improved, including:
➢ Clear data sharing agreements
➢ Strong and consistent messaging and external/public communication about the study
➢ Recruitment that ensures representation from the BAME communities who might be most affected be SARS-COV-2 and/or the coronavirus outbreak in general
Next steps and study results
The REACT study is now underway. More information and updates on the latest findings can be found on the REACT study page. This includes our study findings on the usability and acceptability of coronavirus antibody testing, which was published on 12 August 2020. Click the following links to read the full peer-reviewed publication or an Infographic Summary (REACT-2: Usability and Acceptability Study). This long-read blog also gives more insight into what we learnt during our journey testing the usability of at-home antibody tests with members of the public.
We have established a Public Advisory Group comprised of eight public members who are continuing to guide and inform our research plans, study material and communication. You can also learn more about a related public involvement activity in which we invited parents/carers and young people to share their views on the acceptability of antibody testing on children.
More on antibody testing and the REACT study
How we're using antibody testing to track the outbreak
Experts at Imperial outline the basis of the REACT testing programme at Imperial
Researchers at Imperial College London have been working with clinicians at Imperial College Healthcare NHS Trust on a programme of work to develop a ‘gold standard’ antibody test that can be used widely to track rates of coronavirus infections in the UK’s population.
Assessing antibody tests for use in the community
How you go about finding an antibody test for use in the community
Professor Helen Ward, Professor of Public Health at Imperial College London, talks about her involvement in the REACT study to assess a range of different antibody tests for their accuracy against SARS-CoV-2 (the virus that causes COVID-19) and how easily people can use them at home. This was part of the Imperial College Academic Health Science Centre (AHSC) COVID-19 webinar series.
Developing effective COVID-19 antibody tests
Professor Graham Taylor talks through the steps involved in developing and assessing antibody tests
Professor Graham Taylor, Professor of Human Retrovirology in the Department of Infectious Diseases at Imperial College London, is part of a team carrying out antibody testing to assess if a person has previously been infected with the coronavirus that causes COVID-19. At the Imperial College Academic Health Science Centre (AHSC) COVID-19 webinar series, he talked us through how teams at St Mary’s Hospital and North West London Pathology based at Charing Cross Hospital, part of Imperial College Healthcare NHS Trust, were performing developing and testing antibody tests to inform a nationwide study.
Q&A: COVID-19 Antibody Testing
Catch up on our Q&A session about antibody testing and the REACT study
Dr Christina Atchison and Professor Wendy Barclay gave a live Q&A session on 22 July to share all things testing, from why antibody testing is helping our response to the outbreak, to why it's too soon to rely on them to change our behaviour. They responded to questions posed by a live online audience.