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 UK’s 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 socioeconomic 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.

WHAT IS ALREADY KNOWN ON THIS TOPIC

• Test, trace and isolate systems are one of the cornerstones of COVID-19 recovery strategy.

• The success of the test, trace and isolation system depends on adherence to isolating if symptomatic, getting a test if symptomatic, passing on details of close contacts if infection is confirmed, and quarantining of contacts.

• Rates of adherence to test, trace and isolate behaviours in the UK need to be systematically investigated.

WHAT THIS STUDY ADDS

• Self-reported adherence to test, trace and isolate behaviours is low; intention to carry out these behaviours is much higher.

• Identification of COVID-19 symptoms is also low.

• Practical support and financial reimbursement are likely to improve adherence to test, trace and isolate behaviours.