Staff working in care homes and across healthcare settings are among those most likely to have already been infected with coronavirus, according to the findings of the world’s largest home antibody testing programme.
More than 100,000 people across England tested themselves at home using a finger prick test between 20 June and 13 July to find out if they had antibodies against the virus, as part of a major research programme.
“Large scale antibody surveillance studies are crucial to helping us understand how the virus has spread across the country”
Findings from the REACT (REal Time Assessment of Community Transmission) study, led by Imperial College London, suggest that 3.4 million people – 6% of the population – had already been infected by the virus by 13 July.
Those working in care homes and healthcare, people from Black, Asian and other minority ethnic (BAME) groups, people living in larger households and those living in London were the most likely to be infected.
The study showed the rate of infection of people working in care homes was 16% and those in health care was 12%, compared to 5% of people who were not key workers.
Researchers said the “high prevalence in individuals with people-facing roles in social and health care suggests that infection control in the early months of the epidemic was inadequate in these settings and likely placed both staff and residents/patients at risk”.
They also highlighted that almost 50% of infections in people over 65 were asymptomatic.
These two factors combined emphasised the “need for expanded testing in the care home setting in particular among staff and residents”, the study authors said.
The new findings come after it was revealed at the end of July that the government had failed to keep its promise to provide weekly coronavirus tests for staff in care homes.
At the time, care homes in England had been told there would be a five-week wait before another round of testing was available.
This came after the government had outlined plans at the start of July to roll-out weekly tests for staff at care homes for older people, and monthly tests for residents.
The researchers also flagged that there were far higher rates of antibodies in people from black (17%) and Asian (12%) backgrounds in comparison to white people (5%).
Overall, the study said: “The pandemic of SARS-CoV-2 infection in England disproportionately affected ethnic minority groups and health and care home workers.
“The higher risk of infection in these groups may explain, at least in part, their increased risk of hospitalisation and mortality from Covid-19.”
During the pandemic, the emergence of the disproportionate affect of Covid-19 on people from BAME groups also placed a stark lens on the inequalities faced by nurses from these backgrounds.
Recent reviews uncovered that institutional racism and bullying at work meant that nurses from BAME backgrounds were “afraid to speak up” about issues that put them at a higher risk of Covid-19.
Meanwhile, research from June revealed more than 10,000 nurses, midwives and nursing associates had contracted Covid-19 since the start of the pandemic, with rates of infection highest among Asian staff.
According to the government, work is underway between the Department of Health and Social Care, directors of public health and councils to understand and mitigate risks of transmission for BAME communities at a local level.
Other findings from the REACT home testing study showed that in London 13% of people had antibodies of the virus, while in the South West it was less than 3%.
In addition, it found that those aged 18-34 were most likely to have antibodies (8%), with the lowest prevalence in those over 65 (3%).
People living in the most deprived areas had higher antibody levels than those in the wealthiest areas and people in households of over six or seven were more likely to have had the virus than those living alone or with one other.
Overall, 32% of people reported no symptoms and this was more common in people over 65.
“Using the finger-prick tests has given us clearest insight yet into the spread of the virus and who has been at greatest risk”
Commenting on the study, health minister Edward Argar said: “Large scale antibody surveillance studies are crucial to helping us understand how the virus has spread across the country and whether there are specific groups who are more vulnerable, as we continue our work to drive down the spread of the disease.
“We don’t yet know that antibodies provide immunity to coronavirus, but the more information we can gather on this virus, and the easier we can make it for people to participate in these studies, the better equipped we will be to respond.”
Meanwhile, Professor Graham Cooke, National Institute for Health Research professor of infectious diseases and research lead at Imperial, said: “There are still many unknowns with this new virus, including the extent to which the presence of antibodies offers protection against future infections.
“Using the finger-prick tests suitable for large scale home testing has given us clearest insight yet into the spread of the virus in the country and who has been at greatest risk.”
Professor Cooke added that such data would have “important implications for decisions around ongoing control measures in England”.
REACT has been commissioned by the Department of Health and Social Care and is being carried out in partnership with Imperial College London, Imperial College Healthcare NHS Trust and Ipsos MORI.