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Academic papers

*NEW* studies on vaccine effectiveness

The impact of SARS-CoV-2 vaccines on antibody responses in the general population in the United Kingdom [MedrXiv, 23 April 2021]

Impact of vaccination on SARS-CoV-2 cases in the community: a population-based study using the UK’s COVID-19 Infection Survey [MedrXiv, 23 April 2021]

Ct threshold values, a proxy for viral load in community SARS-CoV-2 cases, demonstrate wide variation across populations and over time [MedrXiv, 4 April 2021, previous version 27 October 2020] 

Increased infections, but not viral burden, with a new SARS-CoV-2 variant [MedrXiv, 15 January 2020]

Community prevalence of SARS-CoV-2 in England from April to November, 2020: Results from the ONS Coronavirus Infection Survey [Lancet Public Health, 10 December 2020]

Community prevalence of SARS-CoV-2 in England: Results from the ONS Coronavirus Infection Survey Pilot [MedrXiv, 7 July 2020]

Articles and longer adhoc publications

20 May - characteristics of people testing positive for COVID-19 in countries of the UK

  • In the weeks prior to 2 May 2021, the percentage of people testing positive for the coronavirus (COVID-19) appears to have decreased in both patient-facing and non-patient-facing job roles in the UK.
  • The number of socially distanced and physical contacts that adults and school-age children reported with people outside their household has increased since March 2021 up to 2 May 2021 across the UK.
  • In April 2021, 53% (95% confidence intervals: 45% to 60%) of people who tested positive for COVID-19 with a strong positive test reported symptoms within 35 days of the test in the UK.

5 May - characteristics of people testing positive for COVID-19 in countries of the UK

  • Transmission of the coronavirus (COVID-19) is a complex, continuous risk that can occur in any setting; although work location, mode of travel to work, and ability to socially distance at work were associated with the likelihood of testing positive, these factors alone cannot be assumed to be the only cause of the spread of the virus.
  • Between 1 December 2020 and 4 April 2021, over half the people who tested positive for COVID-19 with a strong positive test reported having one or more symptoms within 35 days of the test in England, Wales and Scotland; just under half reported symptoms in Northern Ireland.
  • Across all four UK countries, cough, fatigue and headache were the most common symptoms reported in strong positive COVID-19 cases between 1 December 2020 and 4 April 2021.

22 April - characteristics of people testing positive for COVID-19 in countries of the UK

  • In recent weeks, there is evidence that the percentage testing positive for the coronavirus (COVID-19) appears to have levelled off for those in both patient-facing and non-patient-facing job roles.
  • The number of socially distanced and physical contacts that adults and school-age children reported with people outside their household has increased through March 2021 across the UK.

8 April - characteristics of people testing positive for COVID-19 in England

  • In March 2021, 47% (95% confidence intervals: 42% to 53%) of people testing positive for the coronavirus (COVID-19) in the UK with a strong positive test reported symptoms and 53% (95% confidence intervals: 47% to 58%) did not report having any symptoms.
  • Fatigue, headache and cough were the most commonly reported symptoms from people who tested positive for COVID-19 with a strong positive test between 1 December 2020 and 22 March 2021.
  • Nausea, abdominal pain and diarrhoea were less commonly reported symptoms.
  • Of those testing positive for COVID-19 with a strong positive test, 18% (95% confidence intervals: 13% to 22%) of people reported a loss or taste of smell only.

1 April - Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK ("Long COVID")

  • Over the four-week period ending 6 March 2021, an estimated 1.1 million people in private households in the UK reported experiencing long COVID (symptoms persisting more than four weeks after the first suspected coronavirus (COVID-19) episode that are not explained by something else).
  • The estimates presented in this analysis relate to self-reported long COVID, as experienced by study participants, rather than clinically diagnosed ongoing symptomatic COVID-19 or post-COVID-19 syndrome. There is no universally agreed definition of long COVID, but it covers a broad range of symptoms such as fatigue, muscle pain, and difficulty concentrating.
  • Self-reported long COVID symptoms were adversely affecting the day-to-day activities of 674,000 people in private households in the UK, with 196,000 of these individuals reporting that their ability to undertake their day-to-day activities had been limited a lot.
  • Of people with self-reported long COVID, 697,000 first had (or suspected they had) COVID-19 at least 12 weeks previously, and 70,000 first had (or suspected they had) COVID-19 at least one year previously.
  • Prevalence rates of self-reported long COVID were greatest in people aged 35 to 69 years, females, those living in the most deprived areas, those working in health or social care, and those with a pre-existing, activity-limiting health condition; however, it is not possible to say whether these patterns are because of differences in the risk of coronavirus infection or susceptibility to experiencing long COVID following infection.
  • These estimates provide a measure of the prevalence of self-reported long COVID across the whole population, and reflect both the risk of being infected with coronavirus and the risk of developing long COVID following infection; to investigate the second of these components, we examined the duration of self-reported symptoms following confirmed infection.
  • Among a sample of over 20,000 study participants who tested positive for COVID-19 between 26 April 2020 and 6 March 2021, 13.7% continued to experience symptoms for at least 12 weeks. This was eight times higher than in a control group of participants who are unlikely to have had COVID-19, suggesting that the prevalence of ongoing symptoms following coronavirus infection is higher than in the general population.
  • Of study participants who tested positive for COVID-19, symptom prevalence at 12 weeks post-infection was higher for female participants (14.7%) than male participants (12.7%) and was highest among those aged 25 to 34 years (18.2%).

    25 March 2021characteristics of people testing positive for COVID-19 in England

    • In recent weeks, there is evidence that the percentage testing positive for the coronavirus (COVID-19) has continued to decrease for those in both patient-facing and non-patient-facing job roles.
    • The number of socially distanced and physical contacts that adults and school-age children reported with people outside their household decreased at the start of the year and remained low in early March 2021.
    • Disabled people who were limited a lot in their daily activities were less likely to test positive for COVID-19 than non-disabled people.

    22 February - Coronavirus (COVID-19) Infection Survey: characteristics of people testing positive for COVID-19 in England

    • This analysis covers the period from 1 September 2020 to 7 January 2021. During this period of time, there was a national lockdown in England between 5 November and 1 December 2020 and varying local tier restrictions in place; there was also a significant rise in the positivity rate across the country, including that related to the new variant. This analysis should be understood in that context as opposed to the reducing prevalence currently being experienced.
    • The general contact individuals have with others both in and out of work will contribute to their likelihood of testing positive. Within every occupation group, there were people who were working from home, some who found social distancing at work easy and those who found it hard. These factors in part explain the differences in testing positive between occupations.
    • After adjusting for differences across occupations and reported ability to socially distance in the workplace and work from home, there was no statistical evidence of a difference in the likelihood of testing positive for the coronavirus (COVID-19) between the majority of occupations. For nearly all occupations there is no statistical evidence of difference with at least 15 of the other 24 occupation groups.
    • This analysis shows that for 25 occupations, the likelihood of testing positive for COVID-19 at some time between 1 September 2020 and 7 January 2021 ranged from 2.1% to 4.8.% and that the different occupations were largely distributed uniformly across this continuum. The mean likelihood of testing positive for COVID-19 across the 25 occupations was 3.9%, and over half of these occupations had likelihoods of testing positive at some time between 1 September 2020 and 7 January 2021 of between 3.5% and 4.2%.
    • Pairwise comparisons of the probability of testing positive between individual occupations show that there is no difference between the majority of occupations. To illustrate this a matrix of the comparison between each occupation with every other occupation is presented. This shows that 226 of the 300 comparisons were not significant.
    • Evidence of difference presents as a continuum, which can be seen in the comparisons between different occupations. Within this, there are a group of occupations at the upper end of the continuum, that have no significant difference with the majority of other occupations, but do show a higher probability of testing positive compared with some of those at the lower end. At the upper end are caring personal service occupations, protective service occupations, teaching and other education professionals, secretarial and related occupations, and other managers and proprietors; while at the lower end are skilled agricultural and related trades; science, research, engineering and technology professionals; business, media and public service professionals; textiles, printing and other skilled trades.
    • This is the first stage in an analysis to explore the impact of occupation. We welcome input and dialogue from users on its benefit and how we can continue to explore our data. We will continue to publish here and in academic journals.

    9 FebruaryCoronavirus (COVID-19) Infection Survey: characteristics of people testing positive for COVID-19, countries of the UK, 9 February 2021

    • In England, 47% of people who tested positive for COVID-19 (95% confidence intervals: 46% to 48%) reported having any symptoms.
    • In Wales, 55% of people who tested positive for COVID-19 (95% confidence intervals: 49% to 62%) reported having any symptoms.
    • In Northern Ireland, 38% of people who tested positive for COVID-19 (95% confidence intervals: 31% to 46%) reported having any symptoms.
    • In Scotland, 47% of people who tested positive for COVID-19 (95% confidence intervals: 41% to 54%) reported having any symptoms.
    • Cough, fatigue and headache were the most commonly reported symptoms from people who tested positive between 1 October 2020 and 30 January 2021 for all four countries of the UK.
    • Abdominal pain, diarrhoea and nausea were less commonly reported symptoms.

    27 JanuaryCoronavirus (COVID-19) Infection Survey: characteristics of people testing positive for COVID-19 in England, 27 January 2021

    • In recent weeks, there is evidence that the percentage testing positive for the coronavirus (COVID-19) has decreased in non-patient facing job roles but increased amongst those in patient-facing roles in England.
    • The largest differences in reported symptoms between the new variant compatible positives and those not compatible with the new UK variant were found in cough, sore throat, fatigue and myalgia.
    • The number of socially distanced and physical contacts that adults and school age children had with people outside their household decreased in January 2021.
    • Of those in school Year 12 to 24 years old, the highest percentage testing positive was among those who are employed.

    30 December COVID-19 Infection Survey: estimates of COVID-19 cases to 23 December for England, regions of England and by cases compatible with the new variant

    21 December - COVID-19 Infection Survey Ct analysis

    14 Decembercharacteristics of people testing positive for COVID-19 in England and antibody data for the UK: December 2020

    • Looking in more detail at those testing positive for COVID-19 in England on a nose and throat swab, there is evidence that rates of positivity have decreased in those in non-patient-facing roles, and those in patient-facing roles aged under 35 years in the most recent week.
    • Across regions, people from the "Other" ethnic groups had the highest risk of testing positive compared with those in the "White" ethnic group in the following occupations: personal services, social care, and the arts, entertainment and recreation industry.

    24 November - characteristics of people testing positive for COVID-19 in England and antibody data for the UK: November 2020

    • In the most recent weeks, there is evidence that positivity rates are higher among those aged under 35 years working in patient-facing roles compared with other individuals, based on analysis of positive nose and throat swab results.

    27 Octobercharacteristics of people testing positive for COVID-19 in England: October 2020

    • From 28 September to 11 October 2020, around a third of those who tested positive for COVID-19 reported any evidence of symptoms at the time of their test.
    • From 25 September to 08 October 2020, 17- to 24-year-olds have higher positivity rates in both the higher and lower rate regions, however the difference from other age groups is much greater in the higher rate regions.
    • Urban areas in England have higher positivity rates than rural areas, with 0.70% of the community population in these areas testing positive for COVID-19 between 27 September and 10 October 2020 (95% confidence interval: 0.56% to 0.88%) while in rural areas 0.47% tested positive in the same period (95% confidence interval: 0.35% to 0.62%).
    • In the most recent fortnight (25 September to 08 October 2020) we no longer see a difference in positivity rates depending on travel abroad.

    28 September - characteristics of people testing positive for COVID-19 in England, including positivity trends over time in different subgroups

    • Between 23 July and 10 September, COVID-19 Infection rates have increased primarily in the least deprived areas within each region.

    • Positivity rates have increased over time amongst those aged under 35 years who had socially-distanced direct contact with six or more people aged 18 to 69 years, suggesting socially-distanced direct contact in younger age groups is an increasingly important factor in contracting COVID-19.

    • In recent weeks, COVID-19 positivity rates have been higher amongst people who have travelled abroad, although increases are seen in both those who have and have not travelled.

    • There is no evidence that working location is driving the greater increase in positivity rate in younger age groups in recent weeks.

    • There is evidence that Asian or Asian British individuals were more likely to have ever tested positive for antibodies against SARS-CoV-2 on a blood test than White individuals, suggesting they were more likely to have had COVID-19 in the past.

    18 August 2020 - characteristics of people testing positive for the coronavirus

    • There is evidence that Asian or Asian British individuals were more likely to test positive for COVID-19 than White individuals over the most recent eight weeks of the study, and there is also some evidence to suggest a higher percentage of individuals from ethnic minorities have had COVID-19 in the past.

    • Those in one-person households were more likely to test positive for COVID-19 on a nose and throat swab than individuals in two-person households over the latest eight-week period of the study, but there was no evidence of differences for larger households.

    • It is not possible to say whether those working in patient-facing healthcare roles were more likely to test positive for COVID-19 than other individuals based on swabs taken over the most recent eight-week period of the study, although there is evidence to suggest this was not the case earlier in our study.

    • A higher percentage of those in patient-facing healthcare roles or resident-facing social care roles tested positive for antibodies, indicating past infection, than individuals not working in these roles.

    • While those who have symptoms are more likely to test positive on nose and throat swabs than those without symptoms, out of those who have ever tested positive for COVID-19 on nose and throat swabs over the whole period of our study just 28% reported any evidence of symptoms around the time of their positive swab test.

    • There is no evidence to suggest differences in the likelihood of people of different ages testing positive for COVID-19 on nose and throat swabs over the most recent eight-week period of the study, but there is some limited evidence to suggest a smaller proportion of older people within community settings test positive for COVID-19 antibodies, indicating they have had COVID-19 in the past.

    • There is no evidence to suggest differences in the likelihood of males and females testing positive for COVID-19 on nose and throat swabs over the most recent eight-week period of the study nor evidence of differences in the percentage of people of either sex testing positive for COVID-19 antibodies, indicating they have had COVID-19 in the past.

    • It is not possible to say whether there were differences in the likelihood of testing positive for COVID-19 on a nose and throat swab over the most recent eight-week period of the study based on working location nor whether there were differences in the percentage of individuals testing positive for COVID-19 antibodies by working location, indicating they have had COVID-19 in the past.

    7 July 2020 - characteristics of those testing positive on a nose and throat swab

    • Individuals working outside the home show higher rates of positive swab tests than those who work from home.
    • Over the study period, infection rates are higher for those working in patient-facing healthcare or resident-facing social care roles than for people not working in these roles.
    • There is some evidence to suggest that infection rates are lower in one- and two-person households than in larger households.
    • While those who have symptoms are more likely to test positive than those without symptoms, out of those within our study who have ever tested positive for COVID-19, 33% reported any evidence of symptoms around the time of their positive swab test.
    • There is evidence to suggest that infection rates are higher among people who have reported coming into recent contact with a known case of the coronavirus than those who have had no reported contact with potential cases.
    • It is too early to say whether COVID-19 infection rates differ between ethnic groups because the number of people testing positive in groups other than the White ethnic group are very small, although antibody test results provide an indication that individuals identifying as White are less likely to have had COVID-19 in the past than non-white ethnic groups.