ArticleThe Lancet regional health. Europe2021
Evaluating social and spatial inequalities of large scale rapid lateral flow SARS-CoV-2 antigen testing in COVID-19 management: An observational study of Liverpool, UK (November 2020 to January 2021).
Article in The Lancet regional health. Europe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of testing, contact tracing and isolation interventions among the general population on reducing transmission of SARS-CoV-2: a systematic review.Philosophical transactions. Series A, Mathematical, physical, and engineering sciences · 2023Pooled it
- Intensified screening for SARS-CoV-2 in 18 emergency departments in the Paris metropolitan area, France (DEPIST-COVID): A cluster-randomized, two-period, crossover trial.PLoS medicine · 2023Trial
- Disparities in COVID-19 Testing and Infection Among Beneficiaries in the Military Health System During the First Year of the Pandemic.Journal of racial and ethnic health disparities · 2026Article
- Adherence to mask wearing and social distancing and use of lateral flow tests during the COVID19 pandemic in England and Wales based on the virus watch community cohort study.Discover public health · 2026Article
- Who got tested and who got sick? Sociodemographic inequalities in COVID-19 testing and hospitalization among 1.48 million individuals in Sweden.European journal of epidemiology · 2025Article
- SARS-CoV-2 infection and new-onset type 1 diabetes in the post-acute period among children and young people in England.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- Effectiveness and user experience of nose and throat swabbing techniques for SARS-CoV-2 detection: results from the UK COVID-19 National Testing Programme.BMC global and public health · 2025Article
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- At-home testing for respiratory viruses: a minireview of the current landscape.Journal of clinical microbiology · 2024Review
- Near-source passive sampling for monitoring viral outbreaks within a university residential setting.Epidemiology and infection · 2024Article
- Sociodemographic characteristics and COVID-19 testing rates: spatiotemporal patterns and impact of test accessibility in Sweden.European journal of public health · 2024Article
- COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region.Journal of the Royal Society of Medicine · 2024Observational
- How science and policy came together and made a global impact: The EU common list of COVID-19 antigen tests.Open research Europe · 2024Article
- KCL TEST: an open-source inspired asymptomatic SARS-CoV-2 surveillance programme in an academic institution.Biology methods & protocols · 2024Article
- Socio-economic inequalities in access to COVID-19 tests in France in 2020: evidence from the EPICOV socio-epidemiological cohort.Frontiers in public health · 2024Article
- Bayesian spatial modelling of localised SARS-CoV-2 transmission through mobility networks across England.PLoS computational biology · 2023Article
- Assessing the importance of demographic risk factors across two waves of SARS-CoV-2 using fine-scale case data.PLoS computational biology · 2023Article
- Equitable access to COVID-19 diagnostics: factors associated with the uptake of rapid antigen testing in Victoria, Australia, January - February 2022.BMC public health · 2023Article
- Between-occupation differences in work-related COVID-19 mitigation strategies over time: Analysis of the Virus Watch Cohort in England and Wales.Scandinavian journal of work, environment & health · 2023Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundLarge-scale asymptomatic testing of communities in Liverpool (UK) for SARS-CoV-2 was used as a public health tool for containing COVID-19. The aim of the study is to explore social and spatial inequalities in uptake and case-detection of rapid lateral flow SARS-CoV-2 antigen tests (LFTs) offered to people without symptoms of COVID-19.
methodsLinked pseudonymised records for asymptomatic residents in Liverpool who received a LFT for COVID-19 between 6th November 2020 to 31st January 2021 were accessed using the Combined Intelligence for Population Health Action resource. Bayesian Hierarchical Poisson Besag, York, and Mollié models were used to estimate ecological associations for uptake and positivity of testing.
findings214 525 residents (43%) received a LFT identifying 5192 individuals as positive cases of COVID-19 (1.3% of tests were positive). Uptake was highest in November when there was military assistance. High uptake was observed again in the week preceding Christmas and was sustained into a national lockdown. Overall uptake were lower among males (e.g. 40% uptake over the whole period), Black Asian and other Minority Ethnic groups (e.g. 27% uptake for 'Mixed' ethnicity) and in the most deprived areas (e.g. 32% uptake in most deprived areas). These population groups were also more likely to have received positive tests for COVID-19. Models demonstrated that uptake and repeat testing were lower in areas of higher deprivation, areas located further from test sites and areas containing populations less confident in the using Internet technologies. Positive tests were spatially clustered in deprived areas.
interpretationLarge-scale voluntary asymptomatic community testing saw social, ethnic, digital and spatial inequalities in uptake. COVID-19 testing and support to isolate need to be more accessible to the vulnerable communities most impacted by the pandemic, including non-digital means of access.
fundingDepartment of Health and Social Care (UK) and Economic and Social Research Council.
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Registered trials
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