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Universal weekly testing as the UK COVID-19 lockdown exit strategy

Universal weekly testing as the UK COVID-19 lockdown exit strategy
Universal weekly testing as the UK COVID-19 lockdown exit strategy
he British public have been offered alternating periods of lockdown and relaxation of restrictions as part of the coronavirus disease 2019 (COVID-19) lockdown exit strategy.
Extended periods of lockdown will increase economic and social damage, and each relaxation will almost certainly trigger a further epidemic wave of deaths. These cycles will kill tens of thousands, perhaps hundreds of thousands, of people before a vaccine becomes available, with the most disadvantaged groups experiencing the greatest suffering.

There is an alternative strategy: universal repeated testing. We recommend evaluation of weekly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen testing of the whole population in an entire city as a demonstration site (preferably several towns and cities, if possible), with strict household quarantine after a positive test. Quarantine would end when all residents of the household test negative at the same time; everyone else in the city can resume normal life, if they choose to. This testing programme should be assessed for feasibility in one or more cities with 200 000–300 000 people. Such a feasibility study should begin as soon as possible and continue after the current lockdown ends, when the infection rate will be fairly low but rising. The rate at which the number of infections then rises or falls, compared with the rest of the UK, will be apparent within a few weeks. A decision to proceed with national roll-out can then be made, beginning in high-risk areas and limited only by reagent supplies. If the epidemic is controlled, hundreds of thousands of lives could be saved, intensive care units will no longer be overloaded, and the adverse effects of lockdown on mental ill health and unemployment will end.
0140-6736
1420-1421
Peto, Julian
40e60585-f87c-4b25-9cbc-f8a6fdebcde8
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Burgess, Rochelle A.
030fd819-991a-4489-9f19-666b526ae1ef
Hunter, David J.
9ae0f4fc-2727-4907-a925-6fad78984f9d
Riboli, Elio
41e8d861-5905-44ee-abb0-481971462a39
Romer, Paul
4d67c5d9-a94c-4541-a5bb-13883beaa75c
Peto, Julian
40e60585-f87c-4b25-9cbc-f8a6fdebcde8
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Burgess, Rochelle A.
030fd819-991a-4489-9f19-666b526ae1ef
Hunter, David J.
9ae0f4fc-2727-4907-a925-6fad78984f9d
Riboli, Elio
41e8d861-5905-44ee-abb0-481971462a39
Romer, Paul
4d67c5d9-a94c-4541-a5bb-13883beaa75c

Peto, Julian, Alwan, Nisreen, Godfrey, Keith, Burgess, Rochelle A., Hunter, David J., Riboli, Elio and Romer, Paul (2020) Universal weekly testing as the UK COVID-19 lockdown exit strategy. The Lancet, 395 (10234), 1420-1421. (doi:10.1016/S0140-6736(20)30936-3).

Record type: Letter

Abstract

he British public have been offered alternating periods of lockdown and relaxation of restrictions as part of the coronavirus disease 2019 (COVID-19) lockdown exit strategy.
Extended periods of lockdown will increase economic and social damage, and each relaxation will almost certainly trigger a further epidemic wave of deaths. These cycles will kill tens of thousands, perhaps hundreds of thousands, of people before a vaccine becomes available, with the most disadvantaged groups experiencing the greatest suffering.

There is an alternative strategy: universal repeated testing. We recommend evaluation of weekly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen testing of the whole population in an entire city as a demonstration site (preferably several towns and cities, if possible), with strict household quarantine after a positive test. Quarantine would end when all residents of the household test negative at the same time; everyone else in the city can resume normal life, if they choose to. This testing programme should be assessed for feasibility in one or more cities with 200 000–300 000 people. Such a feasibility study should begin as soon as possible and continue after the current lockdown ends, when the infection rate will be fairly low but rising. The rate at which the number of infections then rises or falls, compared with the rest of the UK, will be apparent within a few weeks. A decision to proceed with national roll-out can then be made, beginning in high-risk areas and limited only by reagent supplies. If the epidemic is controlled, hundreds of thousands of lives could be saved, intensive care units will no longer be overloaded, and the adverse effects of lockdown on mental ill health and unemployment will end.

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More information

e-pub ahead of print date: 20 April 2020
Published date: 2 May 2020
Additional Information: A more detailed version of this Correspondence was sent to the UK Government on April 10, 2020, with 34 signatories. The full letter is available online https://ephg-covid-19.org/ KMG has received reimbursement for speaking at Nestle Nutrition Institute conferences and research funding from Nestec. All other authors declare no competing interests. 27 signatories: Iain Buchan, Tim Colbourn, Céire Costelloe, George Davey Smith, Paul Elliott, Majid Ezzati, Ruth Gilbert, Mark S Gilthorpe, Robbie Foy, Richard Houlston, Hazel Inskip, Deborah A Lawlor, Adrian R Martineau, Nuala McGrath, David McCoy, Martin Mckee, Klim McPherson, Miriam Orcutt, Bharat Pankhania, Neil Pearce, Richard Peto, Andrew Phillips, Jugnoo Rahi, Paul Roderick, Sonia Saxena, Ann Wilson, and Guiqing Lily Yao

Identifiers

Local EPrints ID: 439544
URI: http://eprints.soton.ac.uk/id/eprint/439544
ISSN: 0140-6736
PURE UUID: 075a3859-8cf6-4703-93a6-75dcea00430b
ORCID for Nisreen Alwan: ORCID iD orcid.org/0000-0002-4134-8463
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

Catalogue record

Date deposited: 27 Apr 2020 16:30
Last modified: 26 Nov 2021 03:04

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Contributors

Author: Julian Peto
Author: Nisreen Alwan ORCID iD
Author: Keith Godfrey ORCID iD
Author: Rochelle A. Burgess
Author: David J. Hunter
Author: Elio Riboli
Author: Paul Romer

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