UK looks to get a handle on COVID infection rates as it braces for winter peak

As the number of COVID cases continue to rise the UK has announced it is to embark on a major study in an effort to get ahead of the curve.

The Winter COVID-19 Infection Study (WCIS) will run from November 2023 to March 2024, involving up to 200,000 participants.

The UK Health Security Agency (UKHSA) previously commissioned the Coronavirus Infection Survey (CIS), carried out by the Office for National Statistics (ONS) during the pandemic, in partnership with scientific study leads Oxford University.

Recognised globally as the gold standard for surveillance of the virus, CIS gathered and analysed more than 11.5 million swab tests and 3 million blood tests from April 2020 to March 2023.

The new WCIS is a different study and will involve up to 32,000 lateral flow tests being carried out each week, providing key insight into the levels of COVID-19 circulating across the wider community. This sample will be broadly representative of the population according to key characteristics.

“While widespread vaccination has allowed us to live with COVID-19, some people remain more vulnerable to severe illness, and this in turn can lead to increased pressures on the NHS over the winter months,” the UKHSA stated. “That is why UKHSA is urging eligible adults to book their flu and COVID-19 vaccines online via the NHS website, by downloading the NHS App, or by calling 119, to give themselves the best protection against severe illness and hospitalisation.”

It added the UKHSA’s existing surveillance systems already provide up-to-date information on hospital and intensive care unit (ICU) admission rates, but the introduction of this study will allow it to detect changes in the infection hospitalisation rate (IHR), which requires accurate measurement of infection levels in the community.

Calculating the IHR will enable UKHSA to assess the potential for increased demand on health services due to changes in the way the virus is spreading, which could be driven by the arrival of any new variants, it explained.

Professor Steven Riley, director general of Data, Analytics and Surveillance at UKHSA, said: “The data we collected alongside the ONS during the pandemic provided us with a huge amount of valuable insight, so I am delighted that we are able to work together again to keep policymakers and the wider public informed in the coming months.

“UKHSA continues to lead the way internationally on COVID-19 surveillance and by re-introducing a study of positivity in the community, we can better detect changes in the behaviour of the virus.”

The study will use lateral flow devices (LFDs) supplied by UKHSA. The latest UKHSA technical briefing, published on 22 September, included initial findings of tests performed in the laboratory at Porton Down to examine the effectiveness of LFDs in detecting BA.2.86, and found no reduction in sensitivity compared to previous variants.

The model and scale of this study could also be converted into a programme that captures data on different respiratory viruses, should that be required in future.

Deputy national statistician Emma Rourke at the ONS said: “ONS is committed to building on the experience of standing up the gold standard CIS. Our resources and statistical expertise are here for the public good, and we are delighted to be delivering this study in partnership with UKHSA.

“There remains a need for robust data to help us continue to understand the virus and its effects during the winter months.

“As well as working to provide UKHSA with regular rates of positivity, we will also be looking at analysis of symptoms, risk factors and the impact of respiratory infections, including long COVID, as part of this important surveillance.”