MRC Epidemiology UnitRemote population surveillance for COVID-19 in the Fenland cohort
The speed at which coronavirus disease (COVID-19) has spread around the world created a global health emergency. There was an urgent need for studies to contribute to the understanding of how to mitigate the pandemic and to support decision-making.
The primary aim of the study is to quantify the proportion of people who have had COVID-19 in the Fenland cohort, which is broadly representative of the population of Cambridgeshire. This was a key unknown because initially testing during the first wave was limited to those individuals with symptoms admitted to hospital. It has been suggested that between 10 to 100 times as many people may have truly been infected than official statistics suggest.
In this study antibody testing was repeated at regular intervals so that we can see if those with a positive antibody status remain positive throughout the study period. The study will be for 6 or 12 months, depending on the COVID-19 infection rates.
A real concern as restrictions were eased was the emergence of a second wave of infections. People are potentially infectious before they develop symptoms and this pre-symptomatic phase can be a driver of the spread of COVID-19. The development of approaches to enable the early identification of new cases of infection in this pre-symptomatic phase would be hugely beneficial as part of an overarching strategy to reduce the spread of COVID-19 alongside the government test and trace system.
We partnered with Huma to research the potential of identifying people who are infected in the pre-symptomatic phase using information collected from individuals remotely including measurements from devices, digital measurements on the phone, symptoms and potential COVID-19 risk factors. If successful, this approach could have the benefit of identifying potentially infectious individuals earlier for diagnostic testing and subsequent self-isolation, thereby reducing the transmission of COVID-19.
This study also aimed to measure the effect of the national COVID-19 restrictions including social distancing on health-related behaviours such as diet, physical activity, wellbeing and mental health during this period.
No single study on its own will be sufficient to understand risk factors for COVID-19 disease progression and the Fenland COVID-19 study is designed to contribute to multi-study analyses to better understand and manage the COVID-19 pandemic.