key: cord-0891770-cfazkjq2 authors: Heskin, Joseph; Pallett, Scott J.C.; Mughal, Nabeela; Jones, Rachael; Rayment, Michael; Davies, Gary W.; Moore, Luke S.P. title: Healthcare worker perceptions of routine asymptomatic SARS-CoV-2 screening using lateral flow assays: a qualitative analysis across two London hospitals. date: 2021-11-01 journal: J Infect DOI: 10.1016/j.jinf.2021.10.023 sha: adaacc498cfe68c4e2a543652bc5746967137488 doc_id: 891770 cord_uid: cfazkjq2 nan 544/2370 (23% of respondents). Respondents represented a broad range of staff roles and ages (Table 1) . The majority of respondents (88.5%; 1876/2119) attempted an LFA, of which 93.7% (1867/1992) were successful. Instructions were deemed easy to understand for swabbing (96%; 1913/1993) process during the pandemic. Respondents felt "it is a negligible inconvenience if it helps save lives and livelihoods". An additional theme that caused concern was the environmental impact of "the plastic waste generated from all the packaging" and "creating more waste that will end up in the ocean". Many of our Trust staff have undergone blood antibody prevalence testing using LFAs.(4) The survey mooted the theoretical option of a finger prick test for SARS-CoV-2 antigen. Only 32.3% (575/1776) of respondents found this theoretical method preferable, citing it "too invasive" and "too painful to do twice weekly", but many added "if it were more accurate, I would consider it". We find 2,800/6460 (43.3%) of staff at a multi-site London NHS Trust regularly report twice weekly LFA testing for SARS-CoV-2 antigen , and 94.5% would continue throughout the pandemic if given the opportunity. Technically almost all HCWs have no problem with LFAs but only three-quarters have confidence in reading, and in the accuracy of, LFAs. Only half of respondents find nasopharyngeal sampling comfortable, yet HCWs are still keen to concord to reduce transmission. We find self-reported increased feelings of safety among HCWs participating in the screening programme, yet we also find off-protocol use of the LFAs for symptomatic self-testing (in lieu of PCR based tests). Our respondents were representative of UK HCW populations in age and staffing groups, and while we use the Innova antigen LFA, the majority of assays follow a similar testing procedure. Our study has limitations, including the number of staff who did not elect to take part in the testing program (i.e., the respondent cohort were those who were already participating in the screening programme). Examining the barriers to this uptake must be urgently undertaken so adjustments may be made to increase participation. While correlations may be attempted between our results and experience of the general public, it is important to recognise 63% of our respondents have undergone clinical training, while non-clinical staff may have regular contact with clinical colleagues.(5-7) This may increase knowledge and understanding testing and the basis behind the screening program. In conclusion, HCWs are keen to know their real-time COVID-19 status and take part in available risk reduction strategies. They place significant trust on their employer and national bodies to ensure that testing platforms have undergone rigorous selection processes. Widespread testing amongst hospital staff did not significantly alter PPE usage, but provided reassurance for staff when moving between work and household environments. All listed authors made substantial contributions to the conception or design of the work; or to the acquisition and analysis of data for the work; and drafting the work or revising it critically ahead of submission for publication. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. JH -data curation, formal analysis, investigation, writing -original draft (including figures); SJCPmethodology, data curation, writing -review and editing; NM -conceptualization, supervision; RJ -conceptualization, writing -review and editing; GWD -conceptualization, supervision, project administration, writing -review and editing; MR -conceptualization, data curation, writing -review and editing; LSPM -conceptualization, supervision, writing -review and editing, project administration. This evaluation was commissioned as a service evaluation by the COVID The data analysed during the current study are available from the corresponding author (JH; j.heskin@nhs.net) on reasonable request, as long as this meets local ethical and research governance criteria Table 1 . Demographics of respondents to a qualitative survey on SARS-CoV-2 lateral flow self-testing as part of a nationwide programme. No Real-world evaluation of COVID-19 lateral flow device (LFD) mass-testing in healthcare workers at a London hospital; a prospective cohort analysis Home-based SARS-CoV-2 lateral flow antigen testing in hospital workers Preliminary report from the joint PHE Porton Down & University of Oxford SARS-CoV-2 LFD test development and validation cell Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study Validation testing to determine the sensitivity of lateral flow testing for asymptomatic SARS-CoV-2 detection in low prevalence settings: Testing frequency and public health messaging is key Performance of the Innova SARS-CoV-2 antigen rapid lateral flow test in the Liverpool asymptomatic testing pilot: population based cohort study Letter to the Editor regarding Peto T; UK COVID-19 Lateral Flow Oversight Team: COVID-19: Rapid antigen detection for SARS-CoV-2 by lateral flow assay