Resurgence of SARS-CoV-2: Detection by community viral surveillance
Riley S., Ainslie KEC., Eales O., Walters CE., Wang H., Atchison C., Fronterre C., Diggle PJ., Ashby D., Donnelly CA., Cooke G., Barclay W., Ward H., Darzi A., Elliott P.
Surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has mainly relied on case reporting, which is biased by health service performance, test availability, and test-seeking behaviors. We report a community-wide national representative surveillance program in England based on self-administered swab results from ~594,000 individuals tested for SARS-CoV-2, regardless of symptoms, between May and the beginning of September 2020. The epidemic declined between May and July 2020 but then increased gradually from mid-August, accelerating into early September 2020 at the start of the second wave. When compared with cases detected through routine surveillance, we report here a longer period of decline and a younger age distribution. Representative community sampling for SARS-CoV-2 can substantially improve situational awareness and feed into the public health response even at low prevalence.