Covid-19 infection survey – participants raise concerns

katehrine 1080x1080
issues raised include lack of PPE, samples being taken incorrectly and no-shows by staff.

Reports Katharine Quarmby, Investigations Editor


Participants in the flagship Covid-19 infection survey, which Health Secretary Matt Hancock has said should “inform future action” and “better understand the virus”, have raised concerns about the way in which it is being carried out. These include issues around the use of personal protective equipment (PPE) by healthcare staff taking samples from the public, staff not able to take samples correctly and a considerable number of no-shows by staff.

The Covid-19 infection survey is a major UK study to monitor the current rate of infection at any given time and to explore how many people have developed antibodies in the UK. In the first stage, launched on 23 April, 10,000 households, approximating to 25,000 people, were contacted to take part, with participants asked to provide a nose and throat swab to test. Adults in a smaller number of households were asked to provide a blood sample to see if they had developed antibodies. Up to 300,000 people are expected to take part in an extended study over 12 months. The study is billed as a representative survey of the UK population and is led by the Department for Health and Social Care (DHSC) and the Office for National Statistics (ONS), working with the University of Oxford, the data science company IQVIA UK and the National Biosample Centre in Milton Keynes. Health Secretary Matt Hancock said the study would provide ““a vital part of our ongoing response to this virus.” Very early results from the survey, from 7087 individuals, indicate that 0.24% of the population has tested positive for Covid-19  and further, more detailed results are expected on 14 May.

IQVIA, which is responsible for the doorstep data collection, has been criticised by participants for its lack of capacity to cope with phone calls as soon as the study launched. Members of the public invited to take part said that they could not get through to make appointments. Since then, participants have made other complaints. One survey respondent told Liberty Investigates (LI) that they have concerns about their own health after they were visited, with another telling LI that they made 77 calls to arrange appointments, with only one being made and three appointments being missed. These are not isolated issues. Tweets to IQVIA document participants complaining about systematic no-shows by healthcare workers, poor sample collection, insufficient capacity to deal with calls to make appointments and lack of communication about cancelled appointments.

One participant, who did not want to be named, told Liberty Investigates that they waited in for a first appointment and nobody turned up. A second appointment was booked, and the participant said that they were then “surprised and concerned that a nurse arrived at my doorstep without PPE other than a pair of gloves, especially as she offered to come into my house and do the swabs.” They added: “We had to stand close to receive the testing equipment and sign and return the consent forms. This nurse is going from household to household without any protection for herself or those whom she visits.”

The participant emailed their concerns to the team at the University of Oxford, which is overseeing the project. They passed the email on to ONS, which replied that the nurse didn’t need full PPE, as the nurse should have engaged in social distancing. ONS’s Deputy Lead on Data Collection and Tracking emailed the participant and said: “I am therefore concerned that you state you had to stand in close proximity to receive the swabs and sign the consent forms. There are clear guidelines that state the materials are to be bagged and left for the respondent to collect whilst the study health worker retreats to the requisite distance. I can appreciate why this made you anxious for the health of yourself, the study health practitioner and others” and promised to look into the case.

The paperwork given out to participants states that “the study healthcare worker will use all the recommended precautions to protect you and other people in your home from getting the virus. The study health worker will bring all the necessary equipment, including PPE (personal protective equipment) with them to your home for a visit.”

No healthcare worker turned up for the second test, which was supposed to be a week later and the participant has not been contacted since. This raises concerns about communication and about the extent to which the data is useful if the weekly tests are not carried out in accordance with the survey design. Participants are supposed to be swabbed five times at weekly intervals, and thereafter every month for a period of 12 months.

David Wilkin, who also agreed to take part in the survey, told Liberty Investigates that he and his family had made four appointments. It took 77 phone calls to get through. After one no-show and several more calls a nurse appeared, wearing a clinical mask and gloves. However, the second and third scheduled visits did not happen. Wilkin, who has now withdrawn from the survey, said: “I am absolutely disgusted by the incompetence. It is a sadly missed opportunity to collect important data. That opportunity has now been missed.”

Looking on IQVIA’s Twitter page, there have been frequent no-shows, with other members of the public in the sample raising concerns including poor collection of swabs, lack of test kits, and other issues. Some have waited four times for staff to turn up.

It is a sadly missed opportunity to collect important data.

David Wilkin, participant

One participant said that the healthcare worker “had clearly had almost no training. Didn’t know how to take the swabs properly, gave me the wrong paperwork.” IQVIA apologised and said that they would urgently investigate. Another household said that appointments were booked but there were no test kits available so nobody turned up. One participant said that the nurse who attended them had been flown in from abroad, and had told them that the team carrying out samples were overwhelmed.

IQVIA referred Liberty Investigates to the Office of National Statistics, saying that they are handling media inquiries on the Covid infection survey. A spokesperson for the Covid-19 Infection Survey, from the ONS, said:

“We are unable to comment on individual cases but are aware that our partners are working hard to deliver at pace whilst ensuring PPE and health and safety standards are observed by staff during swab and blood collection appointments.  These are essential to protect the public and our partner healthcare professionals. We’d like to thank everyone who has responded to our call to take part in this vital research.”

This article was also published by the Independent. Its version, co-written with Adam Forrest, can be seen here.