Community prevalence of SARS-CoV-2 in England from April to November, 2020: results from the ONS Coronavirus Infection Survey.

BACKGROUND: Decisions about the continued need for control measures to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rely on accurate and up-to-date information about the number of people testing positive for SARS-CoV-2 and risk factors for testing positive. Existing surveillance systems are generally not based on population samples and are not longitudinal in design. METHODS: Samples were collected from individuals aged 2 years and older living in private households in England that were randomly selected from address lists and previous Office for National Statistics surveys in repeated cross-sectional household surveys with additional serial sampling and longitudinal follow-up. Participants completed a questionnaire and did nose and throat self-swabs. The percentage of individuals testing positive for SARS-CoV-2 RNA was estimated over time by use of dynamic multilevel regression and poststratification, to account for potential residual non-representativeness. Potential changes in risk factors for testing positive over time were also assessed. The study is registered with the ISRCTN Registry, ISRCTN21086382. FINDINGS: Between April 26 and Nov 1, 2020, results were available from 1 191 170 samples from 280 327 individuals; 5231 samples were positive overall, from 3923 individuals. The percentage of people testing positive for SARS-CoV-2 changed substantially over time, with an initial decrease between April 26 and June 28, 2020, from 0·40% (95% credible interval 0·29-0·54) to 0·06% (0·04-0·07), followed by low levels during July and August, 2020, before substantial increases at the end of August, 2020, with percentages testing positive above 1% from the end of October, 2020. Having a patient-facing role and working outside your home were important risk factors for testing positive for SARS-CoV-2 at the end of the first wave (April 26 to June 28, 2020), but not in the second wave (from the end of August to Nov 1, 2020). Age (young adults, particularly those aged 17-24 years) was an important initial driver of increased positivity rates in the second wave. For example, the estimated percentage of individuals testing positive was more than six times higher in those aged 17-24 years than in those aged 70 years or older at the end of September, 2020. A substantial proportion of infections were in individuals not reporting symptoms around their positive test (45-68%, dependent on calendar time. INTERPRETATION: Important risk factors for testing positive for SARS-CoV-2 varied substantially between the part of the first wave that was captured by the study (April to June, 2020) and the first part of the second wave of increased positivity rates (end of August to Nov 1, 2020), and a substantial proportion of infections were in individuals not reporting symptoms, indicating that continued monitoring for SARS-CoV-2 in the community will be important for managing the COVID-19 pandemic moving forwards. FUNDING: Department of Health and Social Care.

The 2007 Census Test: a major step towards the 2011 Census.

The Office for National Statistics (ONS) is planning a major Census field test in 2007. It will form part of the planning and testing programme leading to up the next Census of Population for England and Wales in 2011, which will also include a Rehearsal in 2009. The 2007 Test will be a large-scale test in five local authority (LA) areas selected to reflect a range of field conditions, covering some 100,000 households in total. Within England the Test will cover parts of Bath and North East Somerset, Camden, Liverpool and Stoke-on-Trent. In Wales the Test will take place in Carmarthenshire. The selected LAs have been chosen to provide a varied cross-section of the population and types of housing that would be covered in a full census. This article sets out the main aims for the Test and describes the design and location of the sampled areas and the basis for their selection. It goes on to detail the ways (previously reported in Population Trend 1251) in which the ONS Census team and the LAs involved are working in partnership in planning the census enumeration with the long-term view of improving overall census coverage and user confidence in the results. The article notes that decisions on the topics to be covered in the 2007 Test have only recently been decided, and concludes with an overview of the qustions to be included in the 2007 Test questionnaire.