Introduction
COVID-19 is caused by the severe acute respiratory syndrome coronavirus
2 (SARS-CoV2).[1] Since first being identified in
December 2019 in China[2], it has spread globally,
becoming recognised as a global pandemic on 11 March
2020.[3]The first confirmed case in the United
Kingdom (UK) was on 31st January
2019[4], and since then there have been over
210,000 further cases with more than 31,000
deaths.[5] Social distancing and the widespread
lockdown has reduced the reproducibility of the virus and controlled the
exponential increase in the spread of the infection in the UK.
Nevertheless, the virus is likely to remain in the community, and
therefore, a viable and safe exit plan from the lockdown is required,
without increasing the risk of a second peak.
National guidelines for COVID-19 screening rely on testing symptomatic
individuals who display persistent cough or
fever.[6] Whilst most cases of COVID-19 are spread
through symptomatic individuals, there is accumulating evidence that
transmission can occur from pre-symptomatic individuals (SARS-CoV-2
detected before symptom onset) or asymptomatic (SARS-CoV-2 detected but
symptoms never develop).[7] Therefore, widespread
testing for SARS-CoV2, to interrupt an otherwise undetected transmission
chain and to fill critical knowledge gaps about the incidence of
asymptomatic COVID-19 in the UK population is urgently required in order
for the lockdown to end safely.
Pregnant women have been characterised as a vulnerable group for
developing a severe infection[8], however, they
cannot fully shield because of the multiple encounters with maternity
services as part of their routine care. Therefore, the challenge of
asymptomatic SARS-CoV-2 transmission can be associated with even greater
implications in a pregnant population with the risk of transmission to
their new-borns, other expectant mothers and health care workers (HCW)
rendering control of the pandemic more difficult.
Newham has had the highest age-standardised mortality rate for deaths
involving COVID-19, with a rate of 144.3 deaths per 100,000 between
1st March 2020 and 17th April
2020.[9] We therefore commenced a universal
testing pilot for SARS-CoV-2 for two weeks at Newham University Hospital
(NUH) in East London. In order to inform public health policymakers, we
were interested in how universal testing was perceived by patients.
The aim of our study was therefore to explore patient’s attitudes and
acceptability of universal screening for COVID-19 in a maternity
population.