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.