How groundbreaking testing project has helped flatten covid curve in Norwich
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When thousands of students were set to come to Norfolk at a time of rising coronavirus cases, those working behind the scenes of a groundbreaking project knew they had to go for it.
The Norwich Testing Initiative (NTI) was made available to students and staff at the University of East Anglia (UEA) when they returned at the end of September and has caught around 70pc of positive cases at the university.
Development had been months in the planning, with members working on testing capacity back in March to help testing capacity at the Norfolk and Norwich University Hospital (NNUH).
In early summer, the Norwich Research Park Partners’ collaboration between Earlham Institute, the University of East Anglia (UEA), the NNUH, the John Innes Centre, the Quadram Institute and The Sainsbury Laboratory picked up to work on developing further testing, which became the NTI.
The pilot was run in the summer, testing 3,000 people, before being rolled out to the university for the arrival of students.
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Its work on the UEA campus has seen 8,600 people tested since the end of September, of which 200 have received a positive coronavirus result.
Mark Hitchcock, managing director at UEA health and social care partners, has been focused since March on the programme’s development, which has been driven by the partnership itself, rather than through government.
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Mr Hitchcock said; “There’s a strong civic motivation in all the partners represented. Let’s try and do it rather than keep talking about it or wait for government to do it. We thought we would have a go ourselves.
“The way I described it the other day is I felt it had flattened the curve a little bit. I think around the start of October, it felt as if we were having a significant impact with the number of positive cases we were seeing.”
The in-house testing is one of 10 in universities across the whole country, providing staff and students with the ability to voluntarily get a Covid-19 swab test and results usually within 24 hours.
The small team of around 25 work across the programme, from the running of the website, processing tests to communicating results.
Nick Goodwin, chief operating officer, for Norwich Research Park, said organisations on the park came together quickly when concerns built in the lead up to students arriving at university.
Dr Goodwin said; “That was a bit of a tipping point for the university to decide we have got the capability – we think – we have got the proof of principle over the summer we have got the resources and capacity because the university was operating differently at that time let’s do it. The university look to who it could include to help deliver that.
“Collaboration across the park is natural when you’re doing research and learning collaboration is part of that research experience. What has been a bit different from NTI is we have been collaborating on something that is not research, it’s operational, it’s logistical, it’s required technology people might not have used before in collaboration and at a time of great urgency.
“I certainly think this is an example of how leading locally to respond to covid will have had in our own way a national impact. Everyone that is going back for Christmas without covid is not impacting someone around the country.
“If you can get it right in your local area and your region and lead by example you have a platform to do things on a bigger scale and have the bigger impacts that we want.”
Dr Goodwin, alongside his colleague Dr Kirsty Culley, came on board to help Mr Hitchcock with the logistics of running the programme which has been running over the last two months.
He said; “It’s taken a lot of persistence to keep this going for the length of time it has. It is pretty gruelling work in the laboratories and a lot of responsibility to get the right results to the students and staff and equally we have been grateful to what UEA has in place.”
To get a test, people sign up online and collected a kit from campus, self-administer a swab test and return it that day with the aim to return results in 24 hours.
Mr Hitchcock said; “We have probably found about 70pc of UEA’s positives. That’s significant, if you think we are one of nine or 10 universities that have done this there are an awful lot more positives that have gone undetected.”
Mr Hitchcock said among the challenges was the cost of the project which is running into “fraction of millions” despite donations – but the impact on individual’s health, reducing anxiety and stopping the spread of infection was huge.
Processing the tests were teams from Earlham Institute and the Bob Champions Centre who tested each swab twice to minimise the reporting of false positives or negatives.
Professor Neil Hall, director of the Earlham Institute, said; “It’s doubtful we have told someone they have had coronavirus and they haven’t had it.
“You never know what the impact of something like this is because you cannot do the negative control. We don’t know what would have happened if we weren’t testing, but if you think of those 200 positives that we found, some of those people may never have passed it on to somebody else, some of them would have spread it, some of them would have been super spreaders, we were testing people who weren’t symptomatic.
“They didn’t know they had coronavirus. There’s anecdotal stories of people that were informed as they were about to go to Wetherspoons, of students who might have been going on work placements who found out they were positive. We won’t know what the potential infection chain from those individuals might have been but I am sure some of those will have prevented future infection chains.”
The work of the team early in the pandemic as part of plans to create a project capable of delivering citywide testing has been credited as part of its success.
Professor Hall first raised in May the possibility of citywide testing, which at the time would not form part of the government strategy – but has seen been rolled out to Liverpool.
Prof Hall said; “We often say in science you have lots of ideas and many don’t get funded but they are never a waste of time. The discussions we had about how you might scale up testing to test a city were useful in the end as they were similar sort of ideas that we used for the NTI project at the university. Although we couldn’t’ tempt government at the time those ideas led to the project.”
Another element of the project overseen by the Norwich Research Parks’ collaboration was contacting those who had received a positive coronavirus result.
Dr Kirsty Culley said a team of volunteers at the university’s health and social care and medical school would be making calls, as well as teaching, to inform those with a positive result what the next step were.
Negative test results would be uploaded to the test system, but the initiative engaged call handlers to reach out to those who had a positive result rather than sending a text.
Following the call, the university’s health and safety team would then work with those affected to provide them with support.
Dr Culley said; “I think for me it made me realise my colleagues across the park will go above and beyond to get something delivered. The dedication of our scientists in our lab, the ones working over the weekend doing all the tests, working late at night, they are really making personal sacrifices to make sure this could be delivered.”
Professor Hall praised the leadership of the UEA for their response to provide a testing service from day one.
He added the next area of focus had to be ensuring the transition of students returning home but due to the initiative UEA was in “a really good place”.
Between December 3 and December 9, students will have a “travel window” to return home but unlike the start of term, the government is rolling out a lateral flow test to universities for a rapid testing process in its work to ensure students can go home.
Professor Hall said; “It will be interesting to see what happens with the return to home, nationally, you have millions of students going from areas from high areas of transmission to other areas of the country, it’s really important that has to be focus of everyone that goes well.
“The work that has been done up to now has put UEA in a really good place to be able to have the confidence of the students to know what they are doing, it would be harder at other places to persuade their students to partake in this testing programme. They can roll it out and get as many students tested before they go home.”
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