Falko F Sniehotta, Jan Lecouturier and Michael P Kelly
The aim of this study was to gain an understanding of how to communicate COVID-19 antibody test results to the general public and to inform further research comparing specific policy options. This required an in-depth exploration to address the following questions:
- What is the public understanding of antibody testing for COVID-19?
- In the public’s view, what should these tests be used for?
- How do the public make sense of the uncertainty about test results (chance of false positive and false negatives) and risk of people with antibodies transmitting the virus or re-contracting the disease?
- How do members of the public anticipate they would respond to a positive or negative result to a COVID-19 antibody test?
The data were collected during the period of maximum lockdown when the government’s message was ‘Stay at home, Save lives, Protect the NHS’
We held five virtual focus groups with 59 members of the public, to research public understanding of antibody testing.
- There was limited and confused understanding of what an antibody test is and what its results mean
- There was lack of clarity about reinfection, immunity and risks to self and others following testing
- The meaning of a positive test and a negative test were not well understood and neither were the implications for subsequent behaviour
- There was confusion about whether those with a positive or negative test should return to work and which social distancing and other measures would apply to them or to members of their households
- Some participants were concerned that there might be need for further testing if results were negative, because of potential subsequent infection
- Participants raised concerns about the wider public response to positive antibody test results and the adverse behavioural effects. It was thought the antibody tests could create a divided society particularly if those with a positive test result were given greater freedoms or chose to disregard the lockdown measures, and unfair for those tested negative/not tested
- The 98% accuracy for true positive/negative was generally welcomed, but the 2% false positive/negative raised concerns for some about the potential risks to themselves and to others
- Many participants were uncertain about the difference between antibody and antigen testing
- Participants were content overall with data being shared with NHS and for research purposes. However, there was a good deal of anxiety about data sharing with employers and police.
- Given the general lack of knowledge, it is highly advisable that a major information campaign, developed with the involvement of target audiences, is launched prior to any rollout of testing
- Scientific uncertainty about reinfection and transmission for those with a positive antibody test should be honestly and clearly communicated to the public
- Information about test accuracy must be carefully framed
- There is a danger of creating a perception of a two-tier society through these tests with the potential for discrimination and stigmatisation between those tested positive and those tested negative/not tested
Publications from this work:
Journal: Public understanding of COVID-19 antibody testing and test results: A qualitative study conducted in the U.K. early in the pandemic, Social Science & Medicine, (2021) – see here