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COVID-19 Testing

Testing for COVID-19 is crucial to understand who is infected and therefore a risk to others by spreading the infection.

Number of people tested

4,623

4,623 people were tested between 1 to 254 times

407 staff
3,341 Volunteers

Number of Tests

34,965

PCR Tests

14,296

Antibody Tests

View all current up to date test results

We perform lateral flow antigen (LFA) tests, at least every two days for staff or when a visitor attends the clinic. We have also continued to test for antibodies to both infection and vaccine. By repeating these tests over time, we can establish how long the antibodies take to develop and how long immunity may last in each person.

This page provides a summary of our COVID-19 testing results, further details can be accessed by using the buttons shown below.

COVID-19 Test Results

PCR Test results

% Staff Positive Test Results

Staff | Average Age: 34 Years

179 Positive (120 individuals, some testing positive multiple times)
Number of cases testing positive for the first time

Demographics

54%
Female
47%
Male

Visitors & Volunteers | Average Age: 41 Years

9,718 Negative
84 Positive (77 individuals, some testing positive multiple times)
Number of cases testing positive for the first time

Demographics

33%
Female
67%
Male

Antibody Test results

Staff | Average Age: 34 Years

Number of cases testing positive for the first time
From week 26 antibody test frequency reduced

Visitors & Volunteers | Average Age: 41 Years

317 IgG Positive only
33 IgM Positive only
181 IgM Positive and IgG Positive
3265 Negative
Number of cases testing positive for the first time

Antibody levels over time

For each individual where their antibody levels have been measured more than once their series of results (dots) over time are connected by a coloured line. There is a clear decline in antibody levels overtime. The rate of decline suggests that after four months post infection detectable levels of antibodies are likely to be low. How this translates clinically is unknown.

One individual (purple line) showed a significant change at 171 days with detectable antibodies appearing for the first time, this is probably due to reinfection as 5 months after testing positive for COVID-19 by PCR for the first time, and subsequent negative PCR test results, the individual tested positive again by PCR. A second individual (light purple line) is showing detectable antibody levels for the first time at over 285 days since their first positive PCR test, this may also be due to reinfection. The level of antibodies for both individuals peaked around 4.5 and is now on the decline.

The graphs above show that the number of weekly tests has decreased in recent weeks. This is due to Richmond Research Institute's ongoing commitment to ensure staff safety by increasing home working measures... Read more

Furthermore, travel restrictions imposed by the government mean that fewer volunteers were able to access the unit for testing. As these restrictions continue to be reviewed and will likely be loosened over the coming weeks, we aim to boost testing for COVID-19 again shortly.

Summary of Results

6th June 2022:
The official confirmed UK COVID-19 daily case rate has started to decrease following the release of restrictions, from a nadir of approx. 27,000 cases reported on 25th January 2022 to 5,313 reported on 1st June 2022. The latest ONS survey (1st June 2022) estimates in the week ending 27th May 2022, 784,100 people in England alone had COVID-19 infection, equivalent to 1.44% of the entire population. Previous updates have highlighted the increasing prevalence of a second subvariant (BA.2), which may be more transmissible. The overall proportion of BA.2 amongst cases tested by the relevant assay in England on 8 May 2022 is 97.0%. However the risk of hospitalisation from disease appears to be the same, if not slightly lower, than BA1.

Overall, the Omicron (BA.1 & BA.2) variant appears to be milder in disease severity than the previous dominant Delta variant. The most recent UKHSA of approx. 500,000 Omicron cases reports risk of hospitalisation or presentation to emergency care around half of Delta (HR 0.53, 95% CI: 0.50 to 0.57) and 2 and 3 doses of vaccination reducing hospitalisation by 81% (CI 77-85%) compared to the unvaccinated. Early studies suggest Omicron preferentially infects the upper airways, increasing transmissibility, and struggles to infect lung tissue, which may be responsible for reducing severity.

COVID hospitalisations are now falling, with 5,584 patients on 26th May 2022 testing positive for COVID-19 compared to a peak of 20,544 on 6th April 2022. Mechanical ventilation admission rates, reflecting the highest severity end of the disease, have now plateaued, with 175 patients with COVID-19 admitted on 22nd May 2022. Deaths remain unchanged at around 1000 patients per week recorded with COVID-19 on their death certificate. Recent changes in case rates will be reflected in deaths after approximately 3-4 weeks.

Our results at RPL continue to show a low positivity rate as does the ONS survey data. With our methodology of screening all staff, this remains an accurate tracker for the true community prevalence of the virus. In week 114 since the pandemic began we have had a 0.18% peak positivity rate.

We continue to use the Abbott CMIA test being used to measure levels of antibodies against the virus nucleocapsid and the Roche Elecsys® Anti-SARS-CoV-2 S assay which detects antibodies against the virus spike protein, as we want to be able to detect both natural and vaccine generated immunity. Our recent publication shows that individuals who have been infected with SARS-CoV-2 previously develop higher antibody levels following vaccination, with either the Pfizer/BioNTech or Oxford/AstraZeneca vaccine, in comparison to naive individuals who have not been infected with SARS-CoV-2 prior to vaccination1. Watch the animation summarising these findings. For more information about this clinical trial, registered at ClinicalTrials.gov visit: (NCT04404062). This concurs with studies of healthcare workers at St Bartholomew’s Hospital and Imperial College Healthcare NHS Trust, where individuals previously infected with SARS-CoV-2 developed peak antibody levels 140-fold higher than individuals with no previous infection following vaccination with the Pfizer/BioNTech vaccine2,3

We have detected multiple cases of reinfection at this point, a phenomenon with Omicron well-recognised globally, with over 15% of cases in the UK considered to be re-infection. This is in line with the mutations in key parts of the spike protein of the Omicron variant(Ba.1), evading acquired immunity, as well as the known immunokinetics of the natural antibody response to infection. This again tallies well with larger cohort studies such as the SIREN study following healthcare worker reinfections, which has seen the highest levels of reinfection rates since the pandemic began.

Our recent publication ‘Why the SARS-CoV-2 antibody test results may be misleading: insights from a longitudinal analysis of COVID-19’ shows our results align with the study led by Imperial College reporting antibodies levels decline significantly over four months post infection7,8,9,10. Currently we are trying to understand more about the kinetics of antibody responses post vaccination and the relative protection to future infection and hope to publish this data soon.

Updated on 8th June 2022

Overview of the COVID-19 tests

Since the pandemic began we have used six different tests, including: a Polymerase Chain Reaction (PCR) test, a COVID-19 Rapid Antibody Test, a Chemiluminescent Microparticle Immunoassay (CMIA) test, an electrochemiluminescence immunoassay (ECLIA)  and a microscopic holographic imaging and artificial intelligence (AI) software technology. Lateral flow antigen nasal swabs.

By using different tests, we can determine whether a person is currently infected with the COVID-19 virus or if they previously had the virus. This is important because many people may not develop any symptoms after becoming infected and thus may not be aware that they are spreading the virus.

View more info about each test using the plus symbols below:

Polymerase Chain Reaction (PCR)

The PCR test is currently a gold standard to check for COVID-19 infections. It measures whether SARS-CoV-2 genetic material is present in a person’s system. At Richmond Research Institute, we take throat swab samples and can produce PCR test results within just 20 minutes.

We are using the Menarini Fast Point-of-care RT-PCR test. For positive cases, we also send a sample to be verified by an independent laboratory. This allows us to check for false positive results.

Rapid Antibody Test

The COVID-19 Rapid Antibody test, known as the RAPG-COV-019 kit by Biopanda, indicates whether someone has had the SARS-CoV-2 virus and is potentially immune. It measures Immunoglobulin G (IgG) and Immunoglobulin M (IgM) - antibodies produced by the body as it fights the virus.

Usually, it takes five to 10 days for these antibodies to become measurable in blood. Over time, IgM levels will drop, while IgG levels will increase and peak at around 30 days. This allows us to measure if people had a corona virus infection. The challenge with these tests is that they are not sensitive or specific; therefore, another corona virus infection may cause a positive test result.

By using the RAPG-COV-019 antibody test kit on finger prick blood samples we can generate results within 10 minutes.

Chemiluminescent Microparticle Immunoassay (CMIA)

The Abbott Laboratories chemiluminescent microparticle immunoassay (CMIA) works by binding to SARS-CoV-2-specific IgG antibodies in a blood sample. Upon binding to IgG, a luminescent signal is generated, which can be measured and is directly proportional to the concentration of SARS-CoV-2-specific IgG antibodies.

This test detects antibodies to the SARS-CoV-2 nucleocapsid protein. With the introduction of vaccination we have introduced another test which detects antibodies to the SARS-CoV-2 spike protein to run in parallel with the CMIA test. We made this change because the Oxford/AstraZeneca and Pfizer/BioNTech vaccines generate antibodies to the spike protein and we want to be able to detect both natural and vaccine generated immunity.  

Richmond Research Institute is continuously evaluating new test methods that produce fast and accurate results.


Microscopic Holographic Imaging

The Virolens system was developed in response to surging demand for rapid COVID-19 screening devices. It is a microscopic holographic imaging and AI software technology. The Virolens system works by using a digital camera that is attached to a microscope to analyse saliva samples. The data obtained from a sample is then run through a computer system that is trained by AI to identify the unique pattern of the virus from other cells. A result is available in only 20 seconds.

Electrochemiluminescence Immunoassay (ECLIA)

The Roche Elecsys® Anti-SARS-CoV-2 S assay is an electrochemiluminescence immunoassay (ECLIA) for the quantitative determination of antibodies (including IgG) to the SARS-CoV-2 spike (S) protein in human blood samples.

Continuous Development

We continue to actively source new point of care tests which are simple, fast, and can be administered frequently. The ability to identify infectious individuals quickly is essential to ensure normality is restored.

Study Background

Working with our partner organisation, Richmond Pharmacology Limited (RPL), the initial emphasis of our COVID-19 response was on staff, clinical trial volunteers, and visitor safety.

At RPL’s London Bridge clinical trial facility which we use for our studies, RPL acted quickly and responsibly to mitigate the risks, implementing strict entry control measures for access to the research unit, evaluating key indicators such as symptom scores, body temperature, travel history, and contact tracing for anyone entering the building. The wearing of masks inside the research unit is mandatory and the number of people on site is limited to enable social distancing.

The testing regime is key as it is well-known that COVID-19 can be transmitted by asymptomatic carriers11 and vaccinated individuals

References:

  1. Can a second booster dose be delayed in patients who have had COVID-19?
  2. Antibody response to first BNT162b2 dose in previously SARS-CoV-2-infected individuals
  3. Effect of previous SARS-CoV-2 infection on humoral and T-cell responses to single-dose BNT162b2 vaccine
  4. Reinfection with SARS-CoV-2: Implications for Vaccines
  5. SARS-CoV-2 reinfection and implications for vaccine development
  6. COVID reinfections are unusual — but could still help the virus to spread
  7. Covid.joinzoe: COVID Symptom Study
  8. GOV.UK: Coronavirus (COVID-19) in the UK
  9. COVID-19 Surveillance Report
  10. Why the SARS-CoV-2 antibody test results may be misleading: insights from a longitudinal analysis of COVID-19
  11. National Center for Biotechnology Information
  12. The Lancet: Peer Reviewed Journal
  13. JAMA Network: Open Access Medical Journal
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