Resurgence of SARS-CoV-2: Detection by community viral surveillance

Surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has mainly relied on case reporting, which is biased by health service performance, test availability, and test-seeking behaviors. We report a community-wide national representative surveillance program in England based on self-administered swab results from -594,000 individuals tested for SARS-CoV-2, regardless of symptoms, between May and the beginning of September 2020. The epidemic declined between May and July 2020 but then increased gradually from mid-August, accelerating into early September 2020 at the start of the second wave. When compared with cases detected through routine surveillance, we report here a longer period of decline and a younger age distribution. Representative community sampling for SARS-CoV-2 can substantially improve situational awareness and feed into the public health response even at low prevalence.

Automated summary

Monitoring the SARS-CoV-2 pandemic in England using a national representative surveillance program based on self-administered swab results from over 594,000 individuals tested between May and the beginning of September 2020 revealed a decline followed by a resurgence in cases, indicative of a second wave. The study suggests that representative community sampling can provide valuable insights for public health responses, especially during periods of low prevalence.