Towards new forms of communication and surveillance: a mixed methods study of rapid respiratory virus assessment in general practice during the SARS-CoV-2 pandemic

Introduction Improvements in diagnostic test accuracy across multiple pathogens have resulted in multi-viral point-of-care testing (POCT) via a rapid antigen test (RAT).Aim This study aimed to describe general practice practitioners' reactions to a pilot respiratory virus surveillance programme during the SARS-CoV-2 pandemic, which enabled surveillance for influenza and other respiratory viruses alongside POCT for SARS-CoV-2.Methods Participating general practices collected viral swabs between May and December 2022. Nasopharyngeal swabs were taken for both an immediate COVID-19 RAT and a polymerase chain reaction (PCR) for testing SARS-CoV-2, influenza, respiratory syncytial virus (RSV) and other respiratory viruses. A questionnaire explored practitioners' experiences and perceptions, addressing project setup, swabbing process and perceived overall value.Results Of 4135 swabbed patients, 54% were positive for one of the tested viruses. Involved nurses and doctors reported high adaptability to the swabbing process. Clinicians valued obtaining rapid diagnostic information for patient management and patient communication. While no significant barriers were identified, practitioners acknowledged additional time requirements and potential challenges with swabbing young children.Discussion The study demonstrated the feasibility and clinical utility of using POCT swabbing for immediate RAT and subsequent PCR testing for respiratory viruses in general practices when managing a viral pandemic. The data assisted in identifying community transmission of respiratory viruses, provided information for patient management and reinforced positive health messages about viral illnesses. The study suggests potential benefits for both individual patient care and population-based surveillance. The study also identified the potential value of multi-viral POCT testing via a RAT. What is already known: The introduction of polymerase chain reaction (PCR) has been seen as a rapid and sensitive method for respiratory virus surveillance, and the COVID-19 pandemic highlighted the critical need for rapid diagnosis of SARS-CoV-2 and the importance of using PCR testing for an accurate assessment. What this study adds: This study demonstrated the feasibility and clinical utility of using point-of-care test (POCT) swabbing for immediate rapid antigen test (RAT) and subsequent PCR testing for respiratory viruses in general practices in the middle of managing a viral pandemic.