Data_Sheet_1_Is My Cough a Cold or Covid? A Qualitative Study of COVID-19 Symptom Recognition and Attitudes Toward Testing in the UK.PDF

Objective: Key to reducing the spread of COVID-19 in the UK is increased use of the NHS Test and Trace (NHSTT) system. This study explored one of the main issues that determine whether people engage with NHSTT, how people understand symptoms that may indicate the presence of COVID-19 and that should trigger a request for a test.
Methods: In this qualitative study, a series of semi-structured telephone interviews were conducted with 40 people (21 members of the general population, 19 students). There was nearly an equal split between male and female participants in both samples. Data were collected between 30 November and 11 December 2020 and explored using thematic analysis. There was substantial similarity in responses for both populations so we combined our results and highlighted where differences were present.
Results: Participants generally had good knowledge of the main symptoms of COVID-19 (high temperature, new, persistent cough, anosmia) but had low confidence in their ability to differentiate them from symptoms of other illnesses. Attribution of symptoms to COVID-19 was most likely where the symptoms were severe, many symptoms were present, symptoms had lasted for some time and when perceived risk of exposure to infection was high due to previous contact with others. Participants felt encouraged to engage in testing where symptoms were present and had persisted for several days, though, many had concerns about the safety of testing centres and the accuracy of test results. Students had mixed feelings about mass asymptomatic testing, seeing it as a way to access a more normal student experience, but also a potential waste of resources.
Conclusions: This study offers novel insights into how people attribute symptoms to COVID-19 and barriers and facilitators to engaging with NHSTT. Participants had positive views of testing, but there is a need to improve not just recognition of each main symptom, but also understanding that even single, mild symptoms may necessitate a test rather than a “wait and see” approach, and to address concerns around test accuracy to increase testing uptake.

研究目标：降低英国境内新冠病毒传播的核心路径，在于提升国民保健署检测与追踪（NHS Test and Trace, NHSTT）系统的使用覆盖率。本研究聚焦于影响民众主动使用NHSTT系统的关键问题之一，即民众对可能提示新冠病毒感染、且应触发检测申请的相关症状的认知水平。
研究方法：本项质性研究通过半结构化电话访谈的方式，共招募40名受访者（其中普通民众21名、学生19名），两个子样本的男女参与占比均近乎均衡。数据采集工作于2020年11月30日至12月11日期间开展，并采用主题分析法对采集到的数据进行编码分析。两类群体的应答结果存在高度相似性，因此本研究合并整体分析结果，仅在存在群体差异的部分单独标注说明。
研究结果：受访者普遍对新冠病毒的典型症状（高热、新发持续性咳嗽、嗅觉丧失）具备较好认知，但对自身区分新冠症状与其他疾病症状的能力信心不足。当症状较为严重、伴随多种症状、持续时长较长，且因过往接触他人而感知到较高感染暴露风险时，受访者更倾向于将自身症状归因于新冠病毒感染。当出现症状且持续多日后，受访者会更愿意接受检测，但不少人对检测中心的安全性以及检测结果的准确性存在顾虑。学生群体对大规模无症状检测的态度较为复杂：一方面认为其有助于恢复更正常的学生校园生活，另一方面又认为这可能造成公共资源的浪费。
研究结论：本研究为民众如何将自身症状归因于新冠病毒感染，以及影响民众使用NHSTT系统的阻碍因素与促进因素提供了全新的研究视角。受访者对新冠检测整体持积极态度，但目前仍需改进两方面工作：一是不仅要提升民众对各典型症状的识别能力，还需让民众理解即使是单一轻微症状也可能需要进行检测，而非采取“观望等待”的态度；二是需消解民众对检测准确性的顾虑，以提升检测参与率。