UniCoV is a multi-site study to examine and develop a rapid testing and surveillance system for the identification of SARS-CoV-2 infection in further and Higher Education Institutes in the Republic of Ireland (UniCoV). The research goal of UniCoV is to develop and inform SARS-CoV-2 Infection rapid testing and Surveillance Systems in further and Higher Education Institutes in the Republic of Ireland and provide evidence to assist the return to campus activity.
Background
Researchers at the four partnering universities piloted research studies to develop large-scale SARS-CoV-2 screening systems based on a variety of testing methods using different sample types. As such, Uni-CoV partners have a unique capability with skilled, experienced scientific and technical staff, and appropriately equipped laboratories to investigate and refine a methodology to implement large-scale SARS-CoV-2 surveillance. The synergistic integration and coordination of existing studies facilitate new research that builds on existing Science Foundation Ireland-supported work.
The PLAN
UniCoV includes a large-scale comparative analysis of SARS-CoV-2 screening technologies, both experimental and licenced, in conjunction with the exploration and translation of these technologies for use in disease surveillance and prevention in a real-world setting.
UniCoV’s Research Objectives are to:
- Compare serial testing data for SARS-CoV-2 with integrated analysis of surveillance data from multiple sources including testing, GP referral data, sewage surveillance and qualitative data.
- Comparatively assess different biosamples/sampling modalities (saliva, nasal, including self-swabbing) and SARS-CoV-2 infection testing approaches (PCR, LAMP, lateral-flow rapid antigen test (LFAT)) in terms of test sensitivity, specificity, acceptability, speed and cost, for their relative effectiveness for large-scale surveillance and screening in different settings. This will include Health Technology Assessments on different technologies in different settings, and subject reported outcome measures (SROM) which will include behavioural changes in participants.
- Develop an integrated surveillance system to inform and support an Early Warning system to prevent SARS-CoV-2 infection outbreaks in Higher Education Institutes. This will include, SARS-CoV-2 infection testing of a random sample of the population, sewage surveillance, GP referral data and qualitative data from participants. In addition, it will include modelling of multi-source data and use of statistical techniques to assist with the development of robust statistically methods to identify data signals to inform action.
- Use whole genome sequencing (PCR) of SARS-CoV-2 for large-scale viral surveillance for identification of variants of concern and of interest in the college population
- Conduct viral infectiousness assays to establish the performance of testing strategies at detecting infectious cases and the proportion of the window of infectiousness that each screening test can detect.
- Explore the use of artificial intelligence technologies to assist in objective interpretation of LFAT results and to inform IT-driven approaches to test interpretation and standardised reporting.
Learn the Lingo!
LAMP | Loop-mediated Isothermal Amplification (UCD and TCD) |
VOCs | Variants of concern |
PCR | Polymerase Chain Reaction Have you heard the song? |
Why is UniCoV important?
UniCoV will generate significant research outputs, outcomes and impacts on many areas within and beyond its lifetime. UniCoV is important for the following reasons:
Health and Wellbeing
COVID-19 restrictions have given rise to a deterioration of societal health and wellbeing. Eleven per cent of the student population reported feeling depressed with 13.7 per cent reporting loneliness. This study will assist in providing evidence to facilitate the safe return of students to on-campus education. This will improve the quality of life for students by facilitating a safe and controlled environment for social interaction, contributing to their overall health and wellbeing. A safe return to in-person education will allow people to develop interpersonal skills, be fully supported in education and reduce social isolation. UniCoV will enable early detection of outbreaks in the student population which will, in turn, reduce transmission among the student population, and beyond. This will reduce the risk of infection and consequences such as short-term illness, long term sequelae, severe illness, and mortality, thus improving self-confidence and an improvement in overall mental health.
Societal
Education is a fundamental right of all citizens. The UniCoV study could significantly impact the delivery of education through the HEIs. It will enable HEIs to more effectively deliver education during the pandemic which will have a significant beneficial impact on students and staff, as well as the wider public. A return to on-campus activities and in-person education will greatly improve the standard of teaching delivered by academic staff to students.
Ultimately, the UniCoV study will develop a system that can be deployed in each University/city of Ireland for surveillance, serial screening, and early warning of SARS-CoV-2 infection outbreaks, with the aim of enabling return to campus-based activities. The scalability of the system proposed by the study extends the potential of positive impacts beyond HEIs to the wider public. The translation and transfer of the learnings of this study to workplaces has the potential to assist the safe return of employees to work and in the standards of work being carried out, further impacting employers and employees in a positive manner. Furthermore, the knowledge gained from this study could be translated to industry, sport and tourism.
Public Health Service
UniCoV will provide novel tools and evidence for Ireland’s Public Health Service to improve the responsiveness and effectiveness of the health service response to COVID-19. The project will investigate a high-volume screening approach for SARS-CoV-2 infection that will allow student and staff volunteers to be screened routinely for SARS-CoV-2, thereby generating data on the prevalence and dynamics of transmission of SARS-CoV-2 (including variants of concern) in relation to asymptomatic individuals in demographically differentiated University settings. It will put in place an early warning system to identify early signs of outbreaks and enable Public Health to act promptly in response to these signals. The outputs of UniCoV have the potential to reduce the requirement for public health outbreak management due to the reduction in outbreaks. Testing on campus has the potential to reduce infection rates as low as 0.5% of the college population as seen internationally thereby reducing the impact on public health resources and outbreak management teams.
Economic
The COVID-19 pandemic has severely impacted Ireland’s educational system, including future and HEIs where on-campus activities have been extremely curtailed or stopped completely for over a year. Overall, the net cost of the COVID-19 pandemic for the University sector is projected to be €328 million over 2019/20 to 2020/21. Non-exchequer fees are now the largest single source of income for Universities which mostly consists of the fees paid by international or non-EU students, EU postgraduate students and mature students. Recurring outbreaks of SARS-CoV-2 infection reduces the attractiveness of Irish University campuses for international students. Increasing health and safety through SARS-CoV- 2 serial testing or surveillance would enable the promotion of ‘safe return-to on-campus activity’ throughout this sector.
The HEI sector is aware that the student cohort is a high-risk community for transmission of SARS- CoV-2 infection. Currently, student cohorts are likely to be one of the last vaccinated cohorts in the republic of Ireland. Therefore, there will be challenges associated with returning unvaccinated students on campus in September 2021. A robust surveillance and testing system enabled by the findings of UniCoV will assist this safe return to on-campus activity and restore confidence of staff and students. This, in turn, could potentially increase the number and quality of graduates in Ireland available to join the workforce when the job market recovers, further contributing to the economic impact of the project. The human capital impact from reduction of the quality of education received by “Pandemic-era" graduates will have economic knock-on effects in Ireland and all economies. By accelerating return to on-campus activities the UniCoV project will mitigate such negative human capital impacts on the economy of Ireland and other economies hiring Irish graduates.
The Irish economy has been negatively affected by the pandemic. Many sectors of the domestic economy have been severely affected with wide-scale job losses in areas such as accommodation, food, arts and entertainment. The unemployment rate stood at 14.7 per cent in September 2020 which is much higher than the pre-pandemic level of approximately 5 per cent. Household spending and modified investment declined by 22 and 24 per cent respectively in the second quarter of 2020. This is as a result of the closure of a significant proportion of the economy, along with costs to the state that have come as a consequence of the pandemic, including but not limited to outbreak response, testing, and the Pandemic Unemployment Payment Scheme. The serial-testing and surveillance technologies tested in the UniCoV study have the potential to be scaled up for use in different settings including industry, sport, and tourism along with the educational sector. As a result, it has the potential to support the reopening of the economy and return-to-work of employees across multiple sectors in multiple settings that have suffered severely as a consequence of the pandemic.
In addition, the economic analysis proposed in this study of the various rapid testing modalities will provide data to support the identification of the most cost-effective testing modality for testing at scale. Currently, the gold standard PCR nasopharyngeal swab test is used by the HSE. This costs almost 200 euro per test. Currently in Ireland, up to 125,000 tests can be carried out daily with a daily cost of 25 million euros. Rapid tests using antigen swab or nucleic acid saliva formats can cost as little as 5 to 7 euro per test. Their use as an alternative to more expensive testing methods can reduce the cost of testing to the Health System and society.
Human Capital Impact
UniCoV is a collaboration between HEIs in Ireland and scientific leaders who are experts in the field of immunology, infectious disease, molecular genetics, microbiology and public health. A consortium of this nature will likely lead to further partnerships, and accelerate sharing of expertise, skills, research findings and innovations. It will increase the student, staff and public awareness regarding appropriate use of rapid tests and the societal value of rapid testing. Moreover, it will improve skills to support Ireland’s health system to implement rapid testing into public health surveillance systems, as well as critical science literacy of the wider population. This will undoubtedly lead to further research, innovations and outputs in the future.