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Exploring the ethics of asymptomatic COVID-19 testing

Tuesday 2 March 2021

St Catharine’s alumna Dr Caitríona Cox (2011, Medical Sciences) recently returned to Cambridge as an NIHR Academic Clinical Fellow at The Healthcare Improvement Studies (THIS) Institute. Students and staff at St Catharine’s kindly agreed to participate in her latest research project exploring the ethical considerations for asymptomatic testing programmes launched in response to the COVID-19 pandemic.

These ethical considerations are particularly relevant for higher education institutions in the UK, some of which have already been providing mass asymptomatic testing for students to help monitor and reduce the risk of COVID-19. Around half of people infected show no symptoms, and are unaware that they are infected at all. There are concerns that the rate of asymptomatic infection may be even higher among university students.

Since October 2020, St Catharine’s has offered our students weekly asymptomatic testing as a part of a programme coordinated by the University of Cambridge. The initial scope for the programme was focused on student households in college accommodation but students living in private accommodation were also able to participate by December 2020.

Dr Cox is part of a team of researchers from THIS Institute and other organisations looking to identify influences on participation, barriers or concerns about the programme, and views on ethical considerations. The team conducted a consultation to gather the views of students and staff relating to an asymptomatic COVID-19 testing programme at the University of Cambridge. Findings from this consultation, a literature review, and expert ethical and legal analysis were used to produce an ethical framework with practical recommendations, and hypothetical illustrative examples to demonstrate how they might be put into practice.

Dr Cox comments, "We hope the resulting framework will help decision-making about student testing programmes. It is vital to include students and staff in the process, and I was so glad that Catz students and staff participated in the consultation. I am excited to share the new ethical framework and resources with the Catz community."

Additionally, a checklist and an infographic were produced to capture the different areas of ethical consideration identified by the project:

  • Design and operation of the programme
  • Goals of the programme
  • Properties of the test(s) selected for the programme
  • Enabling isolation
  • Choices regarding participation in the programme
  • Benefits, harms and opportunity costs
  • Responsibilities between students and institutions
  • Privacy, confidentiality and data-sharing
  • Communication

Visit the THIS Institute website to find out more.