Temporal trends in test-seeking behaviour during the COVID-19 pandemic

Publication date: Jun 06, 2024

BackgroundDuring the COVID-19 pandemic, many countries implemented mass community testing programs, where individuals would seek tests due to (primarily) the onset of symptoms. The cases recorded by mass testing programs represent only a fraction of infected individuals, and depend on how many people seek testing. If test-seeking behaviour exhibits heterogeneities or changes over time, and this is not accounted for when analysing case data, then inferred epidemic dynamics used to inform public health decision-making can be biased. MethodsHere we describe temporal trends in COVID-19 test-seeking behaviour in Australia by symptoms, age group, test type, and jurisdiction from November 2021-September 2023. We use data from two surveillance systems: a weekly nationwide behavioural survey (NBS), established by the Australian Government to monitor a range of behavioural responses to COVID-19; and Australias FluTracking system, a participatory surveillance system designed for monitoring influenza-like illness and health-care seeking behaviour, which was adapted in early 2020 to include questions relevant to COVID-19. ResultsWe found that peaks in test-seeking behaviour generally aligned with peaks in the rate of reported cases. Test-seeking behaviour rapidly increased in early-2022 coinciding with greater availability of rapid antigen tests. There were heterogeneities in test-seeking behaviour by jurisdiction and age-group, which were dynamic through time. Test-seeking behaviour was lowest in older individuals (60+ years) until July 2022, after which there was greater homogeneity across age-groups. Test-seeking behaviour was highest in the Australian Capital Territory and Tasmania and consistently lowest in Queensland. Over the course of the study test-seeking behaviour was highest in individuals who reported symptoms more predictive of COVID-19 infection. There was a greater probability of seeking a test for individuals in FluTracking compared to the NBS, suggesting that participatory surveillance systems such as FluTracking may include a health-conscious subset of the population. ConclusionsOur findings demonstrate the dynamism of test-seeking behaviour, highlighting the importance of the continued collection of behavioural data through dedicated surveillance systems.

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Concepts Keywords
Australian Behaviour
Biostatistics Covid
Influenzanet Individuals
Tropicalmed4010012 Infection
Medrxiv
Preprint
Probability
Proportion
Reporting
Seeking
Surveillance
Symptom
Symptoms
Test
Testing

Semantics

Type Source Name
disease VO USA
disease MESH influenza
disease VO time
disease MESH COVID-19 pandemic
disease VO vaccine
disease IDO contact tracing
pathway REACTOME Reproduction
disease VO effectiveness
disease VO effective
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH emergency
drug DRUGBANK Etoperidone
disease MESH Communicable Diseases
drug DRUGBANK Coenzyme M
disease VO company
disease MESH death
disease VO Imovax ID
disease IDO country
disease VO vaccination
disease VO dose
disease MESH Delta infection
disease VO report
drug DRUGBANK Barium
disease MESH sore throat
disease IDO symptom
disease MESH uncertainty
disease IDO process
drug DRUGBANK Aspartame
disease IDO infection prevalence
disease VO Optaflu
disease IDO infection incidence
disease VO population
disease MESH infection

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