1. Introduction
The coronavirus disease (COVID-19) pandemic caused by the virus SARS-CoV-2, resulted in a United Kingdom (UK) national lockdown in March 2020 and stay-at-home orders, followed by long-lasting national social distancing measures and travel restrictions (gov.uk/coronavirus). Throughout this time, universities have remained open in the UK. The University of Nottingham hosts the first veterinary school in the UK to operate a dual intake system, which began at the start of the academic year in September 2019. The first cohort of 2020 (Cohort 1) were disrupted by the national lockdown, meaning that teaching started remotely in the weeks prior to the initiation of small-group face-to-face teaching, which started in July [1]. The potential for COVID-19 transmission on university campuses is high [2]. In preparation, the university implemented health and safety measures across teaching buildings and accommodation to allow for the safe return of students onto a single, semi-rural campus. Since university-age students have a higher prevalence of SARS-CoV-2 infection [3], and higher rates of asymptomatic infection [4], this included a 12-week mass COVID-19 testing service piloted as a health protection approach to the early identification and control of potential outbreaks on campus. While the institution has certainly capitalised on digital innovation in remote learning [5], the intention of this mass testing approach was to enable face-to-face teaching that cannot be delivered remotely, such as essential animal handling and health and safety skills that would be required prior to embarking on work experience placements, a core element of training. The new students in Cohort 1, therefore, joined the University of Nottingham at the height of the UK lockdown, and together with existing final-year students undertaking clinical rotations, were among the first students in the UK to experience SARS-CoV-2 asymptomatic testing, social distancing and hygiene measures in a university setting.
To date, there is only one prior published study assessing the feasibility or acceptability of a universal programme for SARS-CoV-2 testing on a UK university campus [6] although this reports the findings of a shorter pilot programme (2 weeks), using only PCR (polymerase chain reaction) swab tests and did not assess the acceptability of saliva tests or antibody tests or measures of anxiety or any other aspects of student wellbeing. Berger Gillam and colleagues primarily focused on costs, guidance materials, logistics, laboratory and data processes and a user-facing web application, and participant acceptability was determined only from email communications and an 11-item survey [6].
To our knowledge, this is the first study to explore student and staff views towards university-based asymptomatic testing programmes alongside perceptions of COVID-19 risk, anxiety of student participants, reasons for uptake and the facilitators and barriers to testing adherence. The aim of this study was to (i) evaluate the acceptability of a pilot COVID-19 asymptomatic testing service to students and staff on a university campus; (ii) describe benefits and barriers to programme engagement and testing adherence; (iii) establish whether there are any relationships between adherence to testing, and students’ anxiety levels, COVID-19 risk perceptions, views towards protective behaviours (social distancing, self-isolation); (iv) identify any perceived broader impacts of participation in an asymptomatic testing programme for students or staff to assist with recommendations for future testing services in higher education settings.