Cambridge institute publishes ethical framework for asymptomatic COVID-19 student testing in HE institutions

The Healthcare Improvement Studies (THIS) Institute has today published an ethical framework for higher education institutions considering running asymptomatic COVID-19 testing programmes for their students.

Higher education institutions must be certain that they can deliver asymptomatic COVID-19 testing programmes for students that are responsive to new evidence, policy and guidance, pandemic conditions, and views of their students and staff

Mary Dixon-Woods

The use of asymptomatic COVID-19 testing is accelerating in a range of UK settings, including in higher education institutions. The University of Cambridge introduced a weekly asymptomatic testing programme for students in College accommodation in October 2020 as part of its efforts to reduce the spread of COVID-19. The programme, based on laboratory PCR tests facilitated by the national lighthouse laboratory network, involves pooling swabs from students in their households. If the pool tests positive, individual tests are performed for each participating student to investigate further.

Researchers at THIS Institute consulted students and staff at the University on ethical issues relating to its student testing programme. Their views, combined with expert legal and ethical analysis, resulted in a new ethical framework aimed at helping higher education institutions make complex decisions about student testing programmes.

The framework offers recommendations in nine areas:

  1. Design and operation of the programme
  2. Goals of the programme
  3. Properties of the test
  4. Enabling isolation
  5. Choices regarding participation
  6. Benefits, harms and opportunity costs
  7. Responsibilities
  8. Privacy, confidentiality and data protection
  9. Communication

Professor Mary Dixon-Woods, Director of THIS Institute, said: “Higher education institutions must be certain that they can deliver asymptomatic COVID-19 testing programmes for students that are responsive to new evidence, policy and guidance, pandemic conditions, and views of their students and staff. This new ethical framework is intended to help leaders to think through whether asymptomatic COVID-19 testing is the right option for their institution, and to support good organisational decision-making around implementing testing programmes.”

Dr Caitriona Cox, NIHR Academic Clinical Fellow at THIS Institute and project lead, said: “The framework and checklist are freely available and will hopefully act as valuable and timely resources for higher education institutions seeking ethically sound ways to keep people safe and support public health efforts.”

Supported by the Wellcome Trust, Dr Cox and colleagues consulted over 200 students and staff from the University of Cambridge. Participants took part via an online questionnaire or interview. The consultation, conducted through Thiscovery, THIS Institute’s online research platform, gathered views about the asymptomatic COVID-19 testing programme. The consultation findings were integrated with ethical and legal analysis and expert discussion to produce an ethical framework and checklist.

The framework, checklist and further information about the work is available on the THIS Institute website.

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