Testing the feasibility of a national respiratory swabbing tool in FluSurvey to support pandemic preparedness in England, 2025-26

Background FluSurvey is a participatory surveillance system, through which participants report weekly respiratory symptoms, healthcare use and social contacts. To support rapid public health assessment we developed a respiratory self-swabbing feature. We aimed to assess the feasibility of self-swabbing among symptomatic FluSurvey participants. Methods FluSurvey self-swabbing was deployed in England between January-March 2026. Adults reporting recent Acute Respiratory Infection symptoms were eligible for a self-swabbing Covid-19, RSV and Influenza PCR test which was returned to the laboratory by post. Participants were sent optional feedback surveys. We described swabbing interest, timeliness and participant demographics. We evaluated participant feedback to improve the process. Results There were 234 eligible illnesses during the study period; 45.7% (107/234) requested test kits and 93.5%(100/107) test kits were returned. Of these, 97.0%(97/100) had valid results; median participant age was 61.74 years (IQR:47.4-67.4), 68.4% were female and 90.0% were of white ethnicity. All nine regions in England were represented. Timeliness was high; the median time from symptom onset to specimen date was 4.0 days (IQR:3.0-5.0). Of participants completing feedback surveys, 96.7%(59/61) would consider participating in self-swabbing again. Conclusions We developed a tool to test individuals, often not presenting to healthcare, for respiratory viruses using an established community-based surveillance system. This tool can be rapidly deployed and adapted to public health need, to assess community-based emerging respiratory or pandemic infections. The high return rate and positive feedback suggest continued engagement of the cohort in respiratory virus swabbing.