The UK healthcare system has been profoundly affected by the COVID‐19 Pandemic, including skin cancer departments. Despite service capacity and a worldwide increase in incidence, anecdotal reports suggest a decline in skin cancer diagnoses following COVID‐19. To determine if there is a decrease in skin cancer diagnosis in the UK in the COVID‐19 era, we analysed data from the Northern Cancer Network from March 23 rd 2020 to June 23 rd 2020 and compared it to the same period last year. In the COVID Period there was a decrease in skin cancer diagnoses of 68.61% from 3619 to 1136 (p<0.0028). Surprisingly, skin cancer waiting times were also reduced in the COVID Period compared to Before COVID Period (median 8 days and 12 days respectively; p<0.0001). Collectively these data highlight a statistically significant reduction in both skin cancer diagnoses and waiting times during the COVID Period.

The COVID-19 pandemic has demonstrated the need for massively-parallel, cost-effective tests monitoring viral spread. Here we present SARSeq, saliva analysis by RNA sequencing, a method to detect SARS-CoV-2 and other respiratory viruses on tens of thousands of samples in parallel. SARSeq relies on next generation sequencing of multiple amplicons generated in a multiplexed RT-PCR reaction. Two-dimensional, unique dual indexing, using four indices per sample, enables unambiguous and scalable assignment of reads to individual samples. We calibrate SARSeq on SARS-CoV-2 synthetic RNA, virions, and hundreds of human samples of various types. Robustness and sensitivity were virtually identical to quantitative RT-PCR. Double-blinded benchmarking to gold standard quantitative-RT-PCR performed by human diagnostics laboratories confirms this high sensitivity. SARSeq can be used to detect Influenza A and B viruses and human rhinovirus in parallel, and can be expanded for detection of other pathogens. Thus, SARSeq is ideally suited for differential diagnostic of infections during a pandemic.

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