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Covid SAFE: Rapid Implementation of a Saliva-Based SARS-CoV-2 Surveillance Testing Program with Automated Scheduling and Reporting

ABSTRACT: To safely reopen schools and businesses, widespread surveillance testing for Covid-19 will be necessary. We quickly designed and implemented a surveillance testing program that remotely enrolls participants, uses automated bidirectional text message communications, incorporates symptom monitoring, and automatically reports test results. Summary To manage the Covid-19 pandemic, a multi-stakeholder group at Penn Medicine recognized a need to implement a surveillance testing program for its faculty, staff, and students. Such a program would help to identify asymptomatic, presymptomatic, or mildly symptomatic cases that would otherwise go undetected, and could monitor for spread of possible vaccine-resistant viral variants. Covid SAFE (Screening Assessment for Exposure) was designed to leverage separate but existing tools and resources at the health system to accomplish this goal. The data provided by Covid SAFE have allowed health system leadership to make informed decisions about resumption of research and reopening of campus while providing the community with reassurances about their safety. Their experience, having enrolled more than 4,000 participants and conducted more than 25,000 tests, can be used as a framework for other institutions to develop and launch their own programs.

SUBMITTER: Oakes A

PROVIDER: S-EPMC7924814 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe negative impact of continued school closures during the height of the COVID-19 pandemic warrants the establishment of cost-effective strategies for surveillance and screening to safely reopen and monitor for potential in-school transmission. Here, we present a novel approach to increase the availability of repetitive and routine COVID-19 testing that may ultimately reduce the overall viral burden in the community.MethodsWe implemented a testing program using the SalivaClear࣪ pooled surveillance method that included students, faculty and staff from K-12 schools (student age range 5-18 years) and universities (student age range >18 years) across the country (Mirimus Clinical Labs, Brooklyn, NY). The data analysis was performed using descriptive statistics, kappa agreement, and outlier detection analysis.FindingsFrom August 27, 2020 until January 13, 2021, 253,406 saliva specimens were self-collected from students, faculty and staff from 93 K-12 schools and 18 universities. Pool sizes of up to 24 samples were tested over a 20-week period. Pooled testing did not significantly alter the sensitivity of the molecular assay in terms of both qualitative (100% detection rate on both pooled and individual samples) and quantitative (comparable cycle threshold (Ct) values between pooled and individual samples) measures. The detection of SARS-CoV-2 in saliva was comparable to the nasopharyngeal swab. Pooling samples substantially reduced the costs associated with PCR testing and allowed schools to rapidly assess transmission and adjust prevention protocols as necessary. In one instance, in-school transmission of the virus was determined within the main office and led to review and revision of heating, ventilating and air-conditioning systems.InterpretationBy establishing low-cost, weekly testing of students and faculty, pooled saliva analysis for the presence of SARS-CoV-2 enabled schools to determine whether transmission had occurred, make data-driven decisions, and adjust safety protocols. We provide strong evidence that pooled testing may be a fundamental component to the reopening of schools by minimizing the risk of in-school transmission among students and faculty.FundingSkoll Foundation generously provided funding to Mobilizing Foundation and Mirimus for these studies.

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Covid SAFE: Rapid Implementation of a Saliva-Based SARS-CoV-2 Surveillance Testing Program with Automated Scheduling and Reporting

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