Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening.
Daniel B. Larremore,Bryan Wilder,Evan Lester,Evan Lester,Soraya Shehata,Soraya Shehata,James M. Burke,James A. Hay,Milind Tambe,Michael J. Mina,Michael J. Mina,Roy Parker +11 more
TLDR
It is demonstrated that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity, and should prioritize accessibility, frequency, and sample-to-answer time.Abstract:
The COVID-19 pandemic has created a public health crisis. Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary.read more
Citations
More filters
Posted ContentDOI
SARS-CoV-2 Viral Load in Saliva Rises Gradually and to Moderate Levels in Some Humans
Alexander Winnett,Matthew M. Cooper,Natasha Shelby,Anna E. Romano,Jessica A. Reyes,Jenny Ji,Michael Porter,Emily S. Savela,Jacob T. Barlow,Reid Akana,Colten Tognazzini,Matthew Feaster,Ying-Ying Goh,Rustem F. Ismagilov +13 more
TL;DR: Evidence is provided that in at least some human cases of SARS-CoV-2, viral load rises slowly (over days, not hours) and not to such high levels to be detectable reliably by any low-sensitivity test.
Journal ArticleDOI
Comparison of infection control strategies to reduce COVID-19 outbreaks in homeless shelters in the United States: a simulation study.
Lloyd A. C. Chapman,Margot Kushel,Sarah N. Cox,Ashley Scarborough,Caroline Cawley,Trang Huyen Nguyen,Isabel Rodriguez-Barraquer,Bryan Greenhouse,Elizabeth Imbert,Nathan Lo +9 more
TL;DR: In high-risk homeless shelter environments and locations with high community incidence of COVID-19 most infection control strategies are unlikely to prevent outbreaks, and combined interventions should be adopted to reduce outbreak risk.
Posted ContentDOI
The effect of eviction moratoria on the transmission of SARS-CoV-2.
Anjalika Nande,Justin Sheen,Emma L. Walters,Brennan Klein,Matteo Chinazzi,Andrei Gheorghe,Ben Adlam,Julianna Shinnick,Maria Florencia Tejeda,Samuel V. Scarpino,Alessandro Vespignani,Andrew J. Greenlee,Daniel W. Schneider,Michael J. Levy,Alison L. Hill,Alison L. Hill +15 more
TL;DR: A model of the effect of evictions on SARS-CoV-2 epidemics, simulating viral transmission within and among households in a theoretical metropolitan area, finds that evictions lead to significant increase in infections.
Journal ArticleDOI
Dual-CRISPR/Cas12a-Assisted RT-RAA for Ultrasensitive SARS-CoV-2 Detection on Automated Centrifugal Microfluidics.
TL;DR: A dual-CRISPR/Cas12a-assisted RT-RAA assay and a ″sample-to-answer″ centrifugal microfluidic platform that can automatically detect 1 copy/μL of the SARS-CoV-2 within 30 min, with a significant potential for clinical diagnosis and disease prevention.
Journal ArticleDOI
Performance of Antigen Detection Tests for SARS-CoV-2: A Systematic Review and Meta-Analysis
Anastasia Tapari,Georgia G. Braliou,Maria Papaefthimiou,Helen Mavriki,Panagiota I. Kontou,Georgios K. Nikolopoulos,Pantelis G. Bagos +6 more
TL;DR: LFIA tests, though with moderate sensitivity, appear as the most attractive method for use in POCs and for performing seroprevalence studies, and rapid ATs show higher sensitivity in symptomatic patients compared to asymptomatic patients.
References
More filters
Journal ArticleDOI
Virological assessment of hospitalized patients with COVID-2019.
Roman Wölfel,Victor M. Corman,Wolfgang Guggemos,M Seilmaier,Sabine Zange,Marcel A. Müller,Daniela Niemeyer,Terry Jones,Terry Jones,Patrick Vollmar,Camilla Rothe,Michael Hoelscher,Tobias Bleicker,Sebastian Brünink,Julia Schneider,Rosina Ehmann,Katrin Zwirglmaier,Christian Drosten,Clemens M. Wendtner +18 more
TL;DR: Detailed virological analysis of nine cases of coronavirus disease 2019 (COVID-19) provides proof of active replication of the SARS-CoV-2 virus in tissues of the upper respiratory tract.
Journal ArticleDOI
The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application.
Stephen A. Lauer,Kyra H. Grantz,Qifang Bi,Forrest K. Jones,Qulu Zheng,Hannah R. Meredith,Andrew S. Azman,Nicholas G. Reich,Justin Lessler +8 more
TL;DR: The results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, although longer monitoring periods might be justified in extreme cases.
Journal ArticleDOI
Temporal dynamics in viral shedding and transmissibility of COVID-19.
Xi He,Eric H. Y. Lau,Peng Wu,Xilong Deng,Jian Wang,Xinxin Hao,Yiu Chung Lau,Jessica Y. Wong,Yujuan Guan,Xinghua Tan,Xiaoneng Mo,Yanqing Chen,Baolin Liao,Weilie Chen,Fengyu Hu,Qing Zhang,Mingqiu Zhong,Yanrong Wu,Lingzhai Zhao,Fuchun Zhang,Benjamin J. Cowling,Fang Li,Gabriel M. Leung +22 more
TL;DR: It is estimated that 44% (95% confidence interval, 25–69%) of secondary cases were infected during the index cases’ presymptomatic stage, in settings with substantial household clustering, active case finding and quarantine outside the home.
Journal ArticleDOI
Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study.
Kelvin K. W. To,Owen Tak Yin Tsang,Wai Shing Leung,Anthony Raymond Tam,Tak Chiu Wu,David Christopher Lung,Cyril C. Y. Yip,Jian Piao Cai,Jacky Man Chun Chan,Thomas Shiu Hong Chik,Daphne Pui-Ling Lau,Chris Yau Chung Choi,Lin Lei Chen,Wan Mui Chan,Kwok-Hung Chan,Jonathan Daniel Ip,Anthony Chin-Ki Ng,Rosana W.S. Poon,Cui Ting Luo,Vincent C.C. Cheng,Jasper Fuk-Woo Chan,Jasper Fuk-Woo Chan,Ivan Hung,Zhiwei Chen,Honglin Chen,Kwok-Yung Yuen +25 more
TL;DR: The serial respiratory viral load of SARS-CoV-2 in posterior oropharyngeal saliva samples from patients with COVID-19, and serum antibody responses from patients infected with severe acute respiratory syndrome coronavirus 2 are ascertained.
Journal ArticleDOI
Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR
TL;DR: In a series of 51 patients with chest CT and real-time polymerase chain reaction assay (RT-PCR) performed within 3 days, the sensitivity of CT for 2019 novel coronavirus infection was 98% and that ...
Related Papers (5)
Virological assessment of hospitalized patients with COVID-2019.
Roman Wölfel,Victor M. Corman,Wolfgang Guggemos,M Seilmaier,Sabine Zange,Marcel A. Müller,Daniela Niemeyer,Terry Jones,Terry Jones,Patrick Vollmar,Camilla Rothe,Michael Hoelscher,Tobias Bleicker,Sebastian Brünink,Julia Schneider,Rosina Ehmann,Katrin Zwirglmaier,Christian Drosten,Clemens M. Wendtner +18 more
Temporal dynamics in viral shedding and transmissibility of COVID-19.
Prevalence of Asymptomatic SARS-CoV-2 Infection : A Narrative Review.
Daniel P Oran,Eric J. Topol +1 more
Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR.
Victor M. Corman,Olfert Landt,Marco Kaiser,Richard Molenkamp,Adam Meijer,Daniel K.W. Chu,Tobias Bleicker,Sebastian Brünink,Julia Schneider,Marie Luisa Schmidt,Daphne G.J.C. Mulders,Bart L. Haagmans,Bas van der Veer,Sharon van den Brink,Lisa Wijsman,Gabriel Goderski,Jean Louis Romette,Joanna Ellis,Maria Zambon,Malik Peiris,Herman Goossens,Chantal B.E.M. Reusken,Marion Koopmans,Christian Drosten +23 more