Abstract
Background: Due to the ongoing COVID-19 pandemic, demand for diagnostic testing has increased drastically, resulting in shortages of necessary materials to conduct the tests and overwhelming the capacity of testing laboratories. The supply scarcity and capacity limits affect test administration: priority must be given to hospitalized patients and symptomatic individuals, which can prevent the identification of asymptomatic and presymptomatic individuals and hence effective tracking and tracing policies. We describe optimized group testing strategies applicable to SARS-CoV-2 tests in scenarios tailored to the current COVID-19 pandemic and assess significant gains compared to individual testing.Methods: We account for biochemically realistic scenarios in the context of dilution effects on SARS-CoV-2 samples and consider evidence on specificity and sensitivity of PCR-based tests for the novel coronavirus. Because of the current uncertainty and the temporal and spatial changes in the prevalence regime, we provide analysis for several realistic scenarios and propose fast and reliable strategies for massive testing procedures.Key Findings: We find significant efficiency gaps between different group testing strategies in realistic scenarios for SARS-CoV-2 testing, highlighting the need for an informed decision of the pooling protocol depending on estimated prevalence, target specificity, and high- vs. low-risk population. For example, using one of the presented methods, all 1.47 million inhabitants of Munich, Germany, could be tested using only around 141 thousand tests if the infection rate is below 0.4% is assumed. Using 1 million tests, the 6.69 million inhabitants from the city of Rio de Janeiro, Brazil, could be tested as long as the infection rate does not exceed 1%. Moreover, we provide an interactive web application, available at www.group-testing.com, for visualizing the different strategies and designing pooling schemes according to specific prevalence scenarios and test configurations.Interpretation: Altogether, this work may help provide a basis for an efficient upscaling of current testing procedures, which takes the population heterogeneity into account and is fine-grained towards the desired study populations, e.g., mild/asymptomatic individuals vs. symptomatic ones but also mixtures thereof.Funding: German Science Foundation (DFG), German Federal Ministry of Education and Research (BMBF), Chan Zuckerberg Initiative DAF, and Austrian Science Fund (FWF).
Highlights
The current spreading state of the COVID-19 pandemic urges authorities around the world to take measures in order to contain the disease or, at least, to reduce its propagation speed, as commonly referred to by the term “curve flattening1.” At the time of writing, the World Health Organization (WHO) reported 12,552,765 cases and 561,617 deaths with 230,370 new cases in the last 24 hours2
We provide a comparison of general strategies for group testing in view of their application to medical diagnosis in the current COVID-19 pandemic
Our numerical study confirms the recent observation that even under practical constraints for pooled SARS-CoV-2 tests, such as restrictions on the pool size, and for prevalence values in the estimated range of current infection rates in many regions13, group testing is typically more efficient than individual testing and it allows for an efficiency increase of up to a factor 10 across realistic scenarios and testing strategies
Summary
The current spreading state of the COVID-19 pandemic urges authorities around the world to take measures in order to contain the disease or, at least, to reduce its propagation speed, as commonly referred to by the term “curve flattening1.” At the time of writing, the World Health Organization (WHO) reported 12,552,765 cases and 561,617 deaths with 230,370 new cases in the last 24 hours. The current spreading state of the COVID-19 pandemic urges authorities around the world to take measures in order to contain the disease or, at least, to reduce its propagation speed, as commonly referred to by the term “curve flattening1.”. Even though a lot of research is currently being performed toward a cure of this infectious disease, to date, the most effective reasonable measure against its spread is the tracking and subsequent isolation of positive cases via an intensive test procedure on a large part of the population or at least important risk groups [1]. Due to the ongoing COVID-19 pandemic, demand for diagnostic testing has increased drastically, resulting in shortages of necessary materials to conduct the tests and overwhelming the capacity of testing laboratories. We describe optimized group testing strategies applicable to SARS-CoV-2 tests in scenarios tailored to the current COVID-19 pandemic and assess significant gains compared to individual testing
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