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Abstract
Background: Pre-symptomatic and asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are important elements in the coronavirus disease 2019 (COVID-19) pandemic, and there remains a reliance on testing to manage the spread of the disease. In the UK, many universities opened for blended learning for the 2020-2021 academic year, with a mixture of face to face and online teaching. Methods: In this study we present a simulation framework to evaluate the effectiveness of different mass testing strategies within a university setting, across a range of transmission scenarios. Results: The sensitivity of 5x pooled RT-qPCR tests appears to be higher than testing using the lateral flow device with relatively little loss compared to single RT-qPCR tests, and is improved by pooling by social cluster. The range of strategies that we evaluated give comparable results for estimating prevalence. Conclusions: Pooling tests by known social structures, such as student households can substantially improve the cost effectiveness of RT-qPCR tests. We also note that routine recording of quantitative RT-qPCR results would facilitate future modelling studies.
Highlights
In the midst of the coronavirus disease 2019 (COVID-19) pandemic, university students represent a demographic in the population who are likely to experience low rates of symptomatic infection[1] while being in a high contact social setting[2,3]
The reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) test has been in widespread use globally for the detection of viral RNA taken from saliva or nasal and throat swabs[6]
We present a framework which can be adapted to accommodate changes in estimates of viral load and RT-qPCR operating parameters, such as efficiency and sensitivity, as these estimates emerge and evolve
Summary
In the midst of the coronavirus disease 2019 (COVID-19) pandemic, university students represent a demographic in the population who are likely to experience low rates of symptomatic infection[1] while being in a high contact social setting[2,3]. One strategy to reduce the financial cost of regular mass testing is to pool samples7 - a single test is performed on a group of individuals, which can optionally be converted into Dorfman’s algorithm in that if the group tests positive, follow up tests are performed on the individuals in the group to identify those infected[8]. Another benefit of this approach is that pooling reduces test reagent use, the supply of which may be outstripped by demand. We note that routine recording of quantitative RT-qPCR results would facilitate future modelling studies
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