Abstract
Population screening played a substantial role in safely reopening the economy and avoiding new outbreaks of COVID-19. PCR-based pooled screening makes it possible to test the population with limited resources by pooling multiple individual samples. Our study compared different population-wide screening methods as transmission-mitigating interventions, including pooled PCR, individual PCR, and antigen screening. Incorporating testing-isolation process and individual-level viral load trajectories into an epidemic model, we further studied the impacts of testing-isolation on test sensitivities. Results show that the testing-isolation process could maintain a stable test sensitivity during the outbreak by removing most infected individuals, especially during the epidemic decline. Moreover, we compared the efficiency, accuracy, and cost of different screening methods during the pandemic. Our results show that PCR-based pooled screening is cost-effective in reversing the pandemic at low prevalence. When the prevalence is high, PCR-based pooled screening may not stop the outbreak. In contrast, antigen screening with sufficient frequency could reverse the epidemic, despite the high cost and the large numbers of false positives in the screening process.
Highlights
COVID-19 outbreaks have caused enormous economic losses and have posed health risks, among disadvantaged populations
As implementing PCR-based pooled screening as a large-scale intervention has not been comprehensively evaluated, we focused on comparing PCR-based pooled screening with different population screening methods as the intervention tool under a dynamic transmission model
Our results show that the testing-isolation process could maintain a stable test sensitivity during the outbreak by removing most infected individuals
Summary
COVID-19 outbreaks have caused enormous economic losses and have posed health risks, among disadvantaged populations. A city of more than 17 million people, conducted two rounds of city-wide population screening, five rounds of screening in Yantian District, and four rounds of screening in Bao’an District by PCR-based Dorfman pooling between May and June 2021 to end the resurgence of COVID-19. Antigen tests offer an alternative way to increase testing capacity, we focus on studying the PCRbased pooled screening in a real-world context, as PCR tests can be quickly developed and scaled up through existing infrastructure in the early stage of an epidemic outbreak. Cleary et al studied the design and dilution effects of pooled testing from the new perspective of population-level viral load distribution during the e pidemic[9] This new perspective is valuable in enlightening the investigation of many important issues during the pandemic, for example, the estimation of epidemic dynamics[10,30] and the evaluation of large-scale screening. Studies revealed that repeated PCR testing, antigen testing, and household-pooled testing could effectively suppress o utbreaks[6,8,48,49]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
