Piloting an integrated SARS-CoV-2 testing and data system for outbreak containment among college students: A prospective cohort study.

Laura Packel,Arthur Reingold,Lauren Hunter,Yi Li,Shelley Facente,Fyodor D Urnov,Anna Harte,Guy Nicolette,Michael Lu,Maya Petersen,Sherief Ghozy

doi:10.1371/journal.pone.0245765

Abstract

BackgroundColleges and universities across the country are struggling to develop strategies for effective control of COVID-19 transmission as students return to campus.Methods and findingsWe conducted a prospective cohort study with students living on or near the UC Berkeley campus from June 1st through August 18th, 2020 with the goal of providing guidance for campus reopening in the safest possible manner. In this cohort, we piloted an alternative testing model to provide access to low-barrier, high-touch testing and augment student-driven testing with data-driven adaptive surveillance that targets higher-risk students and triggers testing notifications based on reported symptoms, exposures, or other relevant information. A total of 2,180 students enrolled in the study, 51% of them undergraduates. Overall, 6,247 PCR tests were administered to 2,178 students over the two-month period. Overall test positivity rate was 0.9%; 2.6% of students tested positive. Uptake and acceptability of regular symptom and exposure surveys was high; 98% of students completed at least one survey, and average completion rate was 67% (Median: 74%, IQR: 39%) for daily reporting of symptoms and 68% (Median: 75%, IQR: 40%) for weekly reporting of exposures. Of symptom-triggered tests, 5% were PCR-positive; of exposure-triggered tests, 10% were PCR-positive. The integrated study database augmented traditional contact tracing during an outbreak; 17 potentially exposed students were contacted the following day and sent testing notifications. At study end, 81% of students selected their desire “to contribute to UC Berkeley’s response to COVID-19” as a reason for their participation in the Safe Campus study.ConclusionsOur results illustrate the synergy created by bringing together a student-friendly, harm reduction approach to COVID-19 testing with an integrated data system and analytics. We recommend the use of a confidential, consequence-free, incentive-based daily symptom and exposure reporting system, coupled with low-barrier, easy access, no stigma testing. Testing should be implemented alongside a system that integrates multiple data sources to effectively trigger testing notifications to those at higher risk of infection and encourages students to come in for low-barrier testing when needed.

Highlights

Colleges and universities across the country are struggling with the design of strategies for effective control of COVID-19 transmission
Testing should be implemented alongside a system that integrates multiple data sources to effectively trigger testing notifications to those at higher risk of infection and encourages students to come in for low-barrier testing when needed
Between June and August 2020, we developed and evaluated a testing and response system as part of the Berkeley Safe Campus Initiative, a multidisciplinary partnership between the University of California, Berkeley School of Public Health, University Health Services (UHS), and the Innovative Genomics Institute

Summary

Introduction

Colleges and universities across the country are struggling with the design of strategies for effective control of COVID-19 transmission. The design of COVID-19 outbreak prevention and detection systems offers an important opportunity to engage students as partners in COVID-19 outbreak control; to date this potential remains to be realized on most campuses. Testing strategies for symptomatic or exposed students often rely on traditional student health service delivery approaches, which require phone-call based screening and appointment scheduling. Among a student population that relies heavily on text-driven communication and may fear judgement or disciplinary reprisal for reporting risky behaviors, such approaches may introduce barriers to rapid detection and isolation of infected individuals. Colleges and universities across the country are struggling to develop strategies for effective control of COVID-19 transmission as students return to campus.

Methods

Results

Discussion

Conclusion