Modeling the effectiveness of olfactory testing to limit SARS-CoV-2 transmission
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Abstract
A central problem in the COVID-19 pandemic is that there is not enough testing to prevent infectious spread of SARS-CoV-2, causing surges and lockdowns with human and economic toll. Molecular tests that detect viral RNAs or antigens will be unable to rise to this challenge unless testing capacity increases by at least an order of magnitude while decreasing turnaround times. Here, we evaluate an alternative strategy based on the monitoring of olfactory dysfunction, a symptom identified in 76–83% of SARS-CoV-2 infections—including those with no other symptoms—when a standardized olfaction test is used. We model how screening for olfactory dysfunction, with reflexive molecular tests, could be beneficial in reducing community spread of SARS-CoV-2 by varying testing frequency and the prevalence, duration, and onset time of olfactory dysfunction. We find that monitoring olfactory dysfunction could reduce spread via regular screening, and could reduce risk when used at point-of-entry for single-day events. In light of these estimated impacts, and because olfactory tests can be mass produced at low cost and self-administered, we suggest that screening for olfactory dysfunction could be a high impact and cost-effective method for broad COVID-19 screening and surveillance.
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SciScore for 10.1101/2020.11.30.20241174: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study is subject to a number of limitations. First, our modeling assumed that olfaction tests would not only correctly identify those with olfactory dysfunction, but would remain sensitive during regular use. Repeated use of the same test could lead to adaptation, decreasing test sensitivity. Second, we assumed that no individual would intentionally fail a test–an issue only averted with reflex molecular testing. Finally, we …
SciScore for 10.1101/2020.11.30.20241174: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study is subject to a number of limitations. First, our modeling assumed that olfaction tests would not only correctly identify those with olfactory dysfunction, but would remain sensitive during regular use. Repeated use of the same test could lead to adaptation, decreasing test sensitivity. Second, we assumed that no individual would intentionally fail a test–an issue only averted with reflex molecular testing. Finally, we assumed that olfactory dysfunction revealed by a test would lead to isolation, but this assumption is unlikely to be valid for essential workers, or those uninterested in adherence to an isolation protocol. These limitations highlight the need to develop, deploy in longitudinal trials, and refine tests for olfaction that can be mass produced at low cost and self-administered. There are three additional points to consider in implementing olfactory screening for COVID-19 control. First, when a new community is subject to olfactory screening, there will be an initial surge of individuals identified with olfactory dysfunction both due to undetected COVID-19 infections, and COVID-19-independent olfactory dysfunction (anosmia and hyposmia). This will require the ability to handle a reflexive surge in molecular testing during the initial phase. However, even in the absence of follow-up molecular testing, unnecessary quarantines of those without COVID-19 (false positives) should be weighed against blanket non-pharmaceutical interventions such as lockdowns and...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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