Rapid antigen testing as a reactive response to surges in nosocomial SARS-CoV-2 outbreak risk
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Abstract
Healthcare facilities are vulnerable to SARS-CoV-2 introductions and subsequent nosocomial outbreaks. Antigen rapid diagnostic testing (Ag-RDT) is widely used for population screening, but its health and economic benefits as a reactive response to local surges in outbreak risk are unclear. We simulate SARS-CoV-2 transmission in a long-term care hospital with varying COVID-19 containment measures in place (social distancing, face masks, vaccination). Across scenarios, nosocomial incidence is reduced by up to 40-47% (range of means) with routine symptomatic RT-PCR testing, 59-63% with the addition of a timely round of Ag-RDT screening, and 69-75% with well-timed two-round screening. For the latter, a delay of 4-5 days between the two screening rounds is optimal for transmission prevention. Screening efficacy varies depending on test sensitivity, test type, subpopulations targeted, and community incidence. Efficiency, however, varies primarily depending on underlying outbreak risk, with health-economic benefits scaling by orders of magnitude depending on the COVID-19 containment measures in place.
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SciScore for 10.1101/2021.08.13.21261968: (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: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our findings should be interpreted in the context of several methodological limitations. First, some results may reflect specificities of the rehabilitation hospital contact network underlying our model. We estimated greater efficiency for screening patients relative to staff, but the opposite result may be expected in settings where …
SciScore for 10.1101/2021.08.13.21261968: (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: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our findings should be interpreted in the context of several methodological limitations. First, some results may reflect specificities of the rehabilitation hospital contact network underlying our model. We estimated greater efficiency for screening patients relative to staff, but the opposite result may be expected in settings where staff have higher rates of contact than patients. Second, our use of retrospective counterfactual analysis facilitated precise estimation of intervention efficacy, but precluded consideration of how surveillance interventions might impact human behaviour. For instance, healthcare workers that conduct screening inevitably come into contact with many individuals, potentially creating new opportunities for transmission. This limitation does not hold if our results are interpreted in the context of self-administered auto-tests, which may be a cost-effective intervention in the context of at-home testing in the community.[36] However, auto-testing may be less feasible for patients or residents than staff, particularly in certain high-risk settings.[37] Third, our cost-effectiveness estimates only considered testing unit costs, but decision-makers must consider a range of other implementation costs, from human resources, to logistical coordination, to opportunity costs of false-positive isolation. Finally, we limited our analysis to the two weeks following intervention implementation, under the assumption that LTCFs came to control nosocomial transmiss...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).
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.
Results from scite Reference Check: We found no unreliable references.
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