Willingness to seek laboratory testing for SARS-CoV-2 with home, drive-through, and clinic-based specimen collection locations

  1. Aaron J. Siegler
  2. Eric Hall
  3. Nicole Luisi
  4. Maria Zlotorzynska
  5. Gretchen Wilde
  6. Travis Sanchez
  7. Heather Bradley
  8. Patrick S. Sullivan

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Abstract

Background

SARS-CoV-2 virus testing for persons with COVID-19 symptoms, and contact tracing for those testing positive, will be critical to successful epidemic control. Willingness of persons experiencing symptoms to seek testing may determine the success of this strategy.

Methods

A cross-sectional, online survey in the United States measured willingness to seek testing if feeling ill under different specimen collection scenarios: home-based saliva, home-based swab, drive-through facility swab, and clinic-based swab. Instructions clarified that home-collected specimens would be mailed to a laboratory for testing. We presented similar willingness questions regarding testing during follow-up care.

Results

Of 1435 participants, comprising a broad range of sociodemographic groups, 92% were willing to test with a home saliva specimen, 88% with home swab, 71% with drive-through swab, and 60% with clinic collected swab. Moreover, 68% indicated they would be more likely to get tested if there was a home testing option. There were no significant differences in willingness items across sociodemographic variables or for those currently experiencing COVID-19 symptoms. Results were nearly identical for willingness to receive testing for follow-up COVID-19 care.

Conclusions

We observed a hierarchy of willingness to test for SARS-CoV-2, ordered by the degree of contact required. Home specimen collection options could result in up to one-third more symptomatic persons seeking testing, facilitating contact tracing and optimal clinical care. Remote specimen collection options may ease supply chain challenges and decrease the likelihood of nosocomial transmission. As home specimen collection options receive regulatory approval, they should be scaled rapidly by health systems.

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  1. ScreenIT

    SciScore for 10.1101/2020.05.06.20093005: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: All participants completed a written electronic consent procedure, and study procedures were approved by the Emory University IRB.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    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:
    There are currently vast differences in how countries and jurisdictions are handling testing due to supply limitations. In Iceland, testing has been widely provided as a strategy to combat epidemic spread, and not surprisingly this appears to be substantially contributing to their control of epidemic spread.23 At-home self-collection of specimens is one of several options worthy of exploration to achieve similar gains in other settings. Home-based and drive-through testing strategies are promising in part because they may allow for rapid scale-up of newly validated approaches that may relieve supply chain problems. For instance, one laboratory is working to validate testing with saliva specimens, which would relieve current stockouts of nasopharyngeal swab supplies.13 It is clear that, if sufficient laboratory capacity and supplies are available, increased testing using at-home specimen collection is critical for public health response for three reasons. First, it would facilitate increased initiation of contact tracing, a tool known to limit epidemic spread, by identifying people with mild symptoms and allowing public health authorities to test close contacts. Second, it would reduce nosocomial infections. Third, it would facilitate improved self-management, because mild and moderate COVID-19 symptoms are nonspecific. Persons receiving a formal SARS-CoV-2 diagnosis are likely to perform self-isolation activities with substantially more rigor than persons whose actions are in...

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.05.06.20093005v1 on medRxiv