SARS-CoV-2 Positivity in Asymptomatic-Screened Dental Patients
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Abstract
Enhanced community surveillance is a key pillar of the public health response to coronavirus disease 2019 (COVID-19). Asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potentially significant source of transmission, yet remains relatively poorly understood. Disruption of dental services continues with significantly reduced capacity. Ongoing precautions include preappointment and/or at appointment COVID-19 symptom screening and use of enhanced personal protective equipment (PPE). This study aimed to investigate SARS-CoV-2 infection in dental patients to inform community surveillance and improve understanding of risks in the dental setting. Thirty-one dental care centers across Scotland invited asymptomatic-screened patients aged over 5 y to participate. Following verbal consent and completion of sociodemographic and symptom history questionnaire, trained dental teams took a combined oropharyngeal and nasal swab sample using standardized Viral Transport Medium–containing test kits. Samples were processed by the Lighthouse Lab and patients informed of their results by SMS/email with appropriate self-isolation guidance in the event of a positive test. All positive cases were successfully followed up by the national contact tracing program. Over a 13-wk period (from August 3, 2020, to October 31, 2020), 4,032 patients, largely representative of the population, were tested. Of these, 22 (0.5%; 95% CI, 0.5%–0.8%) tested positive for SARS-CoV-2. The positivity rate increased over the period, commensurate with uptick in community prevalence identified across all national testing monitoring data streams. To our knowledge, this is the first report of a COVID-19 testing survey in asymptomatic-screened patients presenting in a dental setting. The positivity rate in this patient group reflects the underlying prevalence in community at the time. These data are a salient reminder, particularly when community infection levels are rising, of the importance of appropriate ongoing infection prevention control and PPE vigilance, which is relevant as health care team fatigue increases as the pandemic continues. Dental settings are a valuable location for public health surveillance.
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SciScore for 10.1101/2020.12.30.20248603: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Following surveillance protocols[15], the patients were further informed of the process and verbal consent was obtained, recorded in the clinical notes, and on the testkit registration portal[18]. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Gender was not included in the calculation of the weights as the proportions of men and women in our dental surveillance sample matched the population proportions. Table 2: Resources
Software and Algorithms Sentences Resources Positive test results entered the Electronic Communication of Surveillance in Scotland (ECOSS) system and the Case Management System (CMS) … SciScore for 10.1101/2020.12.30.20248603: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Following surveillance protocols[15], the patients were further informed of the process and verbal consent was obtained, recorded in the clinical notes, and on the testkit registration portal[18]. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Gender was not included in the calculation of the weights as the proportions of men and women in our dental surveillance sample matched the population proportions. Table 2: Resources
Software and Algorithms Sentences Resources Positive test results entered the Electronic Communication of Surveillance in Scotland (ECOSS) system and the Case Management System (CMS) used by health protection teams in local Boards for contact tracing (known as the NHS Scotland’s “Test and Protect” system[21]). Protect”suggested: NonePatients with a positive result were followed up by local Test and Protect teams, and the National Steering Group contacted the relevant health protection team, consultant in dental public health and director of dentistry to ensure all were aware the test had been part of an asymptomatic surveillance program. Protectsuggested: (ProTECT, RRID:SCR_004531)All analyses were undertaken in BusinessObjects, SPSS, and R version 3.6.1. SPSSsuggested: (SPSS, RRID:SCR_002865)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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.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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