Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities
Background: The negative impact of continued school closures during the height of the COVID-19 pandemic warrants the establishment of cost-effective strategies for surveillance and screening to safely reopen and monitor for potential in-school transmission. Here, we present a novel approach to incre...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-08-01
|
| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537021003084 |
| _version_ | 1818601268327743488 |
|---|---|
| author | Rachelle P. Mendoza Chongfeng Bi Hui-Ting Cheng Elmer Gabutan Guillerre Jan Pagaspas Nadia Khan Helen Hoxie Stephen Hanna Kelly Holmes Nicholas Gao Raychel Lewis Huaien Wang Daniel Neumann Angela Chan Meril Takizawa James Lowe Xiao Chen Brianna Kelly Aneeza Asif Keena Barnes Nusrat Khan Brandon May Tasnim Chowdhury Gabriella Pollonini Nourelhoda Gouda Chante Guy Candice Gordon Nana Ayoluwa Elvin Colon Noah Miller-Medzon Shanique Jones Rauful Hossain Arabia Dodson Meimei Weng Miranda McGaskey Ana Vasileva Andrew E. Lincoln Robby Sikka Anne L. Wyllie Ethan M. Berke Jenny Libien Matthew Pincus Prem K. Premsrirut |
| author_facet | Rachelle P. Mendoza Chongfeng Bi Hui-Ting Cheng Elmer Gabutan Guillerre Jan Pagaspas Nadia Khan Helen Hoxie Stephen Hanna Kelly Holmes Nicholas Gao Raychel Lewis Huaien Wang Daniel Neumann Angela Chan Meril Takizawa James Lowe Xiao Chen Brianna Kelly Aneeza Asif Keena Barnes Nusrat Khan Brandon May Tasnim Chowdhury Gabriella Pollonini Nourelhoda Gouda Chante Guy Candice Gordon Nana Ayoluwa Elvin Colon Noah Miller-Medzon Shanique Jones Rauful Hossain Arabia Dodson Meimei Weng Miranda McGaskey Ana Vasileva Andrew E. Lincoln Robby Sikka Anne L. Wyllie Ethan M. Berke Jenny Libien Matthew Pincus Prem K. Premsrirut |
| author_sort | Rachelle P. Mendoza |
| collection | DOAJ |
| description | Background: The negative impact of continued school closures during the height of the COVID-19 pandemic warrants the establishment of cost-effective strategies for surveillance and screening to safely reopen and monitor for potential in-school transmission. Here, we present a novel approach to increase the availability of repetitive and routine COVID-19 testing that may ultimately reduce the overall viral burden in the community. Methods: We implemented a testing program using the SalivaClear࣪ pooled surveillance method that included students, faculty and staff from K-12 schools (student age range 5–18 years) and universities (student age range >18 years) across the country (Mirimus Clinical Labs, Brooklyn, NY). The data analysis was performed using descriptive statistics, kappa agreement, and outlier detection analysis. Findings: From August 27, 2020 until January 13, 2021, 253,406 saliva specimens were self-collected from students, faculty and staff from 93 K-12 schools and 18 universities. Pool sizes of up to 24 samples were tested over a 20-week period. Pooled testing did not significantly alter the sensitivity of the molecular assay in terms of both qualitative (100% detection rate on both pooled and individual samples) and quantitative (comparable cycle threshold (Ct) values between pooled and individual samples) measures. The detection of SARS-CoV-2 in saliva was comparable to the nasopharyngeal swab. Pooling samples substantially reduced the costs associated with PCR testing and allowed schools to rapidly assess transmission and adjust prevention protocols as necessary. In one instance, in-school transmission of the virus was determined within the main office and led to review and revision of heating, ventilating and air-conditioning systems. Interpretation: By establishing low-cost, weekly testing of students and faculty, pooled saliva analysis for the presence of SARS-CoV-2 enabled schools to determine whether transmission had occurred, make data-driven decisions, and adjust safety protocols. We provide strong evidence that pooled testing may be a fundamental component to the reopening of schools by minimizing the risk of in-school transmission among students and faculty. Funding: Skoll Foundation generously provided funding to Mobilizing Foundation and Mirimus for these studies. |
| first_indexed | 2024-12-16T12:48:41Z |
| format | Article |
| id | doaj.art-8ebb8f16ec5144ed93bb7b50cd01ff28 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-16T12:48:41Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-8ebb8f16ec5144ed93bb7b50cd01ff282022-12-21T22:31:13ZengElsevierEClinicalMedicine2589-53702021-08-0138101028Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universitiesRachelle P. Mendoza0Chongfeng Bi1Hui-Ting Cheng2Elmer Gabutan3Guillerre Jan Pagaspas4Nadia Khan5Helen Hoxie6Stephen Hanna7Kelly Holmes8Nicholas Gao9Raychel Lewis10Huaien Wang11Daniel Neumann12Angela Chan13Meril Takizawa14James Lowe15Xiao Chen16Brianna Kelly17Aneeza Asif18Keena Barnes19Nusrat Khan20Brandon May21Tasnim Chowdhury22Gabriella Pollonini23Nourelhoda Gouda24Chante Guy25Candice Gordon26Nana Ayoluwa27Elvin Colon28Noah Miller-Medzon29Shanique Jones30Rauful Hossain31Arabia Dodson32Meimei Weng33Miranda McGaskey34Ana Vasileva35Andrew E. Lincoln36Robby Sikka37Anne L. Wyllie38Ethan M. Berke39Jenny Libien40Matthew Pincus41Prem K. Premsrirut42Mirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USA; Department of Pathology, SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USA; Department of Cell Biology, SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11226, USAMedStar Sports Medicine Research Center, MedStar Health Research Institute, 2900 S Hanover St., Baltimore, MD 21225, USA; Department of Rehabilitation Medicine, Georgetown University Medical Center, 3800 Reservoir Rd NW, Washington, DC 20007, USAMinnesota Timberwolves, 600 Hennepin Ave, Minneapolis, MN 55403, USADepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT 06510, USAOptumLabs, UnitedHealth Group, 12700 Whitewater Dr, Minnetonka, MN 55343 USADepartment of Pathology, SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USA; Department of Pathology, SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11226, USAMirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USA; Department of Cell Biology, SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11226, USA; Corresponding author at: Mirimus Inc, 760 Parkside Ave. Suite 206, Brooklyn, NY 11226, USA.Background: The negative impact of continued school closures during the height of the COVID-19 pandemic warrants the establishment of cost-effective strategies for surveillance and screening to safely reopen and monitor for potential in-school transmission. Here, we present a novel approach to increase the availability of repetitive and routine COVID-19 testing that may ultimately reduce the overall viral burden in the community. Methods: We implemented a testing program using the SalivaClear࣪ pooled surveillance method that included students, faculty and staff from K-12 schools (student age range 5–18 years) and universities (student age range >18 years) across the country (Mirimus Clinical Labs, Brooklyn, NY). The data analysis was performed using descriptive statistics, kappa agreement, and outlier detection analysis. Findings: From August 27, 2020 until January 13, 2021, 253,406 saliva specimens were self-collected from students, faculty and staff from 93 K-12 schools and 18 universities. Pool sizes of up to 24 samples were tested over a 20-week period. Pooled testing did not significantly alter the sensitivity of the molecular assay in terms of both qualitative (100% detection rate on both pooled and individual samples) and quantitative (comparable cycle threshold (Ct) values between pooled and individual samples) measures. The detection of SARS-CoV-2 in saliva was comparable to the nasopharyngeal swab. Pooling samples substantially reduced the costs associated with PCR testing and allowed schools to rapidly assess transmission and adjust prevention protocols as necessary. In one instance, in-school transmission of the virus was determined within the main office and led to review and revision of heating, ventilating and air-conditioning systems. Interpretation: By establishing low-cost, weekly testing of students and faculty, pooled saliva analysis for the presence of SARS-CoV-2 enabled schools to determine whether transmission had occurred, make data-driven decisions, and adjust safety protocols. We provide strong evidence that pooled testing may be a fundamental component to the reopening of schools by minimizing the risk of in-school transmission among students and faculty. Funding: Skoll Foundation generously provided funding to Mobilizing Foundation and Mirimus for these studies.http://www.sciencedirect.com/science/article/pii/S2589537021003084SARS-CoV-2Pooled surveillance testingAsymptomatic infectionsK-12 schools |
| spellingShingle | Rachelle P. Mendoza Chongfeng Bi Hui-Ting Cheng Elmer Gabutan Guillerre Jan Pagaspas Nadia Khan Helen Hoxie Stephen Hanna Kelly Holmes Nicholas Gao Raychel Lewis Huaien Wang Daniel Neumann Angela Chan Meril Takizawa James Lowe Xiao Chen Brianna Kelly Aneeza Asif Keena Barnes Nusrat Khan Brandon May Tasnim Chowdhury Gabriella Pollonini Nourelhoda Gouda Chante Guy Candice Gordon Nana Ayoluwa Elvin Colon Noah Miller-Medzon Shanique Jones Rauful Hossain Arabia Dodson Meimei Weng Miranda McGaskey Ana Vasileva Andrew E. Lincoln Robby Sikka Anne L. Wyllie Ethan M. Berke Jenny Libien Matthew Pincus Prem K. Premsrirut Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities EClinicalMedicine SARS-CoV-2 Pooled surveillance testing Asymptomatic infections K-12 schools |
| title | Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities |
| title_full | Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities |
| title_fullStr | Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities |
| title_full_unstemmed | Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities |
| title_short | Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities |
| title_sort | implementation of a pooled surveillance testing program for asymptomatic sars cov 2 infections in k 12 schools and universities |
| topic | SARS-CoV-2 Pooled surveillance testing Asymptomatic infections K-12 schools |
| url | http://www.sciencedirect.com/science/article/pii/S2589537021003084 |
| work_keys_str_mv | AT rachellepmendoza implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT chongfengbi implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT huitingcheng implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT elmergabutan implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT guillerrejanpagaspas implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT nadiakhan implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT helenhoxie implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT stephenhanna implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT kellyholmes implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT nicholasgao implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT raychellewis implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT huaienwang implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT danielneumann implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT angelachan implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT meriltakizawa implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT jameslowe implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT xiaochen implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT briannakelly implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT aneezaasif implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT keenabarnes implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT nusratkhan implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT brandonmay implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT tasnimchowdhury implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT gabriellapollonini implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT nourelhodagouda implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT chanteguy implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT candicegordon implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT nanaayoluwa implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT elvincolon implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT noahmillermedzon implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT shaniquejones implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT raufulhossain implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT arabiadodson implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT meimeiweng implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT mirandamcgaskey implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT anavasileva implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT andrewelincoln implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT robbysikka implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT annelwyllie implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT ethanmberke implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT jennylibien implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT matthewpincus implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities AT premkpremsrirut implementationofapooledsurveillancetestingprogramforasymptomaticsarscov2infectionsink12schoolsanduniversities |