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SARS-CoV-2 screening testing Programs for Safe In-person Learning in K-12 Schools

JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY 2023年第2期12卷 64-72页

作者： Kalu, Ibukunoluwa C. Zimmerman, Kanecia O. Goldman, Jennifer L. Mast, Dana Keener Blakemore, Ashley M. Moorthy, Ganga Boutzoukas, Angelique E. Campbell, Melissa M. Uthappa, Diya DeLaRosa, Jesse Potts, Jessica M. Edwards, Laura J. Selvarangan, Rangaraj Benjamin, Daniel K. Mann, Tara K. Schuster, Jennifer E. Duke Univ Duke Clin Res Inst Sch Med Durham NC 27701 USA Duke Univ Sch Med Dept Pediat Durham NC 27701 USA ABC Sci Collaborat Durham NC USA Duke Univ Sch Med Doctor Med Program Durham NC 27701 USA ICF Atlanta GA USA Univ Missouri Dept Pediat Div Pediat Infect Dis Childrens Mercy Kansas City Kansas City MO USA Duke Univ Duke Clin Res Inst Sch Med Pediat 300 Morris St Durham NC 27701 USA

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening testing is a recommended mitigation strategy for schools, although few descriptions of program implementation are available. Methods Kindergarten through 12th grade (K-12) students and staff practicing universal masking during the delta and omicron variant waves from five schools in Durham, North Carolina and eight schools in Kansas City, Missouri participated;Durham's program was structured as a public health initiative facilitated by school staff, and Kansas City's as a research study facilitated by a research team. Tests included school-based rapid antigen or polymerase chain reaction testing, at-home rapid antigen testing, and off-site nucleic acid amplification testing. Results We performed nearly 5700 screening tests on more than 1600 K-12 school students and staff members. The total cost for the Durham testing program in 5 public charter K-12 schools, each with 500-1000 students, was $246 587 and approximately 752 h per semester;cost per test was $70 and cost per positive result was $7076. The total cost for the Kansas City program in eight public K-12 schools was $292 591 and required approximately 537 h in personnel time for school-based testing;cost per test was $132 and cost per positive result was $4818. SARS-CoV-2 positivity rates were generally lower (0-16.16%) than rates in the community (2.7-36.47%) throughout all testing weeks. Conclusions and Relevance Voluntary screening testing programs in K-12 schools are costly and rarely detect asymptomatic positive persons, particularly in universally masked settings. We found that school-based SARS-CoV-2 screening testing in K-12 schools is costly and burdensome for personnel. Targeted testing such as diagnostic testing, test-to-stay, or test-to-play may provide better value, particularly when test supplies or personnel are limited.

关键词： K-12 school communities SARS-CoV-2 screening testing

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Predictors of Willingness to Participate in COVID-19 screening testing from a Pilot School Survey in the United States

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JOURNAL OF SCHOOL HEALTH 2023年第12期93卷 1061-1069页

作者： Mark-Carew, Miguella Swanson, Megan Eller, Brian Cullen, Theresa Valenzuela, Manuel O. Labelle, Monica Persad, Neela Barrios, Lisa C. Szucs, Leigh E. Global Govt Solut 4372 N Loop 1604Suite 306 Shavano Pk TX 78249 USA US Ctr Dis Control & Prevent COVID 19 Emergency Response Team 1600 Clifton Rd Atlanta GA 30329 USA Pima Cty Hlth Dept 150 N 18th Ave Phoenix AZ 85007 USA Arizona Dept Hlth Serv 150 N 18th Ave Phoenix AZ 85007 USA Pima Cty Hlth Dept 3950 S Country Club Rd 100 Tucson AZ 85714 USA Sahuarita Unified Sch Dist 350W Sahuarita Rd Sahuarita AZ 85629 USA Katmai Govt Serv 12001 ScienceDrSuite 160 Orlando FL 32826 USA Global Govt Solut G2S Corp 4372 N Loop 1604 Suite 306 Shavano Pk TX 78249 USA

BACKGROUNDCOVID-19 screening testing (ST) can detect asymptomatic or pre-symptomatic cases, allowing for prompt identification of cases and close contacts. This study examined parents' and school staffs' knowledge and attitudes toward to a pilot school-based ST program in a school district in southern *** May 2021, online surveys to parents and school staff were administered to examine attitudes toward ST and impacts of the COVID-19 pandemic. Unweighted percent estimates were calculated, and bivariate differences were examined by demographics. Associations were assessed using chi-square tests and logistic *** survey had response rates of 10% (606/6085) and 22% (187/849) among parents and staff, respectively. Approximately one-third of responding parents (35%) would or already allow their child to participate in school-based ST, 37% would not participate;28% were unsure. Among responding staff, 46% would or already participate in ST, 33% would not;21% were unsure. The top concern (38%) among responding staff was taking job-related leave if testing *** work to balance the needs of students, families, and staff by implementing supportive and flexible policies and practices founded on buy-in and acceptance from their communities

关键词： screening testing COVID-19 K-12 schools teacher concerns parent concerns SARS-CoV-2 transmission

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Identifying significant gene-environment interactions using a combination of screening testing and hierarchical false discovery rate control

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GENETIC EPIDEMIOLOGY 2016年第7期40卷 544-557页

作者： Frost, H. Robert Shen, Li Saykin, Andrew J. Williams, Scott M. Moore, Jason H. Dartmouth Coll Geisel Sch Med Inst Quantitat Biomed Sci Dept Biomed Data Sci Hanover NH 03755 USA Dartmouth Coll Geisel Sch Med Inst Quantitat Biomed Sci Dept Genet Hanover NH 03755 USA Indiana Univ Sch Med Dept Radiol & Imaging Sci Ctr Neuroimaging Indianapolis IN 46202 USA Indiana Univ Sch Med Dept Radiol & Imaging Sci Indiana Alzheimers Dis Ctr Indianapolis IN 46202 USA Univ Penn Perelman Sch Med Inst Biomed Informat Div InformatDept Biostat & Epidemiol Philadelphia PA 19104 USA

Although gene-environment (Gx E) interactions play an important role in many biological systems, detecting these interactions within genome-wide data can be challenging due to the loss in statistical power incurred by multiple hypothesis correction. To address the challenge of poor power and the limitations of existing multistage methods, we recently developed a screening-testing approach for Gx E interaction detection that combines elastic net penalized regression with joint estimation to support a single omnibus test for the presence of Gx E interactions. In our original work on this technique, however, we did not assess type I error control or power and evaluated the method using just a single, small bladder cancer data set. In this paper, we extend the original method in two important directions and provide a more rigorous performance evaluation. First, we introduce a hierarchical false discovery rate approach to formally assess the significance of individual Gx E interactions. Second, to support the analysis of truly genome-wide data sets, we incorporate a score statistic-based prescreening step to reduce the number of single nucleotide polymorphisms prior to fitting the first stage penalized regression model. To assess the statistical properties of our method, we compare the type I error rate and statistical power of our approach with competing techniques using both simple simulation designs as well as designs based on real disease architectures. Finally, we demonstrate the ability of our approach to identify biologically plausible SNP-education interactions relative to Alzheimer's disease status using genome-wide association study data from the Alzheimer's Disease Neuroimaging Initiative (ADNI).

关键词： gene-environment interactions screening testing hierarchical FDR penalized regression

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From Easing Lockdowns to Scaling Up Community-based Coronavirus Disease 2019 screening, testing, and Contact Tracing in Africa-Shared Approaches, Innovations, and Challenges to Minimize Morbidity and Mortality

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CLINICAL INFECTIOUS DISEASES 2021年第2期72卷 327-331页

作者： Nachega, Jean B. Grimwood, Ashraf Mahomed, Hassan Fatti, Geoffrey Preiser, Wolfgang Kallay, Oscar Mbala, Placide K. Muyembe, Jean-Jacques T. Rwagasore, Edson Nsanzimana, Sabin Ngamije, Daniel Condo, Jeanine Sidat, Mohsin Noormahomed, Emilia, V Reid, Michael Lukeni, Beatrice Suleman, Fatima Mteta, Alfred Zumla, Alimuddin Stellenbosch Univ Dept Med & Ctr Infect Dis Fac Med & Hlth Sci Cape Town South Africa Johns Hopkins Bloomberg Sch Publ Hlth Dept Epidemiol & Int Hlth Baltimore MD USA Univ Pittsburgh Dept Epidemiol Infect Dis & Microbiol Pittsburgh PA 15261 USA Univ Pittsburgh Ctr Global Hlth Pittsburgh PA 15261 USA Kheth Impilo AIDS Free Living Cape Town South Africa Stellenbosch Fac Med & Hlth Sci Dept Global Hlth Div Hlth Syst & Publ Hlth Cape Town South Africa Western Cape Dept Hlth Cape Town South Africa Stellenbosch Univ Fac Med & Hlth Sci Dept Global Hlth Div Epidemiol & Biostat Cape Town South Africa Stellenbosch Univ Dept Pathol Fac Med & Hlth Sci Div Med Virol Cape Town South Africa Natl Hlth Lab Serv Cape Town South Africa Univ Libre Bruxelles Erasme Hosp Dept Ophthalmol Brussels Belgium Univ Kinshasa Fac Med Natl Inst Biomed Res Kinshasa DEM REP CONGO Univ Kinshasa Dept Med Microbiol & Virol Kinshasa DEM REP CONGO Rwanda Biomed Ctr Kigali Rwanda Rwanda Minist Hlth Kigali Rwanda Univ Rwanda Sch Publ Hlth Kigali Rwanda Tulane Univ Sch Publ Hlth & Trop Med New Orleans LA USA Eduardo Mondlane Univ Fac Med Maputo Mozambique Mozamb Inst Hlth Educ & Res Maputo Mozambique Univ Calif San Diego Dept Med Infect Dis Div San Diego CA 92103 USA Univ Calif San Francisco Dept Med HIV Infect Dis & Global Med Div San Francisco CA 94143 USA Columbia Univ ICAP Resilient & Respons Hlth Syst Project Lubumbashi DEM REP CONGO Univ KwaZulu Natal Discipline Pharmaceut Sci Durban South Africa Kilimanjaro Christian Med Univ Coll Moshi Tanzania UCL Ctr Clin Microbiol Dept Infect Div Infect & Immun London England Univ Coll London Hosp Natl Inst Hlth Res Biomed Res Ctr London England

The arrival of coronavirus disease 2019 (COVID-19) on the African continent resulted in a range of lockdown measures that curtailed the spread of the infection but caused economic hardship. African countries now face difficult choices regarding easing of lockdowns and sustaining effective public health control measures and surveillance. Pandemic control will require efficient community screening, testing, and contact tracing;behavioral change interventions;adequate resources;and well-supported, community-based teams of trained, protected personnel. We discuss COVID-19 control approaches in selected African countries and the need for shared, affordable, innovative methods to overcome challenges and minimize mortality. This crisis presents a unique opportunity to align COVID-19 services with those already in place for human immunodeficiency virus, tuberculosis, malaria, and non communicable diseases through mobilization of Africa's interprofessional healthcare workforce. By addressing the challenges, the detrimental effect of the COVID-19 pandemic on African citizens can be minimized.

关键词： COVID-19 SARS-CoV-2 screening testing contact trace Africa

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Modeling the Effectiveness of Healthcare Personnel Reactive testing and screening for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Variant Within Nursing Homes

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CLINICAL INFECTIOUS DISEASES 2022年第SUPPLEMENT_2期75卷 S225-S230页

作者： Zipfel, Casey M. Paul, Prabasaj Gowler, Camden D. Reddy, Sujan C. Stone, Nimalie D. Slifka, Kara Jacobs Slayton, Rachel B. Ctr Dis Control & Prevent Div Healthcare Qual Promot 1600 Clifton Rd Atlanta GA 30329 USA

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron variant has been hypothesized to exhibit faster clearance (time from peak viral concentration to clearance of acute infection), decreased sensitivity of antigen tests, and increased immune escape (the ability of the variant to evade immunity conferred by past infection or vaccination) compared to prior variants. These factors necessitate reevaluation of prevention and control strategies, particularly in high-risk, congregate settings like nursing homes that have been heavily impacted by other coronavirus disease 2019 (COVID-19) variants. We used a simple model representing individual-level viral shedding dynamics to estimate the optimal strategy for testing nursing home healthcare personnel and quantify potential reduction in transmission of COVID-19. This provides a framework for prospectively evaluating testing strategies in emerging variant scenarios when data are limited. We find that case-initiated testing prevents 38% of transmission within a facility if implemented within a day of an index case testing positive, and screening testing strategies could prevent 30% to 78% of transmission within a facility if implemented daily, depending on test sensitivity.

关键词： COVID-19 Omicron outbreak testing screening testing nursing homes

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Optimization in the Context of COVID-19 Prediction and Control: A Literature Review

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IEEE ACCESS 2021年 9卷 130072-130093页

作者： Jordan, Elizabeth Shin, Delia E. Leekha, Surbhi Azarm, Shapour Univ Maryland Dept Mech Engn College Pk MD 20742 USA Univ Maryland Sch Med Dept Epidemiol & Publ Hlth Baltimore MD 21201 USA

This paper presents an overview of some key results from a body of optimization studies that are specifically related to COVID-19, as reported in the literature during 2020-2021. As shown in this paper, optimization studies in the context of COVID-19 have been used for many aspects of the pandemic. From these studies, it is observed that since COVID-19 is a multifaceted problem, it cannot be studied from a single perspective or framework, and neither can the related optimization models. Four new and different frameworks are proposed that capture the essence of analyzing COVID-19 (or any pandemic for that matter) and the relevant optimization models. These are: (i) microscale vs. macroscale perspective;(ii) early stages vs. later stages perspective;(iii) aspects with direct vs. indirect relationship to COVID-19;and (iv) compartmentalized perspective. To limit the scope of the review, only optimization studies related to the prediction and control of COVID-19 are considered (public health focused), and which utilize formal optimization techniques or machine learning approaches. In this context and to the best of our knowledge, this survey paper is the first in the literature with a focus on the prediction and control related optimization studies. These studies include optimization of screening testing strategies, prediction, prevention and control, resource management, vaccination prioritization, and decision support tools. Upon reviewing the literature, this paper identifies current gaps and major challenges that hinder the closure of these gaps and provides some insights into future research directions.

关键词： COVID-19 Optimization Pandemics Vaccines Coronaviruses Predictive models Hospitals Optimization COVID-19 decision support screening testing prediction prevention control resource allocation vaccination literature review

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Is Symptom screening Useful for Identifying COVID-19 Infection in School Settings? Georgia, USA

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JOURNAL OF SCHOOL NURSING 2021年第6期37卷 503-512页

作者： Swanson, Megan Hast, Marisa Burnett, Eleanor Oraka, Emeka Kimball, Anne Morris, Elana Marcet, Paula L. Almendares, Olivia Franklin, Rachel Mehari, Lemlem McCloud, Jazmyn Kirking, Hannah L. Tate, Jacqueline E. Scott, Colleen CDC COVID 19 Response Atlanta GA USA CDC Epidem Intelligence Serv Atlanta GA 30333 USA Gen Dynam Informat Technol Falls Church VA USA Cobb & Douglas Publ Hlth Marietta GA USA

This study's goal was to characterize the utility of symptom screening in staff and students for COVID-19 identification and control of transmission in a school setting. We conducted a secondary analysis of cross-sectional data for staff, students and associated household members in a Georgia school district exposed to COVID-19 cases who received RT-PCR testing and symptom monitoring. Among positive contacts, 30/49 (61%) of students and 1/6 (17%) of staff reported no symptoms consistent with COVID-19. Symptom sensitivity was 30% in elementary students and 42% in middle/high students. Fifty-three percent (10/19) of symptomatic positive contacts had at least one household member test positive for SARS-CoV-2 compared with 50% (10/20) of asymptomatic positive contacts. The absence of symptoms in children is not indicative of a lack of SARS-CoV-2 infection or reduced risk of infection for associated household members. testing all close contacts of people with COVID-19 in schools is needed to interrupt transmission networks.

关键词： COVID-19 symptoms epidemiology elementary school students high school students transmission screening testing school nurses

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Setting-specific variability of false-positive result rates with rapid testing for SARS-CoV-2 antigen

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JOURNAL OF CLINICAL VIROLOGY 2022年 149卷 105132-105132页

作者： Posteraro, Patrizia Errico, Federica Maria De Carolis, Antonella Menchinelli, Giulia Sanguinetti, Maurizio Posteraro, Brunella Osped San Carlo GVM Lab Anal Chim Clin & Microbiol Rome Italy Univ Cattolica Sacro Cuore Dipartimento Sci Biotecnol Base Clin Intensivol & Rome Italy Fdn Policlin Univ A Gemelli IRCCS Dipartimento Sci Lab & Infettivol Rome Italy Fdn Policlin Univ A Gemelli IRCCS Dipartimento Sci Med & Chirurg Rome Italy

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A hybrid stochastic model and its Bayesian identification for infectious disease screening in a university campus with application to massive COVID-19 screening at the University of Liege

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MATHEMATICAL BIOSCIENCES 2022年 347卷 108805页

作者： Arnst, M. Louppe, G. Van Hulle, R. Gillet, L. Bureau, F. Denoel, V Univ Liege Fac Appl Sci B-4000 Liege Belgium Univ Liege FARAH Immunol Vaccinol B-4000 Liege Belgium Univ Liege GIGA Inst Lab Cellular & Mol Immunol B-4000 Liege Belgium

Amid the COVID-19 pandemic, universities are implementing various prevention and mitigation measures. Identifying and isolating infectious individuals by using screening testing is one such a measure that can contribute to reducing spread. Here, we propose a hybrid stochastic model for infectious disease transmission in a university campus with screening testing and its surrounding community. Based on a compartmental modeling strategy, this hybrid stochastic model represents the evolution of the infectious disease and its transmission using continuous-time stochastic dynamics, and it represents the screening testing as discrete stochastic events. We also develop, in a Bayesian framework, the identification of parameters of this hybrid stochastic model, including transmission rates. These parameters were identified from the screening test data for the university population and observed incidence counts for the surrounding community. We implement the exploration of the Bayesian posterior using a machine-learning simulation-based inference approach. The proposed methodology was applied in a retrospective modeling study of a massive COVID-19 screening conducted at the University of Liege in Fall 2020. The emphasis of the paper is on the development of the hybrid stochastic model to assess the impact of screening testing as a measure to reduce spread. The hybrid stochastic model allows various factors to be represented and examined, such as interplay with the surrounding community, variability of the transmission dynamics, the rate of participation in the screening testing, the test sensitivity, the test frequency, the diagnosis delay, and compliance with isolation. The application in the retrospective modeling study suggests that a high rate of participation and a high test frequency are important factors to reduce spread.

关键词： Infectious disease transmission COVID-19 screening testing Stochastic dynamics Bayesian inference Simulation-based inference

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