this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).The National Football League (NFL) and the NFL Players Association (NFLPA) began the 2020 football season in July, implementing extensive mitigation and surveillance measures in facilities and during travel and gameplay. Mitigation protocols* were evaluated and modified based on data from routine reverse transcription-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2, the virus that causes coronavirus 2019 (COVID-19); proximity tracking devices; and detailed interviews. Midseason, transmission was observed in persons who had cumulative interactions of <15 minutes' duration, leading to a revised definition of highrisk contacts that required consideration of mask use, setting and room ventilation in addition to proximity and duration of interaction. The NFL also developed an intensive protocol that imposed stricter infection prevention precautions when a case was identified at an NFL club. The intensive protocol effectively prevented the occurrence of high-risk interactions, with no high-risk contacts identified for 71% of traced cases at clubs under the intensive protocol. The incorporation of the nature and location of the interaction, including mask use, indoor versus outdoor setting, and ventilation, in addition to proximity and duration, likely improved identification of exposed persons at higher risk for SARS-CoV-2 infection. Quarantine of these persons, along with testing and intensive protocols, can reduce spread of infection.The NFL consists of 32 member clubs based in 24 states. The NFL-NFLPA implemented a standard COVID-19 mitigation protocol in July that included mandatory masking; physical distancing; frequent handwashing; facility disinfection; restricted facility access; and regular, frequent testing of players and staff members (1). Contact tracing was performed by trained staff members and supported by KINEXON wearable proximity devices (https://kinexon.com) that were required to be worn by players and personnel when in club environments (2). Device recordings captured consecutive and cumulative minutes/seconds of interactions among persons within 1.8 meters (6 feet) of one another. When testing identified a new COVID-19 case, trained staff members conducted interviews to identify contacts *
Background: Rapid COVID-19 testing platforms can identify infected individuals at the point of care (POC), allowing immediate isolation of infected individuals and reducing the risk of transmission. While lab-based nucleic acid amplification testing (NAAT) is often considered the gold standard to detect SARS-CoV-2 in the community, results typically take 2-7 days to return, rendering POC testing a critical diagnostic tool for infection control. The National Football League (NFL) and NFL Players Association deployed a new POC testing strategy using a newly available reverse transcriptase polymerase chain reaction (RT-PCR) rapid test during the 2020 season, and evaluated diagnostic effectiveness compared to other available devices using real-world population surveillance data. Methods: RT-PCR POC test results were compared to NAAT results from same-day samples by calculation of positive and negative concordance. Sensitivity analyses were performed for three subgroups: (1) individuals symptomatic at time of positive test; (2) individuals tested during the pilot phase of rollout; and (3) individuals tested daily.Results: Among 4989 same-day POC/NAAT pairs, 4957 (99.4%) were concordant, with 93.1% positive concordance and 99.6% negative concordance. Based on adjudicated case status, the false negative rate was 0.2% and false positive rate was 2.9%.In 43 instances, the immediate turnaround of results by POC allowed isolation of infected individuals 1 day sooner than lab-based testing. Positive/negative concordance in sensitivity analyses were relatively stable. Conclusion: RT-PCR POC testing provided timely results that were highly concordant with lab-based NAAT in population surveillance. Expanded use of effective RT-PCR POC can enable rapid isolation of infected individuals and reduce COVID-19 infection in the community.
BackgroundViral pathogens are a leading cause of respiratory infection in the pediatric population. In August 2015, Williamson Medical Center implemented a respiratory panel (RP) that enables rapid detection of 20 common pathogens by multiplex polymerase chain reaction. Utilization of the RP was reviewed to assess the impact of the test on healthcare and antimicrobial utilization.MethodsA retrospective chart review was conducted of all patients aged 0 to 17 years with RP specimens collected August 2015 through December 2016. An evaluation of the impact of RP results was completed through review of duration or change in antimicrobial therapy, change in patient management, and avoidance of further workup, antimicrobial therapy, or hospital admission. A subgroup analysis was performed for patients less than 60 days of age.ResultsTwo hundred and ninety-five pediatric patients had a RP specimen collected during the evaluation timeframe. Ninety-six percent of tests were appropriate based on symptoms and 49% of RP results changed patient management (Table 1). RP result did not change management in any patients greater than 10 years of age. A pathogen was identified in 66% of specimens, with rhinovirus/enterovirus (53.6%) and respiratory syncytial virus (20.5%) being the most common viruses isolated. The use of the RP was highest in the months of August through December, with viral pathogen isolation being highest in these months as well. In patients less than 60 days of age (n = 40), the RP result changed management in 22 (55%) cases, including 3 avoided admissions, 12 avoided antibiotic courses, and 7 avoided lumbar punctures.ConclusionThe use of a RP was beneficial in this pediatric population to decrease hospital admissions, avoid further unnecessary procedures, avoid unnecessary antibiotic therapy, decrease duration of antibiotics and target antimicrobial therapy. Further consideration should be given to implement an algorithm for use.Disclosures M. F. Williams, BioFire Diagnostics: Consultant, Speaker honorarium; Joint Commission Resources: Consultant, Speaker honorariumTable 1:Respiratory Panel Collection 0–17 Years of AgeSamples Collected295Test Appropriate Based on Symptoms284 (96%)Pathogen Detected196 (66%)Result Changed Management145 (49%)Avoid Admission44Reduce Further Procedures/Workup33Avoid Antibiotics89Narrow/Decrease Antibiotic Duration20Target Antimicrobial Therapy14
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