SARS-CoV-2 PCR and antibody testing for an entire rural community: methods and feasibility of high-throughput testing procedures

Appa, Ayesha; Chamie, Gabriel; Sawyer, Aenor; Baltzell, Kimberly; Dippell, Kathryn; Ribeiro, Salu; Duarte, Elias; Vinden, Joanna; Kramer-Feldman, Jonathan; Rahdar, Shahryar; MacIntosh, Doug; Nicholson, Katherine; Im, Jonathan; Havlir, Diane V.; Greenhouse, Bryan

doi:10.1101/2020.05.29.20116426

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Other seroprevalence studies conducted prior to summer/fall of 2020 and during shelter-in-place orders [ 9 – 11 , 16 , 33 ] found lower COVID-19 prevalence compared to our study. The exceptions are studies conducted in hotspots, like New York City and Chelsea, Massachusetts [ 19 , 20 ], as well as ski resort communities [ 17 ].…”

Section: Discussioncontrasting

confidence: 74%

Population-based correlates of COVID-19 infection: An analysis from the DFW COVID-19 prevalence study

et al. 2022

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Background COVID-19 has resulted in over 1 million deaths in the U.S. as of June 2022, with continued surges after vaccine availability. Information on related attitudes and behaviors are needed to inform public health strategies. We aimed to estimate the prevalence of COVID-19, risk factors of infection, and related attitudes and behaviors in a racially, ethnically, and socioeconomically diverse urban population. Methods The DFW COVID-19 Prevalence Study Protocol 1 was conducted from July 2020 to March 2021 on a randomly selected sample of adults aged 18–89 years, living in Dallas or Tarrant Counties, Texas. Participants were asked to complete a 15-minute questionnaire and COVID-19 PCR and antibody testing. COVID-19 prevalence estimates were calculated with survey-weighted data. Results Of 2969 adults who completed the questionnaire (7.4% weighted response), 1772 (53.9% weighted) completed COVID-19 testing. Overall, 11.5% of adults had evidence of COVID-19 infection, with a higher prevalence among Hispanic and non-Hispanic Black persons, essential workers, those in low-income neighborhoods, and those with lower education attainment compared to their counterparts. We observed differences in attitudes and behaviors by race and ethnicity, with non-Hispanic White persons being less likely to believe in the importance of mask wearing, and racial and ethnic minorities more likely to attend social gatherings. Conclusion Over 10% of an urban population was infected with COVID-19 early during the pandemic. Differences in attitudes and behaviors likely contribute to sociodemographic disparities in COVID-19 prevalence.

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Section: Discussioncontrasting

confidence: 74%

Population-based correlates of COVID-19 infection: An analysis from the DFW COVID-19 prevalence study

et al. 2022

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“…There were no eligible studies of mass testing (defined as regular and/or large-scale testing of individuals from defined populations regardless of symptom status) that used cheaper, faster tests than Q-PCR. For example, Appa et al described high throughput, community-wide ascertainment of SARS-CoV-2 prevalence using PCR and antibody testing but not rapid methods such as lateral flow tests 14 . It was sometimes difficult to categorise articles as ‘mass testing’ because many studies did not describe the eligible population or tests used in detail.…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of the Experience of Implementing Population Testing for SARS-CoV-2

Foster

Campbell

Blank

et al. 2021

Preprint

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BackgroundThe SARS-CoV-2 pandemic has led to the swift introduction of population testing programmes in many countries across the world, using testing modalities such as drive-through, walk-through, mobile and home visiting programmes. Here, we provide an overview of the literature describing the experience of implementing population testing for SARS-CoV-2.MethodsWe conducted a scoping review using Embase, Medline and the Cochrane Library in addition to a grey literature search. We identified indicators relevant to process, quality and resource outcomes related to each testing modality.Results2,999 titles were identified from the academic literature and the grey literature search, of which 22 were relevant. Most studies were from the USA and the Republic of Korea. Drive-through testing centres were the most common testing modality evaluated and these provided a rapid method of testing whilst minimising resource use.ConclusionsThe evidence base for population testing lacks high quality studies, however, the literature provides evaluations of the advantages and limitations of different testing modalities. There is a need for robust evidence in this area to ensure that testing is deployed in a safe and effective manner in response to the Covid-19 pandemic.

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“…In close partnership with the community and Marin Department of Public Health, oropharyngeal and mid-turbinate swabs for reverse transcription polymerase chain reaction (RT-PCR) testing and blood for antibody testing were collected over five days (April 20 th - April 24 th , 2020) as previously described in detail and summarized below. [ 14 ]…”

Section: Methodsmentioning

confidence: 99%

“…Together with study leadership, these community leaders and stakeholders participated in a virtual Town Hall the week prior to testing and week following results provision to introduce the study to the community, provide education, answer questions, and address concerns. [ 14 ]…”

Section: Methodsmentioning

confidence: 99%

Universal PCR and antibody testing demonstrate little to no transmission of SARS-CoV-2 in a rural community

Appa¹,

Takahashi²,

Rodríguez-Barraquer³

et al. 2020

Preprint

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Background: The absence of systematic surveillance for SARS-CoV-2 has curtailed accurate appraisal of transmission intensity. Our objective was to perform case detection of an entire rural community to quantify SARS-CoV-2 transmission using PCR and antibody testing. Methods: We conducted a cross-sectional survey of the prevalence and cumulative incidence of SARS-CoV-2 infection in the rural town of Bolinas, California (population 1,620), four weeks following shelter-in-place orders. Residents and county essential workers were tested between April 20th-24th, 2020. Prevalence by PCR and seroprevalence combining data from two forms of antibody testing were performed in parallel (Abbott ARCHITECT IgG to nucleocapsid protein and in-house IgG ELISA to the receptor binding domain). Results: Of 1,891 participants, 1,312 were confirmed Bolinas residents (>80% community ascertainment). Zero participants were PCR positive. Assuming 80% sensitivity, it would have been unlikely to observe these results (p<0.05) if there were >3 active infections in the community. Based on antibody results, estimated prevalence of prior infection was 0.16% (95% CrI: 0.02%, 0.46%). Seroprevalence estimates using only one of the two tests would have been higher, with greater uncertainty. The positive predictive value (PPV) of a positive result on both tests was 99.11% (95% CrI: 95.75%, 99.94%), compared to PPV 44.19%-63.32% (95% CrI range 3.25%-98.64%) if only one test was utilized. Conclusions: Four weeks following shelter-in-place, active and prior SARS-CoV-2 infection in a rural Northern California community was extremely rare. In this low prevalence setting, use of two antibody tests increased the PPV and precision of seroprevalence estimates.

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SARS-CoV-2 PCR and antibody testing for an entire rural community: methods and feasibility of high-throughput testing procedures

Abstract: High-volume, community-wide ascertainment of SARS-CoV-2 prevalence by PCR and antibody testing was successfully performed using a community-led, drive-through model with strong operational support, well-trained testing units, and an effective technical platform.

Cited by 3 publications

References 6 publications

Population-based correlates of COVID-19 infection: An analysis from the DFW COVID-19 prevalence study

Population-based correlates of COVID-19 infection: An analysis from the DFW COVID-19 prevalence study

A Scoping Review of the Experience of Implementing Population Testing for SARS-CoV-2

Universal PCR and antibody testing demonstrate little to no transmission of SARS-CoV-2 in a rural community

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