The Role of Testing in Reducing SARS-CoV-2 Transmission on College Campuses

Barrios, Lisa C.; Green, Ridgely Fisk; Honein, Margaret A.

doi:10.1016/j.jadohealth.2020.10.006

Cited by 4 publications

(7 citation statements)

References 4 publications

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“…SBIT can also be extended to at-risk environments beyond university residence halls, such as off-campus student organisations 2,7 (eg, fraternal or athletic organisations) or apartment residencies. Sufficient testing is also necessary to mitigate disease spread in local communities or schools.…”

Section: Discussionmentioning

confidence: 99%

“…Sufficient testing is also necessary to mitigate disease spread in local communities or schools. 7,30 SBIT might be useful for detecting and containing outbreaks in these settings through random and targeted testing of potential hotspots, such as nursing homes or classrooms. If surveillance testing of the population is not practical, community or individual self-reported data could be used to detect outbreaks.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Institutions have implemented a wide range of testing strategies for SARS-CoV-2 detection, including on-demand testing (eg, for students with symptoms), random surveillance testing, and high-frequency surveillance testing (ie, testing repeated weekly or twice per week). 4,7 Although existing evidence suggests that the most successful strategies at mitigating the spread of SARS-CoV-2 involve frequent, repeated testing of all students, 8,9 many institutions do not have the infrastructure to support such testing.…”

Section: Introductionmentioning

confidence: 99%

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Surveillance-based informative testing for detection and containment of SARS-CoV-2 outbreaks on a public university campus: an observational and modelling study

Rennert

McMahan

Kalbaugh

et al. 2021

The Lancet Child & Adolescent Health

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Background Despite severe outbreaks of COVID-19 among colleges and universities across the USA during the Fall 2020 semester, the majority of institutions did not routinely test students. While high-frequency repeated testing is considered the most effective strategy for disease mitigation, most institutions do not have the necessary infrastructure or funding for implementation. Therefore, alternative strategies for testing the student population are needed. Our study detailed the implementation and results of testing strategies to mitigate SARS-CoV-2 spread on a university campus, and we aimed to assess the relative effectiveness of the different testing strategies.Methods For this retrospective cohort study, we included 6273 on-campus students arriving to a large public university in the rural USA (Clemson, SC, USA) for in-person instruction in the Fall 2020 semester (Sept 21 to Nov 25). Individuals arriving after Sept 23, those who tested positive for SARS-CoV-2 before Aug 19, and student athletes and band members were not included in this study. We implemented two testing strategies to mitigate SARS-CoV-2 spread during this period: a novel surveillance-based informative testing (SBIT) strategy, consisting of random surveillance testing to identify outbreaks in residence hall buildings or floors and target them for follow-up testing (Sept 23 to Oct 5); followed by a repeated weekly surveillance testing (Oct 6 to Nov 22). Relative changes in estimated weekly prevalence were examined. We developed SARS-CoV-2 transmission models to compare the relative effectiveness of weekly testing (900 daily surveillance tests), SBIT (450 daily surveillance tests), random surveillance testing (450 daily surveillance tests), and voluntary testing (0 daily surveillance tests) on disease mitigation. Model parameters were based on our empirical surveillance data in conjunction with published sources.Findings SBIT was implemented from Sept 23 to Oct 5, and identified outbreaks in eight residence hall buildings and 45 residence hall floors. Targeted testing of residence halls was 2•03 times more likely to detect a positive case than random testing (95% CI 1•67-2•46). Weekly prevalence was reduced from a peak of 8•7% to 5•6% during this 2-week period, a relative reduction of 36% (95% CI 27-44). Prevalence continued to decrease after implementation of weekly testing, reaching 0•8% at the end of in-person instruction (week 9). SARS-CoV-2 transmission models concluded that, in the absence of SBIT (ie, voluntary testing only), the total number of COVID-19 cases would have increased by 154% throughout the semester. Compared with SBIT, random surveillance testing alone would have resulted in a 24% increase in COVID-19 cases. Implementation of weekly testing at the start of the semester would have resulted in 36% fewer COVID-19 cases throughout the semester compared with SBIT, but it would require twice the number of daily tests.Interpretation It is imperative that institutions rigorously test students during the 2021 academic year. When hi...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surveillance-based informative testing for detection and containment of SARS-CoV-2 outbreaks on a public university campus: an observational and modelling study

Rennert

McMahan

Kalbaugh

et al. 2021

The Lancet Child & Adolescent Health

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“…as well as containment (testing, contact tracing and quarantine). High-frequency surveillance testing (i.e., once or twice per week) is considered to be an effective strategy for COVID-19 disease mitigation [8,9]. Saliva testing is one approach to both asymptomatic and symptomatic detection of the presence of replicative SARS-CoV-2 RNA, with a reported accuracy of > 99% and a sensitivity of 1-10 viral copies/μl [10].…”

Section: Introductionmentioning

confidence: 99%

Mixed-methods process evaluation of a residence-based SARS-CoV-2 testing participation pilot on a UK university campus during the COVID-19 pandemic

et al. 2022

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Background Regular testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is an important strategy for controlling virus outbreaks on university campuses during the COVID-19 pandemic but testing participation rates can be low. The Residence-Based Testing Participation Pilot (RB-TPP) was a novel intervention implemented at two student residences on a large UK university campus over 4 weeks. The aim of the pilot was to increase the frequency of asymptomatic SARS-CoV-2 saliva testing onsite. This process evaluation aimed to determine whether RB-TPP was implemented as planned and identify implementation barriers and facilitators. Methods A mixed-methods process evaluation was conducted alongside the RB-TPP. Evaluation participants were students (opting in, or out of RB-TPP) and staff with a role in service provision or student support. Monitoring data were collected from the intervention delivery team and meeting records. Data were collected from students via online survey (n = 152) and seven focus groups (n = 30), and from staff via individual interviews (n = 13). Quantitative data were analysed descriptively and qualitative data thematically. Barriers and facilitators to implementation were mapped to the ‘Capability, Opportunity, Motivation–Behaviour’ (COM-B) behaviour change framework. Results Four hundred sixty-four students opted to participate in RB-TPP (98% of students living onsite). RB-TPP was implemented broadly as planned but relaxed social distancing was terminated early due to concerns relating to national escalation of the COVID-19 Delta variant, albeit testing continued. Most students (97.9%) perceived the period of relaxed social distancing within residences positively. The majority engaged in asymptomatic testing (88%); 46% (52% of testers) were fully compliant with pre-determined testing frequency. Implementation was facilitated by convenience and efficiency of testing, and reduction in the negative impacts of isolation through opportunities for students to socialise. Main barriers to implementation were perceived mixed-messages about the rules, ambivalent attitudes, and lack of adherence to COVID-19 protective measures in the minority. Conclusions This process evaluation identifies factors that help or hinder the success of university residence-based outbreak prevention and management strategies. RB-TPP led to increased rates of SARS-CoV-2 testing participation among students in university residences. Perceived normalisation of university life significantly enhanced student mental wellbeing. The complexity and challenge generated by multiple lines of communication and rapid adaptions to a changing pandemic context was evident. Trial registration number UKAS 307727–02-01; Pre-results. ClinicalTrials.gov Identifier: NCT05045989; post-results (first posted, 16/09/21). Ethical approval Faculty of Medicine & Health Sciences Research Ethics Committee, University of Nottingham (Ref: FMHS 96-0920)

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Section: Introductionmentioning

confidence: 99%

Mixed-methods Process Evaluation of a Residence-based SARS-CoV-2 Testing Participation Pilot on a UK University Campus during the COVID-19 Pandemic

Blake

Carlisle

Fothergill

et al. 2021

Preprint

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BackgroundRegular testing for SARS Coronavirus-2 (SARS-CoV-2) is an important strategy for controlling virus outbreaks on university campuses during the COVID-19 pandemic but testing participation rates can be low. The Residence-Based Testing Participation Pilot (RB-TPP) was a novel intervention implemented at two student residences on a large UK university campus over four weeks. The aim of the pilot was to increase the frequency of asymptomatic SARS-CoV-2 saliva testing onsite. This process evaluation aimed to determine whether RB-TPP was implemented as planned and identify implementation barriers and facilitators.MethodsA mixed-methods process evaluation was conducted alongside the RB-TPP. Evaluation participants were students (opting in, or out of RB-TPP) and staff with a role in service provision or student support. Monitoring data were collected from the intervention delivery team and meeting records. Data were collected from students via online survey (n=152) and seven focus groups (n=30), and from staff via individual interviews (n=13). Quantitative data were analysed descriptively and qualitative data thematically. Barriers and facilitators to implementation were mapped to the ‘Capability, Opportunity, Motivation–Behaviour’ (COM-B) behaviour change framework.Results464 students opted to participate in RB-TPP (98% of students living onsite). RB-TPP was implemented broadly as planned but was terminated early due to concerns relating to national escalation of the COVID-19 Delta variant. Most students (97.9%) perceived the relaxing of social distancing regulations within residences positively. The majority engaged in asymptomatic testing (88%); 46% (52% of testers) were fully compliant with pre-determined testing frequency. Implementation was facilitated by convenience and efficiency of testing, reduction in the risk of self-isolation and opportunities for students to socialise. Main barriers to implementation were mixed-messages about the rules, ambivalent attitudes, and lack of adherence to COVID-19 protective measures in the minority.ConclusionsThis process evaluation identifies factors that help or hinder the success of university residence-based outbreak prevention and management strategies. RB-TPP led to increased rates of COVID-19 testing participation among students in university residences. Perceived normalisation of university life significantly enhanced student mental wellbeing. The complexity and challenge generated by multiple lines of communication and rapid adaptions to a changing pandemic context was evident.Trial registration numberUKAS 307727-02-01; Pre-results. ClinicalTrials.gov Identifier: NCT05045989; post-results (first posted, 16/09/21).Ethical ApprovalFMHS 96-0920

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The Role of Testing in Reducing SARS-CoV-2 Transmission on College Campuses

Cited by 4 publications

References 4 publications

Surveillance-based informative testing for detection and containment of SARS-CoV-2 outbreaks on a public university campus: an observational and modelling study

Surveillance-based informative testing for detection and containment of SARS-CoV-2 outbreaks on a public university campus: an observational and modelling study

Mixed-methods process evaluation of a residence-based SARS-CoV-2 testing participation pilot on a UK university campus during the COVID-19 pandemic

Mixed-methods Process Evaluation of a Residence-based SARS-CoV-2 Testing Participation Pilot on a UK University Campus during the COVID-19 Pandemic

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