Understanding the impact of rapid antigen tests on SARS-CoV-2 transmission in the fifth wave of COVID-19 in Hong Kong in early 2022

Du, Zhanwei; Jin, Dong Yan

doi:10.1080/22221751.2022.2076616

Cited by 21 publications

(20 citation statements)

References 27 publications

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“…But epidemiological population‐level measures (e.g. the basic reproduction number) usually hide immense variation at the individual level (Du, Hong et al., 2022 ; Du, Javan et al., 2020 ; Du, Liu et al., 2022 ; Du, Tian et al., 2022 ; Du, Xu et al., 2020 ). We thus carried out a systematic review and meta‐analysis of 17 studies on the dispersion parameter to characterize COVID‐19 superspreading.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analyses of superspreading of SARS‐CoV‐2 infections

Wang

Liu

et al. 2022

Transbounding Emerging Dis

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Superspreading, or overdispersion in transmission, is a feature of SARS‐CoV‐2 transmission which results in surging epidemics and large clusters of infection. The dispersion parameter is a statistical parameter used to characterize and quantify heterogeneity. In the context of measuring transmissibility, it is analogous to measures of superspreading potential among populations by assuming that collective offspring distribution follows a negative‐binomial distribution. We conducted a systematic review and meta‐analysis on globally reported dispersion parameters of SARS‐CoV‐2 infection. All searches were carried out on 10 September 2021 in PubMed for articles published from 1 January 2020 to 10 September 2021. Multiple estimates of the dispersion parameter have been published for 17 studies, which could be related to where and when the data were obtained, in 8 countries (e.g. China, the United States, India, Indonesia, Israel, Japan, New Zealand and Singapore). High heterogeneity was reported among the included studies. The mean estimates of dispersion parameters range from 0.06 to 2.97 over eight countries, the pooled estimate was 0.55 (95% CI: 0.30, 0.79), with changing means over countries and decreasing slightly with the increasing reproduction number. The expected proportion of cases accounting for 80% of all transmissions is 19% (95% CrI: 7, 34) globally. The study location and method were found to be important drivers for diversity in estimates of dispersion parameters. While under high potential of superspreading, larger outbreaks could still occur with the import of the COVID‐19 virus by traveling even when an epidemic seems to be under control.

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Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analyses of superspreading of SARS‐CoV‐2 infections

Wang

Liu

et al. 2022

Transbounding Emerging Dis

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“…This situation indicated a higher possibility of Omicron variant breakthrough infection after inactivated vaccine vaccination with more severe and fatal cases. Surprisingly, recent studies have shown that three-dose inactivated vaccine could provide protection efficacy of 98.1% against Omicron-induced severe symptoms and death, similar to the 98.3% efficacy of the mRNA vaccine, in elderly people (> 60 years old) [23][24][25] . The inactivated vaccine was also found to have better protective efficacy in the real world than expected based on an immunogenicity study.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 vaccination-infection pattern imprints and diversifies T cell differentiation and neutralizing response against Omicron subvariants

Wang

Mei

et al. 2022

Cell Discov

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The effects of different SARS-CoV-2 vaccinations and variant infection histories on imprinting population immunity and their influence on emerging escape mutants remain unclear. We found that Omicron (BA.1) breakthrough infection, regardless of vaccination with two-dose mRNA vaccines (M-M-o) or two-dose inactivated vaccines (I-I-o), led to higher neutralizing antibody levels against different variants and stronger T-cell responses than Delta breakthrough infection after two-dose inactivated vaccine vaccination (I-I-δ). Furthermore, different vaccination-infection patterns imprinted virus-specific T-cell differentiation; M-M-ο showed higher S/M/N/E-specific CD4+ T cells and less portion of virus-specific CD45RA+CD27–CD8+ T cells by ex vivo assay. Breakthrough infection groups showed higher proliferation and multi-function capacity by in vitro assay than three-dose inactivated vaccine inoculated group (I-I-I). Thus, under wide vaccination coverage, the higher immunogenicity with the Omicron variant may have helped to eliminate the population of Delta variant. Overall, our data contribute to our understanding of immune imprinting in different sub-populations and may guide future vaccination programs.

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“…Test strategies based on the detection of either viral nucleic acids, primarily by quantitative reverse transcription polymerase chain reaction (qRT-PCR), or of the viral nucleocapsid protein by rapid antigen tests (RATs) contribute to COVID-19 diagnosis and the control of SARS-CoV-2 transmission. This is exemplified by the recent management of the 5th pandemic wave caused by Omicron-BA.1 in Hong Kong [1]. A prerequisite for effective health care interventions is a good sensitivity (> 80%) and high specificity (> 97%) of such RATs fulfilling the minimal criteria set by the Word Health Organization (WHO), especially for RATs recommended for layman's use [2].…”

Section: Introductionmentioning

confidence: 99%

Variable detection of Omicron-BA.1 and -BA.2 by SARS-CoV-2 rapid antigen tests

Osterman¹,

Badell²,

Dächert³

et al. 2022

Med Microbiol Immunol

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During 2022, the COVID-19 pandemic has been dominated by the variant of concern (VoC) Omicron (B.1.1.529) and its rapidly emerging subvariants, including Omicron-BA.1 and -BA.2. Rapid antigen tests (RATs) are part of national testing strategies to identify SARS-CoV-2 infections on site in a community setting or to support layman’s diagnostics at home. We and others have recently demonstrated an impaired RAT detection of infections caused by Omicron-BA.1 compared to Delta. Here, we evaluated the performance of five SARS-CoV-2 RATs in a single-centre laboratory study examining a total of 140 SARS-CoV-2 PCR-positive respiratory swab samples, 70 Omicron-BA.1 and 70 Omicron-BA.2, as well as 52 SARS-CoV-2 PCR-negative swabs collected from March 8th until April 10th, 2022. One test did not meet minimal criteria for specificity. In an assessment of the analytical sensitivity in clinical specimen, the 50% limit of detection (LoD50) ranged from 4.2 × 104 to 9.2 × 105 RNA copies subjected to the RAT for Omicron-BA.1 compared to 1.3 × 105 to 1.5 × 106 for Omicron-BA.2. Overall, intra-assay differences for the detection of Omicron-BA.1-containing and Omicron-BA.2-containing samples were non-significant, while a marked overall heterogeneity among the five RATs was observed. To score positive in these point-of-care tests, up to 22-fold (LoD50) or 68-fold (LoD95) higher viral loads were required for the worst performing compared to the best performing RAT. The rates of true-positive test results for these Omicron subvariant-containing samples in the highest viral load category (Ct values < 25) ranged between 44.7 and 91.1%, while they dropped to 8.7 to 22.7% for samples with intermediate Ct values (25–30). In light of recent reports on the emergence of two novel Omicron-BA.2 subvariants, Omicron-BA.2.75 and BJ.1, awareness must be increased for the overall reduced detection rate and marked differences in RAT performance for these Omicron subvariants.

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Understanding the impact of rapid antigen tests on SARS-CoV-2 transmission in the fifth wave of COVID-19 in Hong Kong in early 2022

Cited by 21 publications

References 27 publications

Systematic review and meta‐analyses of superspreading of SARS‐CoV‐2 infections

Systematic review and meta‐analyses of superspreading of SARS‐CoV‐2 infections

SARS-CoV-2 vaccination-infection pattern imprints and diversifies T cell differentiation and neutralizing response against Omicron subvariants

Variable detection of Omicron-BA.1 and -BA.2 by SARS-CoV-2 rapid antigen tests

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