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Rapid antigen testing as a reactive response to surges in nosocomial SARS-CoV-2 outbreak risk

Abstract:

Healthcare facilities are vulnerable to SARS-CoV-2 introductions and subsequent nosocomial outbreaks. Antigen rapid diagnostic testing (Ag-RDT) is widely used for population screening, but its health and economic benefits as a reactive response to local surges in outbreak risk are unclear. We simulate SARS-CoV-2 transmission in a long-term care hospital with varying COVID-19 containment measures in place (social distancing, face masks, vaccination). Across scenarios, nosocomial incidence is reduced by up to 40-47% (range of means) with routine symptomatic RT-PCR testing, 59-63% with the addition of a timely round of Ag-RDT screening, and 69-75% with well-timed two-round screening. For the latter, a delay of 4-5 days between the two screening rounds is optimal for transmission prevention. Screening efficacy varies depending on test sensitivity, test type, subpopulations targeted, and community incidence. Efficiency, however, varies primarily depending on underlying outbreak risk, with health-economic benefits scaling by orders of magnitude depending on the COVID-19 containment measures in place.

Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1038/s41467-021-27845-w

Authors


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Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Population Health
Role:
Author
ORCID:
0000-0002-7330-4262
More by this author
Role:
Author
ORCID:
0000-0002-8850-5403

Contributors


Publisher:
Springer Nature
Journal:
Nature Communications More from this journal
Volume:
13
Issue:
1
Article number:
236
Publication date:
2022-01-11
Acceptance date:
2021-12-07
DOI:
EISSN:
2041-1723
Pmid:
35017499


Language:
English
Keywords:
Pubs id:
1331745
Local pid:
pubs:1331745
Deposit date:
2023-03-27

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