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Rational use of SARS-CoV-2 polymerase chain reaction tests within institutions caring for the vulnerable

Yates, Tom A., Cooke, Graham S. and MacPherson, Peter ORCID: (2020) 'Rational use of SARS-CoV-2 polymerase chain reaction tests within institutions caring for the vulnerable'. F1000Research, Vol 9, p. 671.

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Institutions such as hospitals and nursing or long-stay residential homes accommodate individuals at considerable risk of mortality should they acquire SARS-CoV-2 infection. In these settings, polymerase chain reaction tests play a central role in infection prevention and control. Here, we argue that both false negative and false positive tests are possible and that careful consideration of the prior probability of infection and of test characteristics are needed to prevent harm. We outline evidence suggesting that regular systematic testing of asymptomatic and pre-symptomatic individuals could play an important role in reducing transmission of SARS-CoV-2 within institutions. We discuss how such a programme might be organised, arguing that frequent testing and rapid reporting of results are particularly important. We highlight studies demonstrating that polymerase chain reaction testing of pooled samples can be undertaken with acceptable loss of sensitivity, and advocate such an approach where test capacity is limited. We provide an approach to calculating the most efficient pool size. Given the current limitations of tests for SARS-CoV-2 infection, physical distancing and meticulous infection prevention and control will remain essential in institutions caring for vulnerable people.

Item Type: Article
Subjects: WA Public Health > WA 105 Epidemiology
WC Communicable Diseases > Isolation and quarantine hospitals. Clinics, dispensaries, etc. Leper colonies > WC 100 General works
WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 505 Viral respiratory tract infections
WT Geriatrics. Chronic Disease > WT 20 Research (General)
WX Hospitals and Other Health Facilities > WX 28.61 Hospices and hospice care programs (General coverage)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
Depositing User: Stacy Murtagh
Date Deposited: 17 Aug 2020 11:32
Last Modified: 03 Aug 2021 14:02


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