Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening
The COVID-19 pandemic has created a public health crisis. Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testi...
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| Veröffentlicht in: | Science advances 2021-01, Vol.7 (1) |
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| container_title | Science advances |
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| creator | Larremore, Daniel B Wilder, Bryan Lester, Evan Shehata, Soraya Burke, James M Hay, James A Tambe, Milind Mina, Michael J Parker, Roy |
| description | The COVID-19 pandemic has created a public health crisis. Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary. |
| doi_str_mv | 10.1126/sciadv.abd5393 |
| format | Article |
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Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary.</description><identifier>ISSN: 2375-2548</identifier><identifier>EISSN: 2375-2548</identifier><identifier>DOI: 10.1126/sciadv.abd5393</identifier><identifier>PMID: 33219112</identifier><language>eng</language><publisher>United States: American Association for the Advancement of Science</publisher><subject>Asymptomatic Infections ; Calibration ; Computer Simulation ; Coronavirus ; COVID-19 - diagnosis ; COVID-19 Nucleic Acid Testing ; Diseases and Disorders ; Epidemics ; Epidemiology ; Humans ; Kinetics ; Limit of Detection ; Mass Screening - methods ; Models, Theoretical ; Polymerase Chain Reaction ; Reproducibility of Results ; SciAdv r-articles ; Sensitivity and Specificity ; Time Factors ; Viral Load</subject><ispartof>Science advances, 2021-01, Vol.7 (1)</ispartof><rights>Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. 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Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary.</description><subject>Asymptomatic Infections</subject><subject>Calibration</subject><subject>Computer Simulation</subject><subject>Coronavirus</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 Nucleic Acid Testing</subject><subject>Diseases and Disorders</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Humans</subject><subject>Kinetics</subject><subject>Limit of Detection</subject><subject>Mass Screening - methods</subject><subject>Models, Theoretical</subject><subject>Polymerase Chain Reaction</subject><subject>Reproducibility of Results</subject><subject>SciAdv r-articles</subject><subject>Sensitivity and Specificity</subject><subject>Time Factors</subject><subject>Viral Load</subject><issn>2375-2548</issn><issn>2375-2548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUTtPwzAQthCIotKVEXlkSfEjcZIFCZVXpUpdWlbLsS_FKLWLnVTqvydVS1WG093pvvvu8SF0R8mYUiYeo7bKbMeqMhkv-QW6YTzPEpalxeVZPECjGL8JITQVIqPlNRpwzmjZU9yg5QJiiyO4aFu7te0O29in2jujwg63HtcBfjpweoeVM7jtglPBd_vQrgHXPuDJ_HP6ktASRx0AnHWrW3RVqybC6OiHaPn2uph8JLP5-3TyPEs0L0uelJRoSAvIC5XVrKiZIFUFFS2oEZzlJieEG6DKpIIA1ZRXJq-V0lRwVVdg-BA9HXg3XbUGo8G1QTVyE-y63156ZeX_irNfcuW3Ms_zrLee4OFIEHx_ZWzl2kYNTaMc-C5KlgpOiRAF66HjA1QHH2OA-jSGErmXQx7kkEc5-ob78-VO8L_n81-YoIni</recordid><startdate>202101</startdate><enddate>202101</enddate><creator>Larremore, Daniel B</creator><creator>Wilder, Bryan</creator><creator>Lester, Evan</creator><creator>Shehata, Soraya</creator><creator>Burke, James M</creator><creator>Hay, James A</creator><creator>Tambe, Milind</creator><creator>Mina, Michael J</creator><creator>Parker, Roy</creator><general>American Association for the Advancement of Science</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1998-1844</orcidid><orcidid>https://orcid.org/0000-0003-3296-3672</orcidid><orcidid>https://orcid.org/0000-0001-5273-5234</orcidid><orcidid>https://orcid.org/0000-0002-0674-5762</orcidid><orcidid>https://orcid.org/0000-0002-8412-4152</orcidid><orcidid>https://orcid.org/0000-0002-0486-0361</orcidid></search><sort><creationdate>202101</creationdate><title>Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening</title><author>Larremore, Daniel B ; 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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Asymptomatic Infections Calibration Computer Simulation Coronavirus COVID-19 - diagnosis COVID-19 Nucleic Acid Testing Diseases and Disorders Epidemics Epidemiology Humans Kinetics Limit of Detection Mass Screening - methods Models, Theoretical Polymerase Chain Reaction Reproducibility of Results SciAdv r-articles Sensitivity and Specificity Time Factors Viral Load |
| title | Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening |
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