Drive-through testing for SARS-CoV-2 in symptomatic health and social care workers and household members: an observational cohort study in Tayside, Scotland

Abstract

It has been recognised that health and social care workers (HSCW) experience higher rates of infection with SARS-CoV-2. Widespread testing of HSCWs and their symptomatic household contacts (SHCs) has not been fully implemented in the United Kingdom. We describe the results of a testing programme for HSCWs and SHCs in a single UK region (Tayside, Scotland). The testing service was established 17 th March 2020 as the first in the country, and samples were collected at a drive-through testing hub based at a local community hospital. HSCWs with mild symptoms who were self-isolating and the SHCs of HSCWs who would therefore be absent from work attended for testing. From 17 th March 2020 to 11 th April, 1887 HSCWs and SHCs underwent testing. Clinical information was available for 1727 HSCWs and SHCs. 4/155 (2.6%) child contacts, 73/374 (19.5%) adult contacts and 325/1173 (27.7%) HSCWs tested positive for SARS-CoV-2. 15 of 188 undetermined cases were positive (8.0%). We estimate that testing prevented up to 3634 lost work days from HSCW testing, 2795 from adult SHC testing and 1402 lost work days from child SHC testing. The establishment of this testing programme has assisted the infection prevention and control team in their investigation of transmission and supported adequate staffing in health and social care sectors.

What do we know about SARS-CoV-2 transmission? A systematic review and meta-analysis of the secondary attack rate and associated risk factors

“…Specific settings where high ARs (> 20%) have been observed were in a correctional and detention facility in Louisiana (72.4%) [ 95 ], nursing homes in California (70.3%) [ 96 ] and the United Kingdom (40.3%) [ 97 ], in cruise ships (59%) [ 98 ], a call centre in South Korea (43.5%) [ 54 ], a church in Arkansas (38%) [ 99 ], among college students during a spring break trip in Mexico (32.8%) [ 100 ], a homeless shelter in Boston (36%) [ 101 ], a fitness dance class in South Korea (26.3%) [ 102 ], and a wedding in Jordan (21.7%) [ 103 ] (S2 Table in S1 Materials ). High ARs have also been reported in healthcare settings in Mexico City (31.9%) [ 104 ] and the United Kingdom (27.7%) [ 105 ].…”

Drive-through testing for SARS-CoV-2 in symptomatic health and social care workers and household members: an observational cohort study

“…Health and social care workers (HSCWs) are disproportionately infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Healthcare workers accounted for 21% of cases of SARS during the 2002 outbreak, 1 and recent experience in China and Italy confirms high rates of healthcare worker infections during the current pandemic. 2 3 In addition to the direct effects of the virus on HSCWs, infections have indirect effects on their families and staff morale and can have a significant impact on the ability of healthcare systems to function due to staff absence.…”

Characteristics and outcomes of health and social care workers testing positive for SARS-CoV-2 in the Tayside region of Scotland

“…Tayside, a health board in Scotland covering a population of 400,000 was the first in Scotland to set up a drive through testing programme for HSCWs, other key workers and their symptomatic household contacts (including children). with results available within 24 hours allowing staff to return to work following a negative test 4 Between 17 th March 2020 and the 27 th April 2020, 2993 symptomatic HSCWs in NHS Tayside were tested for SARS-CoV-2 through the drive-through facility with 677 (22.6%) of these testing positive (Figure 1). Of those who tested positive, 45% presented with a fever, 70% a cough and 9% experienced shortness of breath.…”

“…Early in the outbreak it was recommended in the UK that HSCWs experiencing symptoms of a cough or fever remain absent from work for 7 days. In order to address this problem, National Health Service (NHS) Tayside, a health board in Scotland covering a population of 400,000, was the first in Scotland to set up a drive-through testing programme for HSCWs, other key workers and their symptomatic household contacts (including children), with results available within 24 h, allowing staff to return to work following a negative test [ 4 ]. As testing for SARS-CoV-2 was limited to hospitalised patients across much of Europe there is limited data on the self-reported clinical characteristics and outcomes of patients in the community with coronavirus disease 2019 (COVID-19).…”