Optimizing SARS-CoV-2 Surveillance in the United States: Insights From the National Football League Occupational Health Program

Mack, Christina; Osterholm, Michael T.; Wasserman, Erin B.; Petruski‐Ivleva, Natalia; Anderson, Deverick J.; Myers, Emily; Singh, Navdeep; Walton, Patti; Solomon, Gary S.; Hostler, Christopher J; Mancell, Jimmie; Sills, Allen K.

doi:10.7326/m21-0319

Cited by 17 publications

(40 citation statements)

References 26 publications

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“…42.3% of COVID‐19 positive individuals in the NFL had a false negative antigen POC, but only 0.2% [0.1%–0.3%] had a false negative RT‐PCR POC when collected at the same timepoint 3 . Additionally, although not a direct comparison, the false positive rate of antigen POC testing in the NFL was 35% compared to 2.9% [0.6%–5.2%] for the RT‐PCR POC 3 …”

Section: Discussionmentioning

confidence: 99%

“…Tier 3 staff tested at least weekly or more frequently if circumstances required (e.g., symptomatic, COVID‐19 exposure, schedule/responsibility change). Consistent with CDC guidelines in 2020, individuals with documented NAAT confirmation of prior COVID‐19 were not required to test in the 90 days following infection 3 …”

Section: Methodsmentioning

confidence: 99%

“…The adjudicated case status was used to determine whether the RT‐PCR POC or NAAT result aligned with the true result 3 . We calculated the proportion and 95% confidence intervals for false positives and negatives within same day RT‐PCR POC and NAAT discordant pairs based on the adjudicated case status.…”

Section: Methodsmentioning

confidence: 99%

“…The adjudicated case status was used to determine whether the RT-PCR POC or NAAT result aligned with the true result. 3 We calculated the proportion and 95% confidence intervals for false positives and negatives within same day RT-PCR POC and NAAT discordant pairs based on the adjudicated case status. In instances in which there were multiple pairs of same-day RT-PCR POC and NAAT for the same case, infection status ("diagnosis") was assigned with priority as fol- (1) symptomatic vs. asymptomatic at the time of positive NAAT result;…”

Section: Pilot Phasementioning

confidence: 99%

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Effectiveness and use of reverse transcriptase polymerase chain reaction point of care testing in a large‐scale COVID‐19 surveillance system

Mack

Wasserman

Hostler

et al. 2022

Pharmacoepidemiology and Drug

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Background: Rapid COVID-19 testing platforms can identify infected individuals at the point of care (POC), allowing immediate isolation of infected individuals and reducing the risk of transmission. While lab-based nucleic acid amplification testing (NAAT) is often considered the gold standard to detect SARS-CoV-2 in the community, results typically take 2-7 days to return, rendering POC testing a critical diagnostic tool for infection control. The National Football League (NFL) and NFL Players Association deployed a new POC testing strategy using a newly available reverse transcriptase polymerase chain reaction (RT-PCR) rapid test during the 2020 season, and evaluated diagnostic effectiveness compared to other available devices using real-world population surveillance data. Methods: RT-PCR POC test results were compared to NAAT results from same-day samples by calculation of positive and negative concordance. Sensitivity analyses were performed for three subgroups: (1) individuals symptomatic at time of positive test; (2) individuals tested during the pilot phase of rollout; and (3) individuals tested daily.Results: Among 4989 same-day POC/NAAT pairs, 4957 (99.4%) were concordant, with 93.1% positive concordance and 99.6% negative concordance. Based on adjudicated case status, the false negative rate was 0.2% and false positive rate was 2.9%.In 43 instances, the immediate turnaround of results by POC allowed isolation of infected individuals 1 day sooner than lab-based testing. Positive/negative concordance in sensitivity analyses were relatively stable. Conclusion: RT-PCR POC testing provided timely results that were highly concordant with lab-based NAAT in population surveillance. Expanded use of effective RT-PCR POC can enable rapid isolation of infected individuals and reduce COVID-19 infection in the community.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Pilot Phasementioning

confidence: 99%

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Effectiveness and use of reverse transcriptase polymerase chain reaction point of care testing in a large‐scale COVID‐19 surveillance system

Mack

Wasserman

Hostler

et al. 2022

Pharmacoepidemiology and Drug

Self Cite

View full text Add to dashboard Cite

show abstract

“…Proof of concept on the impact of widespread use of testing has been seen at the level of nations, such as the remarkable impact of a testing blitz in Slovakia in late 2020 ( 16 ), and within organizations. Deep-pocketed professional sports teams have used frequent testing to keep players and coaching staff safe, and to maintain their playing schedules ( 17 , 18 ). Given the economic damage inflicted by the pandemic to date ( 19 ), better epidemic control through widespread use of testing isn’t simply good public health practice, it likely makes economic sense as well.…”

mentioning

confidence: 99%