SARS-CoV-2 PCR and antibody testing for an entire rural community: methods and feasibility of high-throughput testing procedures

Abstract

Background Early in the pandemic, inadequate SARS-CoV-2 testing limited understanding of transmission. Chief among barriers to large-scale testing was unknown feasibility, particularly in non-urban areas. Our objective was to report methods of high-volume, comprehensive SARS-CoV-2 testing, offering one model to augment disease surveillance in a rural community. Methods A community-university partnership created an operational site used to test most residents of Bolinas, California regardless of symptoms in 4 days (April 20th – April 23rd, 2020). Prior to testing, key preparatory elements included community mobilization, pre-registration, volunteer recruitment, and data management. On day of testing, participants were directed to a testing lane after site entry. An administrator viewed the lane-specific queue and pre-prepared test kits, linked to participants’ records. Medical personnel performed sample collection, which included finger prick with blood collection to run laboratory-based antibody testing and respiratory specimen collection for polymerase chain reaction (PCR). Results Using this 4-lane model, 1,840 participants were tested in 4 days. A median of 57 participants (IQR 47–67) were tested hourly. The fewest participants were tested on day 1 (n = 338 participants), an intentionally lower volume day, increasing to n = 571 participants on day 4. The number of testing teams was also increased to two per lane to allow simultaneous testing of multiple participants on days 2–4. Consistent staffing on all days helped optimize proficiency, and strong community partnership was essential from planning through execution. Conclusions High-volume ascertainment of SARS-CoV-2 prevalence by PCR and antibody testing was feasible when conducted in a community-led, drive-through model in a non-urban area.

The COVID-19 drive-through point — screening and testing — first in Poland complex centre experience

“…This drive-through POST system at PUMS, which operated as a unified and efficient testing site accessible to both urban and rural populations, was a pioneering solution in Poland and an alternative to similar drivethrough models previously reported in the literature [6][7][8][9][10][11][12][13][14]. Additionally, according to the authors' knowledge, the current study is the first presentation of the experience of a drive-through point for screening and testing COVID-19 in Poland.…”

Challenges Faced in Large-Scale Nucleic Acid Testing during the Sudden Outbreak of the B.1.617.2 (Delta)

“…In this study, we learned that the health professionals who came from other regions to support Yangzhou did not have a fixed working place, which led to constant changes in personnel. Some studies suggested that consistent staffing on all days helped to optimize proficiency and helped in cooperation [36], while some studies addressed it through interdisciplinary collaboration and active reinforcement programs implemented [37]. In-formation technology should be fully used in nucleic acid testing, and it was feasible to recruit volunteers and materials through the online news platform [38].…”

Universal Polymerase Chain Reaction and Antibody Testing Demonstrate Little to No Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in a Rural Community

“…Four weeks after shelter-in-place health orders, we conducted active population-based surveillance for SARS-CoV-2 infection in Bolinas, California among residents over 4 years of age and in Marin County first responders and essential workers. In close partnership with the community and the Marin Department of Public Health, oropharyngeal and mid-turbinate swabs for reverse-transcription PCR (RT-PCR) testing and blood for antibody testing were collected over 5 days (April 20-April 24, 2020) as previously described in detail and summarized below [17].…”

“…These community leaders and stakeholders, together with the study leadership, participated in a virtual Town Hall the week before testing and week after results provision to introduce the study to the community, provide education, answer questions, and address concerns [17].…”