Novel sampling strategy for regular nucleic acid testing in low risk areas during epidemics

Area of Science:

• Epidemiology
• Public Health
• Infectious Disease Modeling

Background:

• Large-scale nucleic acid testing (NAT) was vital for COVID-19 containment in China.
• Existing regular testing strategies (e.g., Regular-1/7) are prohibitively expensive and time-consuming for widespread, long-term implementation.
• Highly contagious diseases with long incubation periods necessitate more efficient testing approaches.

Purpose of the Study:

• To introduce and evaluate a novel sampling strategy, Weighted Hub and Time Sampling (WHTS), for large-scale NAT.
• To compare the cost-effectiveness and alert timeliness of WHTS against traditional Regular-1/7 testing.
• To provide a scalable solution for infectious disease surveillance during outbreaks.

Main Methods:

• Developed the Weighted Hub and Time Sampling (WHTS) strategy, incorporating social activity intensity, overlap, and time since last NAT.
• Utilized a scale-free contact network model to simulate disease spread within a community.
• Compared WHTS performance (WHTS-1/14 and WHTS-1/7) against the Regular-1/7 strategy.

Main Results:

• The WHTS-1/14 strategy achieved a 50% cost reduction compared to Regular-1/7 testing.
• The WHTS-1/7 strategy provided an alert time advantage of 1.0 day over Regular-1/7.
• WHTS-1/14 demonstrated robust performance across various scenarios, despite testing half the number of individuals.

Conclusions:

• WHTS presents a significantly more cost-effective and efficient alternative for large-scale NAT during infectious disease outbreaks.
• The strategy offers improved early detection capabilities, crucial for managing diseases with long incubation periods.
• WHTS provides a valuable framework for optimizing public health surveillance and response strategies.