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Rapid COVID-19 Testing of Symptomatic Health Care Personnel: A Strategy for Safely Maintaining the Workforce
Monica K Tilly1, James E McNicholas, Jeffrey D Whitman
1From the Division of Occupational, Environmental and Climate Medicine, University of California San Francisco School of Medicine, San Francisco, California (M.K.T., J.P.T., G.M.S.); Division of Occupational and Environmental Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California (M.K.T.); Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, California (J.E.M.); Enterprise Occupational Health, Cleveland Clinic, Cleveland, Ohio (J.E.M.); Department of Laboratory Medicine, University of California San Francisco School of Medicine, San Francisco, California (J.D.W.); Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco School of Medicine, San Francisco, California (J.P.T., M.A.J.); Division of Occupational and Environmental Medicine (A.H.V., J.K.); Zuckerberg San Francisco General Hospital, San Francisco, California (A.H.V., J.K.); and Division of Occupational Environmental and Climate Medicine, University of California San Francisco School of Medicine, San Francisco, California (P.D.B., M.A.J.).
Objective:
Determine performance characteristics and safety outcomes of two rapid COVID-19 screening methods to inform immediate return to work (RTW) decisions while health care personnel (HCP) await results of pending confirmatory laboratory test.
Methods:
This is a retrospective, occupational health quality improvement study comparing screening with rapid SARS-CoV-2 nucleic acid amplification (NAAT) and antigen test.
Results:
Five hundred thirty-one mildly symptomatic HCP screened over 16 months.• Negative predictive values: 96.7% (95% CI 95.1%-98.3%) for the rapid NAAT, 94.8% (92.8%-96.7%) for the rapid antigen test• Rapid antigen screening estimated to prevent 627 unnecessary lost shifts versus 620 with NAAT screening.• No nosocomial transmission identified and could be excluded in all but 4 cases.
Conclusions:
Until more accurate affordable NAAT tests become available, antigen test screening alone addresses simultaneous needs to minimize COVID-19 transmission from symptomatic HCP and maintain an adequate workforce.
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