Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission
Author:
Rivett Lucy12ORCID, Sridhar Sushmita345, Sparkes Dominic12, Routledge Matthew12, Jones Nick K1245, Forrest Sally45, Young Jamie6, Pereira-Dias Joana45, Hamilton William L12, Ferris Mark7, Torok M Estee58, Meredith Luke9, Gupta Ravi, Lyons Paul A, Toshner Mark, Warne Ben, Bartholdson Scott Josefin, Cormie Claire, Gill Harmeet, Kean Iain, Maes Mailis, Reynolds Nicola, Wantoch Michelle, Caddy Sarah, Caller Laura, Feltwell Theresa, Hall Grant, Hosmillo Myra, Houldcroft Charlotte, Jahun Aminu, Khokhar Fahad, Yakovleva Anna, Butcher Helen, Caputo Daniela, Clapham-Riley Debra, Dolling Helen, Furlong Anita, Graves Barbara, Gresley Emma Le, Kingston Nathalie, Papadia Sofia, Stark Hannah, Stirrups Kathleen E, Webster Jennifer, Calder Joanna, Harris Julie, Hewitt Sarah, Kennet Jane, Meadows Anne, Rastall Rebecca, Brien Criona O, Price Jo, Publico Cherry, Rowlands Jane, Ruffolo Valentina, Tordesillas Hugo, Brookes Karen, Canna Laura, Cruz Isabel, Dempsey Katie, Elmer Anne, Escoffery Naidine, Jones Heather, Ribeiro Carla, Saunders Caroline, Wright Angela, Nyagumbo Rutendo, Roberts Anne, Bucke Ashlea, Hargreaves Simone, Johnson Danielle, Narcorda Aileen, Read Debbie, Sparke Christian, Warboys Lucy, Lagadu Kirsty, Mactavous Lenette, Gould Tim, Raine Tim, Mather Claire, Ramenatte Nicola, Vallier Anne-Laure, Kasanicki Mary, Eames Penelope-Jane, McNicholas Chris, Thake Lisa, Bartholomew Neil, Brown Nick, Parmar Surendra, Zhang Hongyi, Bowring Ailsa, Martell Geraldine, Quinnell Natalie, Wright Jo, Murphy Helen, Dunmore Benjamin J, Legchenko Ekaterina, Gräf Stefan, Huang Christopher, Hodgson Josh, Hunter Kelvin, Martin Jennifer, Mescia Federica, O'Donnell Ciara, Pointon Linda, Shih Joy, Sutcliffe Rachel, Tilly Tobias, Tong Zhen, Treacy Carmen, Wood Jennifer, Bergamaschi Laura, Betancourt Ariana, Bowyer Georgie, De Sa Aloka, Epping Maddie, Hinch Andrew, Huhn Oisin, Jarvis Isobel, Lewis Daniel, Marsden Joe, McCallum Simon, Nice Francescsa, Curran Martin D2, Fuller Stewart10, Chaudhry Afzal11, Shaw Ashley10, Samworth Richard J12, Bradley John R413, Dougan Gordon45, Smith Kenneth GC45, Lehner Paul J145ORCID, Matheson Nicholas J14514ORCID, Wright Giles7, Goodfellow Ian G9ORCID, Baker Stephen45, Weekes Michael P145ORCID,
Affiliation:
1. Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge, United Kingdom 2. Clinical Microbiology and Public Health Laboratory, Public Health England, Cambridge, United Kingdom 3. Wellcome Sanger Institute, Hinxton, United Kingdom 4. Department of Medicine, University of Cambridge, Cambridge, United Kingdom 5. Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, University of Cambridge, Cambridge, United Kingdom 6. Academic Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom 7. Occupational Health and Wellbeing, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom 8. Department of Microbiology, Cambridge University NHS Hospitals Foundation Trust, Cambridge, United Kingdom 9. Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom 10. National Institutes for Health Research Cambridge, Clinical Research Facility, Cambridge, United Kingdom 11. Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom 12. Statistical Laboratory, Centre for Mathematical Sciences, Cambridge, United Kingdom 13. National Institutes for Health Research Cambridge Biomedical Research Centre, Cambridge, United Kingdom 14. NHS Blood and Transplant, Cambridge, United Kingdom
Abstract
Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3 week period (April 2020), 1032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19)>7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff.
Funder
Wellcome Addenbrooke's Charitable Trust, Cambridge University Hospitals Medical Research Council NHS Blood and Transplant National Institute for Health Research Academy of Medical Sciences Engineering and Physical Sciences Research Council Cancer Research UK
Publisher
eLife Sciences Publications, Ltd
Subject
General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience
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