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Implementation of a Pooled Surveillance Testing Program for Asymptomatic SARS-CoV-2 Infections on a College Campus - Duke University, Durham, North Carolina, August 2-October 11, 2020.

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Date
2020-11-20
Authors
Denny, Thomas N
Andrews, Laura
Bonsignori, Mattia
Cavanaugh, Kyle
Datto, Michael B
Deckard, Anastasia
DeMarco, C Todd
DeNaeyer, Nicole
Epling, Carol A
Gurley, Thaddeus
Haase, Steven B
Hallberg, Chloe
Harer, John
Kneifel, Charles L
Lee, Mark J
Louzao, Raul
Moody, M Anthony
Moore, Zack
Polage, Christopher R
Puglin, Jamie
Spotts, P Hunter
Vaughn, John A
Wolfe, Cameron R
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(23 total)
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Abstract
On university campuses and in similar congregate environments, surveillance testing of asymptomatic persons is a critical strategy (1,2) for preventing transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). All students at Duke University, a private research university in Durham, North Carolina, signed the Duke Compact (3), agreeing to observe mandatory masking, social distancing, and participation in entry and surveillance testing. The university implemented a five-to-one pooled testing program for SARS-CoV-2 using a quantitative, in-house, laboratory-developed, real-time reverse transcription-polymerase chain reaction (RT-PCR) test (4,5). Pooling of specimens to enable large-scale testing while minimizing use of reagents was pioneered during the human immunodeficiency virus pandemic (6). A similar methodology was adapted for Duke University's asymptomatic testing program. The baseline SARS-CoV-2 testing plan was to distribute tests geospatially and temporally across on- and off-campus student populations. By September 20, 2020, asymptomatic testing was scaled up to testing targets, which include testing for residential undergraduates twice weekly, off-campus undergraduates one to two times per week, and graduate students approximately once weekly. In addition, in response to newly identified positive test results, testing was focused in locations or within cohorts where data suggested an increased risk for transmission. Scale-up over 4 weeks entailed redeploying staff members to prepare 15 campus testing sites for specimen collection, developing information management tools, and repurposing laboratory automation to establish an asymptomatic surveillance system. During August 2-October 11, 68,913 specimens from 10,265 graduate and undergraduate students were tested. Eighty-four specimens were positive for SARS-CoV-2, and 51% were among persons with no symptoms. Testing as a result of contact tracing identified 27.4% of infections. A combination of risk-reduction strategies and frequent surveillance testing likely contributed to a prolonged period of low transmission on campus. These findings highlight the importance of combined testing and contact tracing strategies beyond symptomatic testing, in association with other preventive measures. Pooled testing balances resource availability with supply-chain disruptions, high throughput with high sensitivity, and rapid turnaround with an acceptable workload.
Type
Journal article
Subject
Humans
Pneumonia, Viral
Coronavirus Infections
Clinical Laboratory Techniques
Viral Load
Universities
Program Development
North Carolina
Asymptomatic Diseases
Pandemics
Public Health Surveillance
Betacoronavirus
Permalink
https://hdl.handle.net/10161/21769
Published Version (Please cite this version)
10.15585/mmwr.mm6946e1
Publication Info
Denny, Thomas N; Andrews, Laura; Bonsignori, Mattia; Cavanaugh, Kyle; Datto, Michael B; Deckard, Anastasia; ... Wolfe, Cameron R (2020). Implementation of a Pooled Surveillance Testing Program for Asymptomatic SARS-CoV-2 Infections on a College Campus - Duke University, Durham, North Carolina, August 2-October 11, 2020. MMWR. Morbidity and mortality weekly report, 69(46). pp. 1743-1747. 10.15585/mmwr.mm6946e1. Retrieved from https://hdl.handle.net/10161/21769.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Bonsignori

Mattia Bonsignori

Associate Professor in Medicine
HIV vaccine development Study of B-cell immune responses in HIV positive individuals Determination of correlates of protective immunity to HIV Induction of broadly neutralizing antibodies to HIV Development of multiplex functional assays for the evaluation at a single-cell level of B-cell responses to vaccinations, infections and in vitro stimulation Epidemiology and characterization of bacterial resistance determinants (past) </do
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Datto

Michael Bradley Datto

Associate Professor of Pathology
Dr. Datto is an AP/CP/MGP board certified pathologist who specializes in molecular pathology. He is the Associate Vice President for Duke University Health System Clinical Laboratories, the Vice Chair for Clinical Pathology and Medical Director for Duke University Health System Clinical Laboratories.   In these roles, he is responsible for maintaining the standards of the College of American Pathologists and CLIA/CMS within all Clinical Laboratories at Duke.  Speci
Denny

Thomas Norton Denny

Professor in Medicine
Thomas N. Denny, MSc, M.Phil, is the Chief Operating Officer of the Duke Human Vaccine Institute (DHVI), Associate Dean for Duke Research and Discovery @RTP, and a Professor of Medicine in the Department of Medicine at Duke University Medical Center. He is also an Affiliate Member of the Duke Global Health Institute. Previously, he served on the Health Sector Advisory Council of the Duke University Fuquay School of Business. Prior to joining Duke, he was an Associate Professor of Pathology, Labo
Epling

Carol Ann Epling

Assistant Professor in Family Medicine and Community Health
Haase

Steven B. Haase

Professor of Biology
Our group is broadly interested in understanding the biological clock mechanisms that control the timing of events during the cell division cycle. In 2008, the Haase group proposed a new model in which a complex network of sequentially activated transcription factors regulates the precise timing of gene expression during the cell-cycle, and functions as a robust time-keeping oscillator. Greater than a thousand genes are expressed at distinct phases of the cycle, and the control network itself
Harer

John Harer

Professor Emeritus of Mathematics
Professor Harer's primary research is in the use of geometric, combinatorial and computational techniques to study a variety of problems in data analysis, shape recognition, image segmentation, tracking, cyber security, ioT, biological networks and gene expression.
Lee

Mark Jae Lee

Assistant Professor in Pathology
Moody

Michael Anthony Moody

Professor of Pediatrics
Tony Moody, MD is a Professor in the Department of Pediatrics, Division of Infectious Diseases and Professor in the Department of Immunology at Duke University Medical Center. Research in the Moody lab is focused on understanding the B cell responses during infection, vaccination, and disease. The lab has become a resource for human phenotyping, flow characterization, staining and analysis at the Duke Human Vaccine Institute (DHVI). The Moody lab is currently funded to study influenza, syphil
Spotts

Philip Hunter Spotts

Assistant Professor in Family Medicine and Community Health
Vaughn

John Anthony Vaughn

Associate Professor in Family Medicine and Community Health
My major area of scholarly interest is in the field of Narrative Medicine.  I am particularly interested in exploring how this approach to practice can enhance both the care that clinicians provide to their patients as well as their sense of professional agency and satisfaction.  As Director of Student Health, I am dedicated to maximizing the health and well-being of every member of the Duke student community through the delivery of professional, patient-centered
Wolfe

Cameron Robert Wolfe

Associate Professor of Medicine
HIV infection, Transplant-related infectious diseases, general infectious diseases, Biological and Emergency Preparedness for hospital systems, influenza and respiratory viral pathogens
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