Sample Pooling as a Strategy to Detect Community Transmission of SARS-CoV-2

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has revealed the global importance of robust diagnostic testing to differentiate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from other routine respiratory infections and guide appropriate clinical management. Given the limited testing capacity available in the United States early in the pandemic, individuals with a clinical syndrome consistent with COVID-19, but without travel or exposure history, were not tested.¹ Therefore, it remains uncertain whether there may have been community circulation of SARS-CoV-2 prior to the identification of individuals with positive results through standard public health surveillance. Sample pooling, a strategy used for community monitoring of other infectious diseases such as trachoma, has not, to our knowledge, been deployed for the early comprehensive screening of SARS-CoV-2 in the United States.²