Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening
Open Access
- 1 January 2021
- journal article
- research article
- Published by American Association for the Advancement of Science (AAAS) in Science Advances
- Vol. 7 (1)
- https://doi.org/10.1126/sciadv.abd5393
Abstract
The COVID-19 pandemic has created a public health crisis. Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary.Funding Information
- National Institutes of Health (F32 AI145112)
- National Institutes of Health (F30 AG063468)
- U.S. Department of Defense (MURI W911NF1810208)
- Howard Hughes Medical Institute
- NIH Office of the Director (1DP5OD028145-01)
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