Rapid antigen testing as a reactive response to surges in nosocomial SARS-CoV-2 outbreak risk

David R. M. Smith (1, 2, 3) , Audrey Duval (1, 2, 4) , Jean Ralph Zahar (4, 5) , Niels Hendrickx (1) , Kévin Jean (3, 6, 7) , Sofía Jijón (3, 6) , Ajmal Oodally (1, 2, 3) , George Shirreff (1, 2, 3) , Cynthia Tamandjou (2) , Lulla Opatowski (1, 2) , Laura Temime (3, 6)

1 EMAE - Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials
2 CESP - Centre de recherche en épidémiologie et santé des populations
3 MESuRS - Laboratoire Modélisation, épidémiologie et surveillance des risques sanitaires
4 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
5 Hôpital Avicenne [AP-HP]
6 PACRI - Pasteur-Cnam Risques infectieux et émergents
7 Imperial College London

Healthcare facilities are vulnerable to SARS-CoV-2 introductions and subsequent nosocomial outbreaks. Antigen rapid diagnostic testing (Ag-RDT) is widely used for population screening, but its health and economic benefits as a reactive response to local surges in outbreak risk are unclear. We simulate SARS-CoV-2 transmission in a long-term care hospital with varying COVID-19 containment measures in place (social distancing, face masks, vaccination). Across scenarios, nosocomial incidence is reduced by up to 40-47% (range of means) with routine symptomatic RT-PCR testing, 59-63% with the addition of a timely round of Ag-RDT screening, and 69-75% with well-timed two-round screening. For the latter, a delay of 4-5 days between the two screening rounds is optimal for transmission prevention. Screening efficacy varies depending on test sensitivity, test type, subpopulations targeted, and community incidence. Efficiency, however, varies primarily depending on underlying outbreak risk, with health-economic benefits scaling by orders of magnitude depending on the COVID-19 containment measures in place.

Mots clés: Computational models; Population screening; Viral infection

Domaines: Santé publique et épidémiologie

David R. M. Smith, Audrey Duval, Jean Ralph Zahar, Niels Hendrickx, Kévin Jean, et al.. Rapid antigen testing as a reactive response to surges in nosocomial SARS-CoV-2 outbreak risk. Nature Communications, 2022, 13 (1), pp.236. ⟨10.1038/s41467-021-27845-w⟩. ⟨hal-03615649⟩