Lab Matters Summer 2021 | Page 41

APHL 2021 Poster Abstracts

COVID-19 Test-seeking Behavior : An Important Factor in Quantifying Asymptomatic COVID-19 Cases

C . Fang , K . Asare-Gyeabour , J . Yuen , S . Di Lonardo , S . Hughes and J . Rakeman , New York City Public Health Laboratory , New York City , NY

Prior to the COVID-19 pandemic , only symptomatic individuals typically sought testing associated with a respiratory illness . Amid the COVID-19 pandemic , current messaging encourages individuals to seek COVID-19 testing whether symptomatic or not , for potential exposure , travel or workplace regulations . Studies have suggested asymptomatic individuals accounted for a significant proportion of SARS-CoV-2 cases and that approximately 60 % of all SARS-CoV-2 transmission came from asymptomatic cases . The NYC Department of Health and Mental Hygiene offers COVID-19 laboratory-based SARS-CoV-2 testing with same day results via its nine COVID Express x Quickie Laboratories ( Quickies ) which are located across New York City and serve the general population seeking COVID-19 testing . This project aims to quantify test-seeking behavior and the proportion of symptomatic and asymptomatic COVID-19 cases using analyses of routinely collected demographic , clinical , and laboratory test data . Data were collected from non-hospitalized individuals in NYC seeking COVID-19 testing at the nine Quickies . Symptomatic individuals were defined as self-reporting at least one COVID-like symptom . “ Reason for testing ” data were collected from clients at the Quickies from Sept . 1-Feb . 4 , 2021 . Clients chose from : “ desire test ,” “ travelled internationally within the last month ,” “ potential exposure to COVID-19 ,” “ experiencing COVID-19 symptoms ,” and “ referred by doctor , Test and Trace , or NYC DOHMH .”

The COVID-19 positivity rate was highest in clients that indicated “ referred by doctor , Test and Trace , or NYC DOHMH ” as the reason for testing ( 20.0 %), followed by “ experiencing COVID-19 symptoms ’( 10.7 %),” “ desire test ’( 4.8 %),” “ potential exposure to COVID-19 ( 4.2 %),” and “ travelled internationally in the last month ’( 3.7 %).” Among laboratory-confirmed COVID-19 cases , 68 % were from asymptomatic individuals compared to 32 % symptomatic . While the highest COVID-19 positivity was among individuals experiencing COVID-19 symptoms or referred for testing by a health professional , the most cited reason for testing was a general desire to obtain a test . Notably , 83 % of the 292 individuals who were COVID-19 positive and cited “ desire test ” as the reason for visit , were asymptomatic . This analysis quantified reasons why individuals sought COVID-19 testing . It also highlighted the importance of testing asymptomatic individuals which represent a significant proportion of COVID-19 cases and provides a basis for the messaging encouraging all New Yorkers to get tested .

Limitations of this project include possible selection biases due to a subset of individuals who did not answer the reason for visit questionnaire and the sample population only representing nonhospitalized individuals .

Presenter : Courtney Fang , New York City Public Health Laboratory , cfang3 @ health . nyc . gov

Keeping SARS-CoV-2 Out of the Laboratory Workforce

D . Fayram , S . Heick , W . Aldous and M . Pentella , State Hygienic Laboratory at the University of Iowa , Coralville , IA

Among many challenges faced by public health laboratories during the COVID-19 pandemic is reducing the risk of workplace transmission of SARS-CoV-2 in the laboratory environment . Workplace outbreaks of COVID-19 threaten to decimate the available workforce to perform testing , reduce workplace confidence and morale , and ultimately impair the laboratory from achieving its mission to provide officials with reliable environmental and public health laboratory data . COVID-19 is unique compared to many other infectious diseases because of the broad spectrum of disease presentation , ranging from asymptomatic to severe morbidity and mortality . The possibility of SARS-CoV-2 being asymptomatically spread was previously underappreciated when planning for a pandemic response . The State Hygienic Laboratory at the University of Iowa ( SHL ) considers this threat to its mission as a significant component of the laboratory biosafety program . We describe the multifaceted approach used by the SHL to ensure a safe workplace . Key elements include remote work options , promotion of public health best practices , barrier protection , internal contract tracing , workplace disinfection , easy access to testing , and a complex but clear communications and response process . Importantly , these cumulative efforts required collaboration among many staff and employee groups in order to be successful .

Presenter : Drew Fayram , State Hygienic Laboratory at the University of Iowa , drew-fayam @ uiowa . edu

Implementation of Point-of-Care Tests for COVID-19 Testing : Tips to Maximize the Benefits

M . Hahn ¹ , A . Olsen ¹ , K . Stokes ² , R . Fowler ¹ , R . Gui ³ , S . Semple- Lytch ¹ , A . DeVito ¹ , P . Kurpiel ¹ , S . Hughes ¹ , J . Rakeman ¹ ; ¹ New York City Public Health Laboratory , New York City , NY , ² US Centers for Disease Control and Prevention , Atlanta , GA , ³ Sema4 , Stamford , CT

The SARS-CoV-2 pandemic has highlighted the importance of point-of-care tests ( POCTs ) for SARS-CoV-2 , the virus that causes COVID-19 . POCTs are tests that are can be used in settings other than the laboratory such as at the bedside or near the site of patient care . In addition , many SARS-CoV-2 specific POCTs have been granted emergency use authorization ( EUA ) which deems them to be CLIA-waived . SARS-CoV-2 POCTs tests address the need for rapid results , increase access to testing , and improve affordability . However , implementation of these tests has been challenging . To address this challenge , our goal was to create a toolkit that would facilitate POCT use in a non-laboratory setting . We evaluated two POCTs : Abbot ID NOW COVID-19 assay and Quidel Sofia 2 SARS Antigen FIA which offer rapid detection of SARS-CoV-2 viral RNA and nucleocapsid protein , respectively . We evaluated test usage and protocols . In addition , we used a fluorescent gel to determine the potential for contamination of testing personnel / environment . Evaluation of test usage demonstrated that both tests are intuitive , associated with high user test success rate , and can be implemented by minimally trained staff . However , contamination can be an issue and careful instrument operation is important . The developed POCT toolkit provides guidance for training users , implementing testing , and maintaining quality assurance in a variety of testing environments .

COVID-19