Evidence summary: What is the evidence for mass screening of asymptomatic HCWs?
| dc.contributor.author | National Health Library & Knowledge Service (NHLKS) | |
| dc.date.accessioned | 2020-05-22T11:14:37Z | |
| dc.date.available | 2020-05-22T11:14:37Z | |
| dc.date.issued | 2020-05-13 | |
| dc.identifier.uri | http://hdl.handle.net/10147/627667 | |
| dc.description | Treibel et al5 state that RNA testing to prevalent infection is a key part of the exit strategy, but the role of testing for asymptomatic infection remains unclear. Understanding the determinants of asymptomatic or pauci-symptomatic infection will provide new opportunities for personalised risk stratification and reveal much-needed correlates of protective immunity, whether induced by vaccination or natural exposure. The authors suggest that the rate of asymptomatic infection among HCWs more probably reflects general community transmission than in-hospital exposure. Prospective patients should be reassured that as the overall epidemic wave recedes, asymptomatic infection among HCWs is low and may not be a major source of transmission. The authors conclude that study data reinforce the importance of epidemic multi-timepoint surveillance of HCWs. The data also suggest that a testing strategy should link population-representative epidemiological surveillance to predict prevalence with adaptive testing for symptomatic individuals at times of low prevalence and rapidly expanding to include asymptomatic HCWs during possible new infection waves. Black et al10 put forward the case for mass testing of both symptomatic and asymptomatic HCWs to: 1. mitigate workforce depletion by unnecessary quarantine; 2. reduce spread in atypical, mild or asymptomatic cases; and 3. protect the healthcare workforce. HCW testing could reduce in-hospital transmission. In a retrospective, single-centre study in Wuhan, 41% of 138 patients were thought to have acquired infection in hospital. The scale of this problem is not yet fully understood; nor is the full potential for asymptomatic and presymptomatic HCWs to transmit infection to patients who do not have COVID-19, other HCWs or the public. However, given that asymptomatic transmission has been documented, utmost caution is urged. West et al6 focus on the problem of false-negative tests and argue that for HCWs in endemic areas, return to work after negative testing may need to be delayed until more sensitive tests can be administered and repeat testing is negative. Two American Universities8, 9 are currently conducting research on testing asymptomatic HCWs. The objective of the research from the University of Colorado is to enact an early warning system in long-term care facilities which would permit temporarily removing asymptomatic but COVID-19 positive caregivers from the workforce until they are no longer virus shedding. The School of Public Health at the University of Minnesota is researching how common asymptomatic carriage of the COVID-19 virus is among HCWs. | en_US |
| dc.language.iso | en | en_US |
| dc.publisher | Health Service Executive | en_US |
| dc.subject | CORONAVIRUS | en_US |
| dc.subject | COVID-19 | en_US |
| dc.subject | TESTING | en_US |
| dc.subject | HEALTHCARE WORKERS | en_US |
| dc.title | Evidence summary: What is the evidence for mass screening of asymptomatic HCWs? | en_US |
| dc.type | Other | en_US |
| refterms.dateFOA | 2020-05-22T11:14:43Z |
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HSE Library Summaries of Evidence
Evidence summaries and reviews on the management and treatment of Novel Coronavirus Covid-19 and other clinical topics