Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission
Lucy Rivett, Sushmita Sridhar, Dominic Sparkes, Matthew Routledge, Nick K Jones, Sally Forrest, Jamie Young, Joana Pereira-Dias, William L Hamilton, Mark Ferris, M Estee Torok, Luke Meredith, CITIID-NIHR COVID-19 BioResource Collaboration, Martin D Curran, Stewart Fuller, Afzal Chaudhry, Ashley Shaw, Richard J Samworth, John R Bradley, Gordon Dougan, Kenneth Gc Smith, Paul J Lehner, Nicholas J Matheson, Giles Wright, Ian G Goodfellow, Stephen Baker, Michael P Weekes, Ravi Gupta, Paul A Lyons, Mark Toshner, Ben Warne, Josefin Bartholdson Scott, Claire Cormie, Harmeet Gill, Iain Kean, Mailis Maes, Nicola Reynolds, Michelle Wantoch, Sarah Caddy, Laura Caller, Theresa Feltwell, Grant Hall, Myra Hosmillo, Charlotte Houldcroft, Aminu Jahun, Fahad Khokhar, Anna Yakovleva, Helen Butcher, Daniela Caputo, Debra Clapham-Riley, Helen Dolling, Anita Furlong, Barbara Graves, Emma Le Gresley, Nathalie Kingston, Sofia Papadia, Hannah Stark, Kathleen E Stirrups, Jennifer Webster, Joanna Calder, Julie Harris, Sarah Hewitt, Jane Kennet, Anne Meadows, Rebecca Rastall, Criona O Brien, Jo Price, Cherry Publico, Jane Rowlands, Valentina Ruffolo, Hugo Tordesillas, Karen Brookes, Laura Canna, Isabel Cruz, Katie Dempsey, Anne Elmer, Naidine Escoffery, Heather Jones, Carla Ribeiro, Caroline Saunders, Angela Wright, Rutendo Nyagumbo, Anne Roberts, Ashlea Bucke, Simone Hargreaves, Danielle Johnson, Aileen Narcorda, Debbie Read, Christian Sparke, Lucy Warboys, Kirsty Lagadu, Lenette Mactavous, Tim Gould, Tim Raine, Claire Mather, Nicola Ramenatte, Anne-Laure Vallier, Mary Kasanicki, Penelope-Jane Eames, Chris McNicholas, Lisa Thake, Neil Bartholomew, Nick Brown, Surendra Parmar, Hongyi Zhang, Ailsa Bowring, Geraldine Martell, Natalie Quinnell, Jo Wright, Helen Murphy, Benjamin J Dunmore, Ekaterina Legchenko, Stefan Gräf, Christopher Huang, Josh Hodgson, Kelvin Hunter, Jennifer Martin, Federica Mescia, Ciara O'Donnell, Linda Pointon, Joy Shih, Rachel Sutcliffe, Tobias Tilly, Zhen Tong, Carmen Treacy, Jennifer Wood, Laura Bergamaschi, Ariana Betancourt, Georgie Bowyer, Aloka De Sa, Maddie Epping, Andrew Hinch, Oisin Huhn, Isobel Jarvis, Daniel Lewis, Joe Marsden, Simon McCallum, Francescsa Nice, Lucy Rivett, Sushmita Sridhar, Dominic Sparkes, Matthew Routledge, Nick K Jones, Sally Forrest, Jamie Young, Joana Pereira-Dias, William L Hamilton, Mark Ferris, M Estee Torok, Luke Meredith, CITIID-NIHR COVID-19 BioResource Collaboration, Martin D Curran, Stewart Fuller, Afzal Chaudhry, Ashley Shaw, Richard J Samworth, John R Bradley, Gordon Dougan, Kenneth Gc Smith, Paul J Lehner, Nicholas J Matheson, Giles Wright, Ian G Goodfellow, Stephen Baker, Michael P Weekes, Ravi Gupta, Paul A Lyons, Mark Toshner, Ben Warne, Josefin Bartholdson Scott, Claire Cormie, Harmeet Gill, Iain Kean, Mailis Maes, Nicola Reynolds, Michelle Wantoch, Sarah Caddy, Laura Caller, Theresa Feltwell, Grant Hall, Myra Hosmillo, Charlotte Houldcroft, Aminu Jahun, Fahad Khokhar, Anna Yakovleva, Helen Butcher, Daniela Caputo, Debra Clapham-Riley, Helen Dolling, Anita Furlong, Barbara Graves, Emma Le Gresley, Nathalie Kingston, Sofia Papadia, Hannah Stark, Kathleen E Stirrups, Jennifer Webster, Joanna Calder, Julie Harris, Sarah Hewitt, Jane Kennet, Anne Meadows, Rebecca Rastall, Criona O Brien, Jo Price, Cherry Publico, Jane Rowlands, Valentina Ruffolo, Hugo Tordesillas, Karen Brookes, Laura Canna, Isabel Cruz, Katie Dempsey, Anne Elmer, Naidine Escoffery, Heather Jones, Carla Ribeiro, Caroline Saunders, Angela Wright, Rutendo Nyagumbo, Anne Roberts, Ashlea Bucke, Simone Hargreaves, Danielle Johnson, Aileen Narcorda, Debbie Read, Christian Sparke, Lucy Warboys, Kirsty Lagadu, Lenette Mactavous, Tim Gould, Tim Raine, Claire Mather, Nicola Ramenatte, Anne-Laure Vallier, Mary Kasanicki, Penelope-Jane Eames, Chris McNicholas, Lisa Thake, Neil Bartholomew, Nick Brown, Surendra Parmar, Hongyi Zhang, Ailsa Bowring, Geraldine Martell, Natalie Quinnell, Jo Wright, Helen Murphy, Benjamin J Dunmore, Ekaterina Legchenko, Stefan Gräf, Christopher Huang, Josh Hodgson, Kelvin Hunter, Jennifer Martin, Federica Mescia, Ciara O'Donnell, Linda Pointon, Joy Shih, Rachel Sutcliffe, Tobias Tilly, Zhen Tong, Carmen Treacy, Jennifer Wood, Laura Bergamaschi, Ariana Betancourt, Georgie Bowyer, Aloka De Sa, Maddie Epping, Andrew Hinch, Oisin Huhn, Isobel Jarvis, Daniel Lewis, Joe Marsden, Simon McCallum, Francescsa Nice
Abstract
Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3 week period (April 2020), 1032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19)>7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff.
Keywords: COVID-19; SARS-CoV-2; emerging pathogens; epidemiology; global health; human; human biology; infectious disease; medicine; occupational health; virology; virus.
Conflict of interest statement
LR, SS, DS, MR, NJ, SF, JY, JP, WH, MF, LM, MC, SF, AS, JB, GW No competing interests declared, MT Reports grants from Academy of Medical Sciences and the Health Foundation, non-financial support from National Institute of Health Research, grants from Medical Research Council, grants from Global Challenges Research Fund, personal fees from Wellcome Sanger Institute, personal fees from University of Cambridge, personal fees from Oxford University Press, AC Reports grants from Cambridge Biomedical Research Centre at CUHNFT, RS Reports grants from EPSRC fellowship, GD Reports grants from NIHR, KS, MW Reports grants from Wellcome Trust, PL, IG, SB Reports grants from Wellcome Trust and Addenbrooke's Charitable Trust, NM Reports grants from MRC (UK) and NHS Blood and Transfusion
© 2020, Rivett et al.
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Source: PubMed