SARS-CoV-2 transmission risk from asymptomatic carriers: Results from a mass screening programme in Luxembourg.

Autor:	Wilmes P; Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 7 avenue des Hauts-Fourneaux, L-4362 Esch-sur-Alzette, Luxembourg.; Department of Life Sciences and Medicine, Faculty of Science, Technology and Medicine, University of Luxembourg, 6 avenue du Swing, L-4367 Belvaux, Luxembourg., Zimmer J; Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354 Esch-sur-Alzette, Luxembourg., Schulz J; Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354 Esch-sur-Alzette, Luxembourg.; Luxembourg Institute of Health (LIH), 1A-B rue Thomas Edison, L-1445 Strassen, Luxembourg., Glod F; Luxembourg Institute of Health (LIH), 1A-B rue Thomas Edison, L-1445 Strassen, Luxembourg., Veiber L; Interdisciplinary Centre for Security, Reliability and Trust, University of Luxembourg, 6 rue Richard Coudenhove-Kalergi, L-1359 Luxembourg., Mombaerts L; Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 7 avenue des Hauts-Fourneaux, L-4362 Esch-sur-Alzette, Luxembourg.; Centre Hospitalier de Luxembourg, 4 rue Barblé, L-1210 Luxembourg, Luxembourg., Rodrigues B; Ministry of Higher Education and Research, 18-20 montée de la Pétrusse, L-2327 Luxembourg, Luxembourg., Aalto A; Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 7 avenue des Hauts-Fourneaux, L-4362 Esch-sur-Alzette, Luxembourg., Pastore J; Luxembourg Institute of Health (LIH), 1A-B rue Thomas Edison, L-1445 Strassen, Luxembourg., Snoeck CJ; Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354 Esch-sur-Alzette, Luxembourg., Ollert M; Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354 Esch-sur-Alzette, Luxembourg., Fagherazzi G; Luxembourg Institute of Health (LIH), 1A-B rue Thomas Edison, L-1445 Strassen, Luxembourg., Mossong J; Health Inspectorate, Health Directorate, L-1273 Luxembourg., Goncalves J; Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 7 avenue des Hauts-Fourneaux, L-4362 Esch-sur-Alzette, Luxembourg., Skupin A; Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 7 avenue des Hauts-Fourneaux, L-4362 Esch-sur-Alzette, Luxembourg., Nehrbass U; Luxembourg Institute of Health (LIH), 1A-B rue Thomas Edison, L-1445 Strassen, Luxembourg.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Europe [Lancet Reg Health Eur] 2021 May; Vol. 4, pp. 100056. Date of Electronic Publication: 2021 Feb 27.
DOI:	10.1016/j.lanepe.2021.100056
Abstrakt:	Background: To accompany the lifting of COVID-19 lockdown measures, Luxembourg implemented a mass screening (MS) programme. The first phase coincided with an early summer epidemic wave in 2020. Methods: rRT-PCR-based screening for SARS-CoV-2 was performed by pooling of samples. The infrastructure allowed the testing of the entire resident and cross-border worker populations. The strategy relied on social connectivity within different activity sectors. Invitation frequencies were tactically increased in sectors and regions with higher prevalence. The results were analysed alongside contact tracing data. Findings: The voluntary programme covered 49% of the resident and 22% of the cross-border worker populations. It identified 850 index cases with an additional 249 cases from contact tracing. Over-representation was observed in the services, hospitality and construction sectors alongside regional differences. Asymptomatic cases had a significant but lower secondary attack rate when compared to symptomatic individuals. Based on simulations using an agent-based SEIR model, the total number of expected cases would have been 42·9% (90% CI [-0·3, 96·7]) higher without MS. Mandatory participation would have resulted in a further difference of 39·7% [19·6, 59·2]. Interpretation: Strategic and tactical MS allows the suppression of epidemic dynamics. Asymptomatic carriers represent a significant risk for transmission. Containment of future outbreaks will depend on early testing in sectors and regions. Higher participation rates must be assured through targeted incentivisation and recurrent invitation. Funding: This project was funded by the Luxembourg Ministries of Higher Education and Research, and Health. Competing Interests: All authors report grants from Luxembourg Ministry of Higher Education and Research, and Ministry of Health during the conduct of the study. Dr. Rodrigues reports working for the Ministry of Higher Education and Research as a public servant, during the conduct of the study. Dr. Snoeck reports that Fast Track Diagnostics provided a few SARS-CoV-2 rRT-PCR kits (RUO) free of charge at the time of evaluation of different commercial assays to be procured by the Luxembourg Government in order to do the mass screening intervention in the country. (© 2021 The Author(s).)
Databáze:	MEDLINE
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