Title: Mitigation of SARS-CoV-2 transmission at a large public university
Abstract In Fall 2020, universities saw extensive transmission of SARS-CoV-2 among their populations, threatening health of the university and surrounding communities, and viability of in-person instruction. Here we report a case study at the University of Illinois at Urbana-Champaign, where a multimodal “SHIELD: Target, Test, and Tell” program, with other non-pharmaceutical interventions, was employed to keep classrooms and laboratories open. The program included epidemiological modeling and surveillance, fast/frequent testing using a novel low-cost and scalable saliva-based RT-qPCR assay for SARS-CoV-2 that bypasses RNA extraction, called covidSHIELD, and digital tools for communication and compliance. In Fall 2020, we performed >1,000,000 covidSHIELD tests, positivity rates remained low, we had zero COVID-19-related hospitalizations or deaths amongst our university community, and mortality in the surrounding Champaign County was reduced more than 4-fold relative to expected. This case study shows that fast/frequent testing and other interventions mitigated transmission of SARS-CoV-2 at a large public university. more »« less
Regular surveillance testing of asymptomatic individuals for SARS-CoV-2 has been center to SARS-CoV-2 outbreak prevention on college and university campuses. Here we describe the voluntary saliva testing program instituted at the University of California, Berkeley during an early period of the SARS-CoV-2 pandemic in 2020. The program was administered as a research study ahead of clinical implementation, enabling us to launch surveillance testing while continuing to optimize the assay. Results of both the testing protocol itself and the study participants’ experience show how the program succeeded in providing routine, robust testing capable of contributing to outbreak prevention within a campus community and offer strategies for encouraging participation and a sense of civic responsibility.
Olney, Andrew M; Smith, Jesse; Sen, Saunak; Thomas, Fridtjof; Unwin, H Juliette(
, American Journal of Epidemiology)
Abstract Since its global emergence in 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused multiple epidemics in the United States. When medical treatments for the virus were still emerging and a vaccine was not yet available, state and local governments sought to limit its spread by enacting various social-distancing interventions, such as school closures and lockdowns; however, the effectiveness of these interventions was unknown. We applied an established, semimechanistic Bayesian hierarchical model of these interventions to the spread of SARS-CoV-2 from Europe to the United States, using case fatalities from February 29, 2020, up to April 25, 2020, when some states began reversing their interventions. We estimated the effects of interventions across all states, contrasted the estimated reproduction numbers before and after lockdown for each state, and contrasted the predicted number of future fatalities with the actual number of fatalities as a check of the model’s validity. Overall, school closures and lockdowns were the only interventions modeled that had a reliable impact on the time-varying reproduction number, and lockdown appears to have played a key role in reducing that number to below 1.0. We conclude that reversal of lockdown without implementation of additional, equally effective interventions will enable continued, sustained transmission of SARS-CoV-2 in the United States.
Ciccone, Emily J; Zivich, Paul N; Lodge, Evans K; Zhu, Deanna; Law, Elle; Miller, Elyse; Taylor, Jasmine L; Chung, Suemin; Xu, Jason; Volfovsky, Alexander; et al(
, JMIR Research Protocols)
null
(Ed.)
Background Health care personnel (HCP) are at high risk for exposure to the SARS-CoV-2 virus. While personal protective equipment (PPE) may mitigate this risk, prospective data collection on its use and other risk factors for seroconversion in this population is needed. Objective The primary objectives of this study are to (1) determine the incidence of, and risk factors for, SARS-CoV-2 infection among HCP at a tertiary care medical center and (2) actively monitor PPE use, interactions between study participants via electronic sensors, secondary cases in households, and participant mental health and well-being. Methods To achieve these objectives, we designed a prospective, observational study of SARS-CoV-2 infection among HCP and their household contacts at an academic tertiary care medical center in North Carolina, USA. Enrolled HCP completed frequent surveys on symptoms and work activities and provided serum and nasal samples for SARS-CoV-2 testing every 2 weeks. Additionally, interactions between participants and their movement within the clinical environment were captured with a smartphone app and Bluetooth sensors. Finally, a subset of participants’ households was randomly selected every 2 weeks for further investigation, and enrolled households provided serum and nasal samples via at-home collection kits. Results As of December 31, 2020, 211 HCP and 53 household participants have been enrolled. Recruitment and follow-up are ongoing and expected to continue through September 2021. Conclusions Much remains to be learned regarding the risk of SARS-CoV-2 infection among HCP and their household contacts. Through the use of a multifaceted prospective study design and a well-characterized cohort, we will collect critical information regarding SARS-CoV-2 transmission risks in the health care setting and its linkage to the community. International Registered Report Identifier (IRRID) DERR1-10.2196/25410
Magalis, Brittany R.; Mavian, Carla; Tagliamonte, Massimiliano; Rich, Shannan N.; Cash, Melanie; Riva, Alberto; Loeb, Julia C.; Norris, Michael; Amador, David M.; Zhang, Yanping; et al(
, Journal of Medical Virology)
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) variants of concern (VOC) has raised questions regarding vaccine protection against SARS‐CoV‐2 infection, transmission, and ongoing virus evolution. Twenty‐three mildly symptomatic “vaccination breakthrough” infections were identified as early as January 2021 in Alachua County, Florida, among individuals fully vaccinated with either the BNT162b2 (Pfizer) or the Ad26 (Janssen/J&J) vaccines. SARS‐CoV‐2 genomes were successfully generated for 11 of the vaccine breakthroughs, and 878 individuals in the surrounding area and were included for reference‐based phylogenetic investigation. These 11 individuals were characterized by infection with VOCs, but also low‐frequency variants present within the surrounding population. Low‐frequency mutations were observed, which have been more recently identified as mutations of interest owing to their location within targeted immune epitopes (P812L) and association with increased replicative capacity (L18F). We present these results to posit the nature of the efficacy of vaccines in reducing symptoms as both a blessing and a curse—as vaccination becomes more widespread and self‐motivated testing reduced owing to the absence of severe symptoms, we face the challenge of early recognition of novel mutations of potential concern. This case study highlights the critical need for continued testing and monitoring of infection and transmission among individuals regardless of vaccination status.
Dai, Katherine; Foerster, Steffen; Vora, Neil M; Blaney, Kathleen; Keeley, Chris; Hendricks, Lisa; Varma, Jay K; Long, Theodore; Shaman, Jeffrey; Pei, Sen(
, BMC Infectious Diseases)
Background
Understanding community transmission of SARS-CoV-2 variants of concern (VOCs) is critical for disease control in the post pandemic era. The Delta variant (B.1.617.2) emerged in late 2020 and became the dominant VOC globally in the summer of 2021. While the epidemiological features of the Delta variant have been extensively studied, how those characteristics shaped community transmission in urban settings remains poorly understood.
Methods
Using high-resolution contact tracing data and testing records, we analyze the transmission of SARS-CoV-2 during the Delta wave within New York City (NYC) from May 2021 to October 2021. We reconstruct transmission networks at the individual level and across 177 ZIP code areas, examine network structure and spatial spread patterns, and use statistical analysis to estimate the effects of factors associated with COVID-19 spread.
Results
We find considerable individual variations in reported contacts and secondary infections, consistent with the pre-Delta period. Compared with earlier waves, Delta-period has more frequent long-range transmission events across ZIP codes. Using socioeconomic, mobility and COVID-19 surveillance data at the ZIP code level, we find that a larger number of cumulative cases in a ZIP code area is associated with reduced within- and cross-ZIP code transmission and the number of visitors to each ZIP code is positively associated with the number of non-household infections identified through contact tracing and testing.
Conclusions
The Delta variant produced greater long-range spatial transmission across NYC ZIP code areas, likely caused by its increased transmissibility and elevated human mobility during the study period. Our findings highlight the potential role of population immunity in reducing transmission of VOCs. Quantifying variability of immunity is critical for identifying subpopulations susceptible to future VOCs. In addition, non-pharmaceutical interventions limiting human mobility likely reduced SARS-CoV-2 spread over successive pandemic waves and should be encouraged for reducing transmission of future VOCs.
@article{osti_10332941,
place = {Country unknown/Code not available},
title = {Mitigation of SARS-CoV-2 transmission at a large public university},
url = {https://par.nsf.gov/biblio/10332941},
DOI = {10.1038/s41467-022-30833-3},
abstractNote = {Abstract In Fall 2020, universities saw extensive transmission of SARS-CoV-2 among their populations, threatening health of the university and surrounding communities, and viability of in-person instruction. Here we report a case study at the University of Illinois at Urbana-Champaign, where a multimodal “SHIELD: Target, Test, and Tell” program, with other non-pharmaceutical interventions, was employed to keep classrooms and laboratories open. The program included epidemiological modeling and surveillance, fast/frequent testing using a novel low-cost and scalable saliva-based RT-qPCR assay for SARS-CoV-2 that bypasses RNA extraction, called covidSHIELD, and digital tools for communication and compliance. In Fall 2020, we performed >1,000,000 covidSHIELD tests, positivity rates remained low, we had zero COVID-19-related hospitalizations or deaths amongst our university community, and mortality in the surrounding Champaign County was reduced more than 4-fold relative to expected. This case study shows that fast/frequent testing and other interventions mitigated transmission of SARS-CoV-2 at a large public university.},
journal = {Nature Communications},
volume = {13},
number = {1},
author = {Ranoa, Diana Rose and Holland, Robin L. and Alnaji, Fadi G. and Green, Kelsie J. and Wang, Leyi and Fredrickson, Richard L. and Wang, Tong and Wong, George N. and Uelmen, Johnny and Maslov, Sergei and Weiner, Zachary J. and Tkachenko, Alexei V. and Zhang, Hantao and Liu, Zhiru and Ibrahim, Ahmed and Patel, Sanjay J. and Paul, John M. and Vance, Nickolas P. and Gulick, Joseph G. and Satheesan, Sandeep Puthanveetil and Galvan, Isaac J. and Miller, Andrew and Grohens, Joseph and Nelson, Todd J. and Stevens, Mary P. and Hennessy, P Mark and Parker, Robert C. and Santos, Edward and Brackett, Charles and Steinman, Julie D. and Fenner, Melvin R. and Dohrer, Kirstin and DeLorenzo, Michael and Wilhelm-Barr, Laura and Brauer, Brian R. and Best-Popescu, Catherine and Durack, Gary and Wetter, Nathan and Kranz, David M. and Breitbarth, Jessica and Simpson, Charlie and Pryde, Julie A. and Kaler, Robin N. and Harris, Chris and Vance, Allison C. and Silotto, Jodi L. and Johnson, Mark and Valera, Enrique Andres and Anton, Patricia K. and Mwilambwe, Lowa and Bryan, Stephen P. and Stone, Deborah S. and Young, Danita B. and Ward, Wanda E. and Lantz, John and Vozenilek, John A. and Bashir, Rashid and Moore, Jeffrey S. and Garg, Mayank and Cooper, Julian C. and Snyder, Gillian and Lore, Michelle H. and Yocum, Dustin L. and Cohen, Neal J. and Novakofski, Jan E. and Loots, Melanie J. and Ballard, Randy L. and Band, Mark and Banks, Kayla M. and Barnes, Joseph D. and Bentea, Iuliana and Black, Jessica and Busch, Jeremy and Conte, Abigail and Conte, Madison and Curry, Michael and Eardley, Jennifer and Edwards, April and Eggett, Therese and Fleurimont, Judes and Foster, Delaney and Fouke, Bruce W. and Gallagher, Nicholas and Gastala, Nicole and Genung, Scott A. and Glueck, Declan and Gray, Brittani and Greta, Andrew and Healy, Robert M. and Hetrick, Ashley and Holterman, Arianna A. and Ismail, Nahed and Jasenof, Ian and Kelly, Patrick and Kielbasa, Aaron and Kiesel, Teresa and Kindle, Lorenzo M. and Lipking, Rhonda L. and Manabe, Yukari C. and Mayes, Jade ́ and McGuffin, Reubin and McHenry, Kenton G. and Mirza, Agha and Moseley, Jada and Mostafa, Heba H. and Mumford, Melody and Munoz, Kathleen and Murray, Arika D. and Nolan, Moira and Parikh, Nil A. and Pekosz, Andrew and Pflugmacher, Janna and Phillips, Janise M. and Pitts, Collin and Potter, Mark C. and Quisenberry, James and Rear, Janelle and Robinson, Matthew L. and Rosillo, Edith and Rye, Leslie N. and Sherwood, MaryEllen and Simon, Anna and Singson, Jamie M. and Skadden, Carly and Skelton, Tina H. and Smith, Charlie and Stech, Mary and Thomas, Ryan and Tomaszewski, Matthew A. and Tyburski, Erika A. and Vanwingerden, Scott and Vlach, Evette and Watkins, Ronald S. and Watson, Karriem and White, Karen C. and Killeen, Timothy L. and Jones, Robert J. and Cangellaris, Andreas C. and Martinis, Susan A. and Vaid, Awais and Brooke, Christopher B. and Walsh, Joseph T. and Elbanna, Ahmed and Sullivan, William C. and Smith, Rebecca L. and Goldenfeld, Nigel and Fan, Timothy M. and Hergenrother, Paul J. and Burke, Martin D.},
}
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