Use of Rapid Antigen Tests to End Isolation in a University Setting: Observational Study (Preprint).
JMIR Form Res 2022;
7:e45003. [PMID:
37040562 PMCID:
PMC10176128 DOI:
10.2196/45003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/10/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND
COVID-19 isolation recommendations have evolved over the course of the pandemic. Initially, the U.S Centers for Disease Control and Prevention required ten days of isolation after a positive test result. In December 2021, this was reduced to a minimum of five days with symptom improvement followed by five days of mask-wearing. As a result, several Institutions of Higher Education, including the George Washington University, required persons testing positive for SARS-CoV-2 to either submit a negative rapid antigen test (RAT) with symptom resolution to leave isolation after five days or to maintain a ten-day isolation period in the absence of a negative RAT and/or presence of continued symptoms. Rapid antigen tests (RATs) are a tool that can be used both to shorten isolation periods and to ensure that persons testing positive for SARS-CoV-2 remain in isolation if infectious.
OBJECTIVE
The purpose of this analysis is to report on the experience of implementing RAT policies, examine the number of days that isolation was reduced via RAT testing, determine the factors that predicted uploading a RAT, and determine RAT positivity percentages to illustrate the utility of using RATs to end isolation.
METHODS
In this study, 880 individuals in COVID-19 isolation at a university in Washington, DC uploaded 887 RATs between February 21 and April 14, 2022. Daily positivity percentages were calculated, and multiple logistic regression analysis examined the odds of uploading a RAT by campus residential living status (on/off-campus), student/employee designation, age, and days in isolation.
RESULTS
Seventy-six percent (669/880) of individuals in isolation uploaded a RAT during the study period. Overall, 38.6% (342/887) of uploaded RATs were positive. Uploaded RATs were positive 45.6% (118/259) of the time on day 5, 45.4% (55/121) on day 6, 47.1% (99/210) on day 7, and 11.1% (7/63) on day ten or above. Adjusted logistic regression modeling indicated cases living on-campus had increased odds of uploading a RAT (OR 2.54, 95% CI 1.64-3.92), whereas primary student affiliation (OR 0.29, 95% CI 0.12-0.69), and days in isolation (OR 0.45, 95% CI 0.39-0.52) had decreased odds of uploading a RAT. Of the 545 cases with a negative RAT, 477 were cleared prior to day 10 of their isolation due to a lack of symptoms and timely submission, resulting in a total of 1,547 days of lost productivity saved compared to all being in isolation for ten days.
CONCLUSIONS
Rapid antigen tests are beneficial as they can support a decision to release individuals from isolation when they have recovered and maintain isolation for people who may still be infectious. Future isolation policies should be guided by similar protocols and research to reduce the spread of COVID-19 and minimize lost productivity and disruption to individuals' lives.
CLINICALTRIAL
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