1. Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Intercollegiate Athletics Not Fully Mitigated With Daily Antigen Testing
- Author
-
Gage K. Moreno, Ryan P. Westergaard, Thomas C. Friedrich, Jonathan Meiman, Hannah E Segaloff, Keith Poulson, Katarina M. Braun, Ailam Lim, David H. O’Connor, Ian W Pray, James Borcher, and Michael K Moll
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Universities ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Immunologic Tests ,genomic epidemiology ,medicine.disease_cause ,Article ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,law ,medicine ,Humans ,030212 general & internal medicine ,Antigen testing ,Coronavirus ,biology ,SARS-CoV-2 ,Athletes ,business.industry ,Transmission (medicine) ,COVID-19 ,antigen testing ,Outbreak ,Antigen test ,biology.organism_classification ,Transmission (mechanics) ,AcademicSubjects/MED00290 ,030104 developmental biology ,Infectious Diseases ,FLUORESCENT IMMUNOASSAY ,Emergency medicine ,Supplement Article ,business ,Sports - Abstract
Background High frequency, rapid turnaround SARS-CoV-2 testing continues to be proposed as a way of efficiently identifying and mitigating transmission in congregate settings. However, two SARS-CoV-2 outbreaks occurred among intercollegiate university athletic programs during the fall 2020 semester despite mandatory directly observed daily antigen testing. Methods During the fall 2020 semester, athletes and staff in both programs were tested daily using Quidel’s Sofia SARS Antigen Fluorescent Immunoassay (FIA), with positive antigen results requiring confirmatory testing with real-time reverse transcription polymerase chain reaction (RT-PCR). We used genomic sequencing to investigate transmission dynamics in these two outbreaks. Results In Outbreak 1, 32 confirmed cases occurred within a university athletics program after the index patient attended a meeting while infectious despite a negative antigen test on the day of the meeting. Among isolates sequenced from Outbreak 1, 24 (92%) of 26 were closely related, suggesting sustained transmission following an initial introduction event. In Outbreak 2, 12 confirmed cases occurred among athletes from two university programs that faced each other in an athletic competition despite receiving negative antigen test results on the day of the competition. Sequences from both teams were closely related and unique from strains circulating in the community, suggesting transmission during intercollegiate competition. Conclusions These findings suggest that antigen testing alone, even when mandated and directly observed, may not be sufficient as an intervention to prevent SARS-CoV-2 outbreaks in congregate settings, and highlights the importance of supplementing serial antigen testing with appropriate mitigation strategies to prevent SARS-CoV-2 outbreak in congregate settings., Summary: High frequency, rapid turnaround SARS-CoV-2 testing continues to be proposed as a way of efficiently identifying and mitigating transmission in congregate settings. However, here we describe two SARS-CoV-2 outbreaks occurred among intercollegiate university athletic programs during the fall 2020 semester.
- Published
- 2021