Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission

• Published in: eLife Vol. 9
• Main Authors: Rivett, Lucy, Sridhar, Sushmita, Sparkes, Dominic, Routledge, Matthew, Jones, Nick K, Forrest, Sally, Young, Jamie, Pereira-Dias, Joana, Hamilton, William L, Ferris, Mark, Torok, M Estee, Meredith, Luke, Curran, Martin D, Fuller, Stewart, Chaudhry, Afzal, Shaw, Ashley, Samworth, Richard J, Bradley, John R, Dougan, Gordon, Smith, Kenneth Gc, Lehner, Paul J, Matheson, Nicholas J, Wright, Giles, Goodfellow, Ian G, Baker, Stephen, Weekes, Michael P
• Format: Journal Article
• Language: English
• Published: England eLife Sciences Publications Ltd 11-05-2020; eLife Sciences Publications, Ltd
• Subjects: Asymptomatic; Asymptomatic Infections; Betacoronavirus - physiology; Clinical Laboratory Techniques; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronavirus Infections - transmission; Coronaviruses; COVID-19; COVID-19 Testing; COVID-19 Vaccines; Disease transmission; emerging pathogens; Epidemiology and Global Health; Female; Genomes; Health care; Health Personnel; Households; Human Biology and Medicine; Humans; Infection Control; infectious disease; Male; Medical personnel; occupational health; Pandemics; Personal protective equipment; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pneumonia, Viral - transmission; Polymerase chain reaction; Quarantine; Real-Time Polymerase Chain Reaction; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; United Kingdom - epidemiology; virology; United Kingdom; United Kingdom > UK; COVID-19; global health; human biology; epidemiology; SARS-CoV-2; emerging pathogens; infectious disease; virology; medicine; human; occupational health; virus
• ISSN: 2050-084X; 2050-084X
• DOI: 10.7554/eLife.58728

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
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.