Many universities saw extensive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission among their populations in Fall 2020. This threatened the health of students, staff and faculty, in-person instruction, and also the health of nearby communities.
Researchers from the U.S. recently reported a multimodal “SHIELD: Target, Test, and Tell” program that helped mitigate the transmission of SARS-CoV-2 at a large public university. The program also prevented community transmission and helped the continuation of in-person classes during the pandemic. This study is available on the medRxiv* preprint server.
SHIELD: Target, Test, and Tell program to mitigate SARS-CoV-2 transmission at a large public university
The SHIELD program was developed to minimize SARS-CoV-2 transmission via identification and safe isolation of infected individuals before the spread of the virus. The Target, Test and Tell components of SHIELD are synergistically used and helped achieve the transmission mitigation goal.
The program combines three elements: 1. epidemiological modeling and surveillance (Target), 2. covidSHIELD (Test) – a fast and frequent testing assay that uses a novel, low cost, FDA Emergency Use Authorized, and scalable saliva-based RT-qPCR assay for SARS-CoV-2 that bypasses RNA extraction, and 3. digital tools that can provide test results, notify of possible exposures, and promote compliance with public health measures (Tell). These 3 elements were combined with social distancing, mask usage, and robust education efforts. As a result, the researchers performed over 1,000,000 covidSHIELD tests while keeping classrooms, labs, and other activities open at the university.
Multimodal transmission mitigation programs could help university communities achieve positive outcomes
Generally, the case positivity rates remained under 0.5%, and transmission from students to faculty and staff was prevented, and data gathered indicate that there was no spread in classrooms or research labs. During the fall semester, there were no COVID-19-related hospitalizations or deaths among the university community.
The program also prevented transmission of the virus from the university population to the surrounding Champaign County community. The authors’ experience demonstrates that multimodal transmission mitigation programs could help university communities achieve positive outcomes until mass vaccination against COVID-19 is achieved. These programs also provide a roadmap for addressing future pandemics.
As the ~35,000 undergraduate students at the University of Illinois at Urbana-Champaign (UIUC) left the campus in Spring 2020 to continue their learning remotely, it was clear that their return in the Fall would pose significant challenges. The biggest concern was that unmitigated transmission of the virus among the undergraduate student population would drive more cases in the staff and faculty and the surrounding community.
“Combined with masking and social distancing, fast/frequent testing helped mitigate the spread of COVID-19 in the Fall 2020 semester for a large and diverse public University community.”
The SHIELD program was also deployed in other communities such as a large public university, a few high schools, a community college, a federal courthouse, and a large private corporate campus. Saliva samples collected from these communities were processed and analyzed using the covidSHIELD assay. The test results were evaluated as per the interpretation tables in the EUA Summary and the weekly averaged positivity rates plotted against the period during which the samples were processed.
“The covidSHIELD saliva test is highly scalable and easy to implement, allowing fast, frequent and accurate testing in a large community.”
According to the authors, the three significant contributions of their work are: 1. the development and deployment of the multimodal program – a comprehensive effort to mitigate the transmission of COVID-19 at a large university that prevented community transmission and helped continue in-person classes during the pandemic; 2. the description of the novel, saliva-based, and scalable RT-qPCR assay for SARS-CoV-2 that bypasses RNA extraction; and 3. the evidence that fast and frequent testing can help mitigate SARS-CoV-2 transmission after infection spikes occur.
“Our results stand to better enable communities to open more safely as the world bridges to widespread vaccination against COVID-19. They also provide a playbook for addressing the next pandemic.”
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.