COVID-19 screenings may be missing large portion of infected people

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RALEIGH, N.C. (WNCN) – While COVID-19 health screenings are in effect in places like airports or places of employment, a new study shows they may not be effective enough.

RTI International compiled information from more than a dozen studies with more than 17,000 participants. Their study analyzed one-time screening methods like temperature checks, symptom assessment, travel history, potential exposure assessments and rapid point-of-care tests.

They found taking a group of 100 people infected with coronavirus, anywhere from 20 to 100 of them would be missed in a screening.

Taking a group of 100 healthy people, anywhere from zero to 38 people may be misidentified as infected. That would result in one-third of people unnecessarily needing to isolate.

Dr. Meera Viswanathan, director of the RTI International-UNC Chapel Hill Evidence-based Practice Center, said the inaccuracy can be attributed to two things. The first is asymptomatic people. Aside from a full COVID-19 test, those people can continue to spread the virus undetected. Secondly, Dr. Viswanathan said people early on in their infection may have low virus particles present in their body at the time of a screening. Viral loads can increase over time and become more detectable at a later time.

That part of the population was not surprising to Dr. Viswanathan. What was surprising was that rapid laboratory tests incorrectly identified between 20 percent and 100 percent of infected people as healthy. Meanwhile, 27 percent to 100 percent of healthy people were incorrectly identified as infected. She said currently these tests are not sensitive enough to detect low viral loads.

“What we’re hopeful for is that maybe technology will improve and there will be better, more sensitive tests in the future,” said Dr. Viswanathan.

Dr. Viswanathan said current one-time screenings could provide a false sense of security for people who are actually infected.

“If you’re screened positive, don’t assume that you’re sick. Go look for a full fledged COVID-19 test. And if you’re told that your negative, don’t assume that you’re healthy and that you can’t infect others,” said Dr. Viswanathan.

A presentation with complete findings is below.

What can be done in the meantime?

Dr. Viswanathan said it’s important to continue to social distance, wear a face covering and staying home if you feel sick.

“It is indeed worrisome so this is why we need to rely on things we know do work,” said Dr. Viswanathan.

As countries grapple with how to slow spread, Dr. Viswanathan said screening has the potential to do that. She said mass screenings require:

  • Sensitive screening strategies
  • Public health infrastructure with guideline on how to handle a COVID-19 positive screening
  • Public buy-in to universal testing

Read more on the study here and here.

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