The evidence for alternative active monitoring schedules for confirmed cases of COVID-19 and their cases is limited
The prevailing consensus is that confirmed cases of COVID-19 and their high-risk close contacts should undergo active daily monitoring
When public health resources are limited, active monitoring programs should consider prioritizing vulnerable populations, incorporating passive monitoring practices and adopting virtual monitoring platforms
McLean, M; Groot, G; Dalidowicz, M; Miller, L. Are less frequent (than daily) follow-up/monitoring used in COVID or other communicable diseases? 2020 Oct 6; Document no.:PH092301 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 31 p. (CEST rapid review report)
· Infrared thermometers detect the infrared waves emitted by an object and convert into an electrical signal to display the distribution of temperature
· Infrared thermometers do not emit radiation, however many are equipped with a laser tracker beam, similar to that found in television remote controls
· The Pineal Gland is located deep inside the brain, separated from the forehead by the presence of the skull and several centimeters of brain tissue
Badea, A; Groot, G; Ellsworth, C; Fox, L. Is there evidence of risks for using infrared thermometers? 2020 Aug 29; Document no.: EOC082502 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 12 p. (CEST rapid review report)
Most of the reference exposure studies observed the morbidity/mortality of individuals working in sterilization plants with direct, chronic exposure to high concentrations of ethylene oxide gas prior to changes in allowable environmental levels in 1985, and also formed the basis for the United States Environmental Protection Agency (EPA) and National Institute for Occupational Safety and Health (NIOSH) findings of cancer causation
Meta-analyses of more recent observational cohort studies performed in the 2000s and 2010s of sterilization workers directly exposed to ethylene oxide gas in the workplace do not support the association between ethylene oxide exposure and increased risk of lymphohematopoietic or breast cancers
The elimination half-life of ethylene oxide in humans is approximately 42 minutes – thus almost 90% of any ethylene oxide in a single exposure would be eliminated from the body in two hours
In order to gain FDA approval, testing swabs need to have demonstrated to meet tolerable contact limits of ethylene oxide residuals – experts claim that once packaged for a period of time and aerated prior to use, it is unlikely to contain any ethylene oxide residuals; corroborated by a study assessing the residuals on DNA swabs, finding no detectable levels of ethylene oxide on swabs 3 weeks after sterilization treatment
Badea, A; Groot, G; Hernandez-Ronquillo, L; Fox, L; Mueller, M. What are the risks associated with repeated exposure to Ethylene Oxide from ongoing use of the Abbott Panbio AG COVID-19 Nasal swabs? 2021 Nov 30. Document no.: EOC211126 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 14 p. (CEST rapid review report).
There are no published or grey literature that directly address the review questions
· A number of principle based guidelines/recommendations/criteria are available and reviewed. It appears that the WHO interim guidance "Considerations in adjusting public health and social measures in the context of COVID-19" is the best piece of evidence available right now. It is included in the reference list below.
Badea, A; Reeder, B; Groot, G; Miller, L; Young, C. What is the best evidence to guide the sequence or priority of re-opening each type of healthcare service and how have the closures impacted patients? 2020 Apr 24; Document no.: EOC042202 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 11 p. (CEST rapid review report)
· The significance of rhinorrhea as a presenting/predictive clinical feature of COVID-19 is unclear at this time with rates ranging from as low as 2% to as high as 60% in the published literature
· Rhinorrhea generally associated with less severe disease
· No reports of sneezing as a clinical symptom of COVID-19
Badea, A; Groot, G; Howell-Spooner, B; Young, C. What is the evidence that runny nose or sneezing are symptoms of COVID-19? 2020 Sep 29; Document no.: EOC092401 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 16 p. (CEST rapid review report)
· The CDC does not recommend universal symptom screening (all students in K-12 grades) to be done by schools prior to entry
· Schools/districts should individually work with public health officials to determine the necessity and details of implementing any testing strategies
· European CDC recommends that all symptomatic individuals and asymptomatic high-risk close contacts should be referred for testing – fast and effective contact tracing following testing is key
· Large scale universal testing in school settings has not been studied and it’s efficacy compared to implementation of other infection prevention control measures is unknown
· Large scale testing in school settings to date has largely been done in response to an outbreak, not as routine surveillance
Badea, A; Muhajarine, N; Howell-Spooner, B; Mueller, M. What laboratory surveillance testing strategies are effective for COVID-19 in school settings? 2020 Aug 27; Document no.: PH082501 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 23 p. (CEST rapid review report)
Several references provide estimates of the proportion of HCW infected with SARS-CoV2 that range from 0.9% -20%. A recent review from Alberta Health Services that examined the COVID-19 rt-PCR test results among HCW indicates that in that province 2.4% of physicians and 0.9% of non-MD HCW who were tested were positive for SARS-CoV-2 compared to 3.5% of the general population.
In the studies reviewed, the majority of cases are confirmed by RT-PCR, while only one reference also used serology testing.
Vanstone, J; Reeder, B; Duncan, V; Howell-Spooner, B. What proportion of healthcare workers are rt-PCR positive and IgM or IgG positive? 2020 Jun 2; Document no.: LAB040802v3 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 10 p. (CEST rapid review report)
An optimal surveillance strategy for COVID-19 infection in healthcare workers (HCWs) has yet to be determined.
Weekly screening of HCWs for infection through polymerase chain reaction (PCR) testing would reduce their contribution to SARS-CoV-2 transmission by approximately one quarter.
Any testing surveillance strategy should be in addition to other strategies already in place to identify symptomatic HCW.
Any strategy needs to take into consideration the availability of testing (i.e. feasibility) and the level of community transmission (i.e. the risk of asymptomatic HCWs entering the facility and spreading the virus).
HCWs could be categorized as high, medium, or low risk based upon their exposure to COVID-19 and the frequency of surveillance could be designed accordingly.
Newaz, S; Lee, S; Reeder, B; Groot, G; Young, C; Fox, L. What surveillance strategy is most effective for COVID-19 testing in healthcare workers? 2020 Nov 10; Document no.: EOC110401 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 26 p. (CEST rapid review report)
