An Assessment of Symptom and Risk Screening to Determine COVID-19 Testing Eligibility in the State of Georgia, March 2020- April 2020 Open Access

Abstract

Importance: The emergence of SARS-CoV-2 led to rapid, but limited rollout of diagnostic testing causing the CDC and states to make dynamic decisions on testing eligibility to match available test kits. Historically, symptom based screening and traveler screening have been proven ineffective for determining disease risk, but little is known about how symptom presentation impacted decisions to approve test requests and ultimate test disposition^1–4. This study will assess the use of the COVID-19 testing request form at the Georgia Department of Public Health (GDPH) during the first month of the pandemic.

 

Objective: Assess the symptom and risk screening tool developed by GDPH, based on CDC testing eligibility requirements, to determine testing request approval for Georgia Public Health Labs GPHL and provide recommendations for future outbreaks and pandemics.

 

Design: This cross-sectional study was conducted utilizing data obtained from COVID-19 testing requests received between March 5, 2020 and April 11, 2020 to reflect the first iteration of the testing request form used during the COVID-19 pandemic in the state of Georgia.

 

Setting: Study data was collected at healthcare facilities across Georgia.

 

Participants: The sample included all individuals who had COVID-19 testing requests submitted during the study time period.

 

Main Outcomes and Measures: The main outcomes of interest are test request approval or denial, and results of the approved tests. Both outcomes of interest were assessed relative to presenting symptom profiles.

 

Results: In total, there were 4828 test requests approved or denied in this time period. Among all submitted requests, 3712 (80.6%) indicated the patient exhibited coughing. Of approved test requests, 678 (14.0%) tested positive for COVID-19; key symptoms presentation differences between positive and negative tests were rhinorrhea and sore throat. Using factor analysis, we identified a subset of symptoms more likely to be associated with approved test requests and positive tests. Factors were reduced to assess parsimony and further narrow the symptom profiles most common with each outcome level.

 

Conclusion and Relevance: Real time data analysis should be conducted during the early phases of a pandemic. It provides valuable insight that can be used to create evidence-based recommendations to best allocate limited supplies in a pandemic setting.

Table of Contents

Chapter 1 - Introduction: Pg. 6-8

Chapter 2 - Literature Review: Pg. 9-11

Chapter 3 - Manuscript: Pg. 12-28

Chapter 4 - Implications/Recommendations: Pg. 29-31

References: Pg. 32-36

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Symptom Screening Pandemic Preparedness SARS-CoV-2 COVID-19
Committee Chair / Thesis Advisor	Robert Bednarczyk, PhD, Emory University
Committee Members	Amanda Feldpausch, DVM, MPH, Georgia Department of Public Health
Partnering Agencies	Georgia state or local health department

Last modified

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	An Assessment of Symptom and Risk Screening to Determine COVID-19 Testing Eligibility in the State of Georgia, March 2020- April 2020 ()	2021-05-03 14:05:04 -0400	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions