Changing laboratory capacity requirements across strategies, with attendant changes in total human resources (health care professionals, clerical staff and laboratory staff). For at-risk populations, testing may occur once or repeatedly, depending on prevalence and infection risk. What the rules are in each province and territory, Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study, Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2), Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study, Reconstruction of the full transmission dynamics of COVID-19 in Wuhan, Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review, Temporal dynamics in viral shedding and transmissibility of COVID-19, Presumed asymptomatic carrier transmission of COVID-19, Asymptomatic and human-to-human transmission of SARS-CoV-2 in a 2-family cluster, Xuzhou, China, Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster, Public Health–Seattle and King County and CDC COVID-19 Investigation Team, Presymptomatic SARS-CoV-2 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As shown in Table 1 and Table 2, systematic contact tracing and testing in addition to the status quo required 47 353 tests per day. Yet, the approach to testing has largely been passive,23,24 placing the onus to be tested on the individual. By initiating surveillance testing immediately, evidence-based decisions on further testing entire groups could be made as capacity is built. There are other potential benefits to our proposed approach. Table 1 and Table 2 detail human resource needs, laboratory capacity and costs of testing all members of at-risk populations on a single occasion. We examined changes in costs and human resource needs if testing uptake (consent) was 90%, 80% or 60%. independently classified occupations as essential using Quebec’s stringent definition from March 2020.38 Using a published algorithm,39 validated with O*Net,40 we classified essential occupations as those not able to be performed at home. Deux possibilités de recherche : - Dans la rubrique "Consulter les archives numérisées", bouton "État civil numérisé" : un formulaire de recherche vous permettra d'interroger la base en indiquant les informations en votre possession. Les listes numérisées correspondent à la collection constituée par l'exemplaire envoyé à la préfecture par les communes et conservée dans la sous-série 6M aux Archives départementales. 98-316-X2016001. Conducted over a month, testing all hospital employees would require 1823 additional personnel, costing $29.0 million; testing all community health care workers and persons in long-term care facilities would require 11 074 additional personnel and cost $124.8 million; and testing all essential employees would cost $321.7 million, requiring 25 965 added personnel. Listes nominatives de recensement de population numérisées. The most notable is gathering saliva samples. Month INTERPRETATION: Active testing of groups at increased risk of acquiring SARS-CoV-2 appears feasible and would support the safe reopening of the economy and schools more broadly. In brief, we estimated the number of health care professionals, clerical and laboratory personnel required per day (1 d was 8 h; we considered part-time staff) for each strategy. This form of sampling would be more acceptable — particularly to children, a key consideration when schools reopen — and has excellent sensitivity.45–50 Saliva samples also eliminate the need for nasopharyngeal swabs, a trained health care professional to perform sampling, and the use of costly and scarce PPE. Implementing interventions to reduce inefficiencies in sampling and laboratory procedures could substantially reduce these costs. We estimated sample sizes at the 95% confidence level, adjusting for finite sample size,43 and assuming the cluster size was 10% of individuals from each school or facility. Data from Statistics Canada provided the number of acute care hospitals and long-term care facilities,28,29 the number of employees for each in June 2020,4,30 and the number of residents of long-term care facilities.31,32 Without an estimate of the number of community health care workers in Canada,33 we used American data34–36 and assumed the number employed in Canada was proportional to population. Reduced acceptance of testing resulted in parallel reductions in human resource requirements and costs (Appendix 1, Table e11). Gathering samples for both serologic64,65 and RT-PCR testing to detect previous and current infection could add considerably to the epidemiologic value of active testing, particularly as the epidemic continues. Pooling samples 4:1 could reduce reagents and laboratory technician time by nearly 70%. As of July 17, 2020, there were 488 SARS-CoV-2 testing sites; the estimated RT-PCR laboratory capacity was 80 750 tests per day. At the global level, studies have demonstrated that gender-based violence is perpetrated by husbands or male partners and that these husbands/partners or former partners force between 12% and 25% of women to Interpreting diagnostic tests for SARS-CoV-2, Centers for Disease Control and Prevention, Testing in Ottawa now open to anyone with COVID-19 symptoms, Can I get tested for COVID-19? If daily SARS-CoV-2 infection risk is 1 per 100 000 (corresponding to a population prevalence of about 0.01%), then population groups of 100 or fewer (e.g., smaller workforces or classes in primary or secondary schools) would be more than 90% likely to remain infection free for more than 3 months, and testing could be repeated quarterly. The population of the U.S. on April 1, 2000 was 281,421,906 [PDF 2M]. In our simulations, the critical determinant of the frequency of repeat surveillance or universal testing was the daily risk of acquiring SARS-CoV-2. Les recensements ont lieu tous les 5 ans à l'exception des périodes de guerre (recensement effectué en 1872 au lieu de 1871, et absence de recensement en 1916). For more than 2,000 years, the Chadian Basin has been inhabited by agricultural and sedentary people. The country lies mostly between latitudes 12°S and 26°S, and longitudes 43°E and 51°E. Jonathon Campbell and Dick Menzies drafted the manuscript. 1,598 Followers, 356 Following, 316 Posts - See Instagram photos and videos from Auto Moto Officiel (@automotoofficiel) Therefore, we report cost, human resource and laboratory capacity estimates for 1 complete round of testing over time intervals we considered feasible; we also report estimates if testing of at-risk populations was conducted while systematic tracing and testing of contacts were continued. RESULTS: During July 8–17, 2020, across all provinces in Canada, an average of 41 751 RT-PCR tests were performed daily; we estimated this required 5122 personnel and cost $2.4 million per day ($67.8 million per month). Thank you, America, for your participation in Census 2000. Introduction. Search the world's information, including webpages, images, videos and more. We estimated additional costs and human resource needs if whole-blood sampling for serologic testing with an enzyme-linked immunosorbent assay was done concurrently with sampling for RT-PCR. We suggest that actively testing those at increased risk of acquiring SARS-CoV-2 — and isolating individuals found to be infected — could be equally effective to arrest community transmission and is associated with far less social and economic cost. We defined the status quo based on the testing performed between July 8 and 17, 2020, which includes testing of symptomatic people and limited testing of asymptomatic people (e.g., some individuals with exposure or at high risk of exposure). Innovative programs to expand testing, like the Rapid Acceleration of Diagnostics (RADx) program in the United States,63 are also under way. Our findings place into context the substantial response needed to ensure regular testing can be provided to populations who need it most. Much of how SARS-CoV-2 sampling and contact tracing is performed was derived from Quebec during the first wave of the pandemic, although this was validated with other settings.69–73 There is heterogeneity among provincial health systems, and the epidemiology of SARS-CoV-2 is changing rapidly. We estimated costs, human resources and laboratory capacity required to perform surveillance testing over 14 days in at-risk populations. Interventions addressing inefficiencies, including saliva-based sampling and pooling samples, could reduce costs by 40% and personnel by 20%. Changes in laboratory capacity and human resource needs with each strategy are shown in Figure 1. Copyright 2020, Joule Inc. or its licensors. Even if repeated, these costs represent a small fraction of the $169.2 billion in Canadian federal fiscal response to the COVID-19 pandemic (as of June 2020). The number of repeat tests required for positive individuals and negative contacts in this strategy was 180 840 per month, which would cost an extra $9.9 million. Active testing of groups at increased risk of acquiring SARS-CoV-2 in Canada: costs and human resource needs, Variation in government responses to COVID-19, Blavatnik School of Government, University of Oxford, Our ongoing list of how countries are reopening, and which ones remain under lockdown, Scenario analysis update: COVID-19 pandemic and oil price shocks, Office of the Parliamentary Budget Officer, World economic outlook update: a crisis like no other, an uncertain recovery, Out to regain footing, Trump shifts virus focus to economy. If groups are found to have a low prevalence of SARS-CoV-2 infection, routine surveillance testing would be essential to rapidly respond to increases. Census data from 2016 estimated the number of people employed under each national occupation code,37 which were adjusted to June 2020 labour force size.4 Three authors (J.R.C., N.W., S.L.) We separately calculated downstream costs of repeat testing and contact tracing and testing for each strategy. We did not include capital costs of scaling capacity (e.g., equipment, training) or existing infrastructure. Are we ready? What's the world’s most highly valued startup? We performed 1-way sensitivity analysis for costs, human resource inputs and estimated number of contacts for strategies 1 and 4. The first group consisted of household and nonhousehold contacts of people who were newly diagnosed with SARS-CoV-2 infection (strategy 1), who would be systematically traced and tested to reach an average of 2 household and 14 nonhousehold contacts.25,26 The remaining 4 groups comprised “at-risk populations.” These included all employees of acute care hospitals (strategy 2); all community health care workers, and employees and residents of long-term care facilities (strategy 3); all non–health care employees of essential businesses with major interpersonal or public contact (strategy 4); and all students and employees in primary and secondary schools (strategy 5). Costs were estimated to be about 5% those of universal testing of at-risk groups. All rights reserved. Version 2.0, CERN, European Organization for Nuclear Research, Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts, Modelling the COVID-19 epidemic and implementation of population-wide interventions in Italy, Serial interval of SARS-CoV-2 was shortened over time by nonpharmaceutical interventions, Aggressively find, test, trace and isolate to beat COVID-19, Dépistage actif chez les groupes courant un risque accru de contracter le SRAS-CoV-2 au Canada : coûts et ressources humaines nécessaires, Characteristics of patients with mental illness and persistent high-cost status: a population-based analysis, Preoperative levels of natriuretic peptides and the incidence of postoperative atrial fibrillation after noncardiac surgery: a prospective cohort study, Hyoscine butylbromide versus acetaminophen for nonspecific colicky abdominal pain in children: a randomized controlled trial, www.cmaj.ca/lookup/doi/10.1503/cmaj.202120, www.cmaj.ca/lookup/doi/10.1503/cmaj.201128/tab-related-content, www.bsg.ox.ac.uk/research/publications/variation-government-responses-covid-19, www.businessinsider.com/countries-on-lockdown-coronavirus-italy-2020-3, www.pbo-dpb.gc.ca/web/default/files/Documents/Reports/RP-2021-009-S/RP-2021-009-S_en.pdf, www150.statcan.gc.ca/n1/daily-quotidien/200710/dq200710a-eng.htm, www.imf.org/en/Publications/WEO/Issues/2020/06/24/WEOUpdateJune2020, www.dailyherald.com/news/20200427/out-to-regain-footing-trump-shifts-virus-focus-to-economy, www.cbc.ca/news/canada/montreal/quebec-open-schools-economy-covid-19-1.5541594, https://santemontreal.qc.ca/en/public/coronavirus-covid-19/, www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html, www.cbc.ca/news/canada/ottawa/ottawa-covid19-test-symptoms-1.5567441, www.ctvnews.ca/health/coronavirus/can-i-get-tested-for-covid-19-what-the-rules-are-in-each-province-and-territory-1.4953618, www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/2019_covid_testing_guidance.pdf, www.theglobeandmail.com/canada/article-ontarios-contact-tracing-efforts-are-falling-short-experts-say/, www12.statcan.gc.ca/census-recensement/2016/dp-pd/dt-td/Rp-eng.cfm?TABID=2&Lang=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GID=1159582&GK=0&GRP=1&PID=109536&PRID=10&PTYPE=109445&S=0&SHOWALL=0&SUB=0&Temporal=2016&THEME=116&VID=0&VNAMEE=&VNAMEF=&D1=0&D2=0&D3=0&D4=0&D5=0&D6=0, https://ottawa.ctvnews.ca/mobile/1-500-close-contacts-for-positive-covid-19-cases-in-ottawa-dr-etches-1.4867734?cache=almppngbro?clipId=89950, https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a6, https://strategis.ic.gc.ca/app/scr/app/cis/summary-sommaire/6221, https://strategis.ic.gc.ca/app/scr/app/cis/businesses-entreprises/623, www12.statcan.gc.ca/census-recensement/2016/dp-pd/dt-td/Rp-eng.cfm?LANG=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GID=0&GK=0&GRP=1&PID=110695&PRID=10&PTYPE=109445&S=0&SHOWALL=0&SUB=0&Temporal=2017&THEME=124&VID=0&VNAMEE=&VNAMEF=, www12.statcan.gc.ca/census-recensement/2016/dp-pd/dt-td/Rp-eng.cfm?LANG=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GID=0&GK=0&GRP=1&PID=109537&PRID=0&PTYPE=109445&S=0&SHOWALL=0&SUB=0&Temporal=2016&THEME=116&VID=0&VNAMEE=&VNAMEF=, www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1710000901, https://crh.arizona.edu/sites/default/files/pdf/publications/CAHsummaryALL.pdf, www12.statcan.gc.ca/census-recensement/2016/dp-pd/dt-td/Rp-eng.cfm?TABID=2&Lang=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GID=1341679&GK=0&GRP=1&PID=111858&PRID=10&PTYPE=109445&S=0&SHOWALL=0&SUB=0&Temporal=2017&THEME=124&VID=0&VNAMEE=&VNAMEF=&D1=0&D2=0&D3=0&D4=0&D5=0&D6=0, www.stikeman.com/en-ca/kh/corporations-commercial-law/Government-of-Quebec-Communicates-the-List-of-Essential-Services-and-Commercial-Activities, https://bfi.uchicago.edu/wp-content/uploads/BFI_White-Paper_Dingel_Neiman_3.2020.pdf, www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=3710010901, www.who.int/publications-detail-redirect/who-consolidated-guidelines-on-tuberculosis-module-1-prevention-tuberculosis-preventive-treatment, www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/assumptions.html#a4, www.rockefellerfoundation.org/national-covid-19-testing-action-plan/, http://english.moef.go.kr/pc/selectTbPressCenterDtl.do?boardCd=N0001&seq=4868, www.thelocal.de/20200429/german-coronavirus-testing-capacity-increases-to-900000-a-week, www.cbc.ca/news/canada/manitoba/manitoba-cadham-dynacare-covid-testing-1.5661784. Costs, human resources and laboratory capacity required when conducting testing of at-risk populations with systematic contact tracing and testing are shown in Table 1 and Table 2. Consultez l'instrument de recherche complet du Recensement de population. These examples show massive testing programs are possible when governments prioritize efforts, provide adequate funding, involve all sectors and leverage human resources. No other competing interests were declared. This study assessed needs and outcomes for people with developmental disability (DD) to understand the socioeconomic status of this group prior to implementation of the Accessible Canada Act in June 2019. Stephanie Law is a part-time employee at Carebook Technologies Inc., a mobile app tech company; Carebook Technologies Inc. is currently pilot-testing an app for monitoring symptoms related to coronavirus disease 2019 (COVID-19); this is unrelated to and outside the submitted work. Mobile teams would visit health care facilities with ≥ 5 employees, essential businesses with ≥ 20 employees, and all schools; all others (including contacts) would be referred to existing sampling centres. The cost of universal testing for at-risk populations would be $1.3 billion for 1 round of testing. These resource and population size estimates are useful for other jurisdictions seeking to implement active testing strategies for SARS-CoV-2. Larger groups, or higher infection risk, would require repeated testing at shorter intervals (Appendix 1, Table e10). As workplaces and schools reopen after the first wave of COVID-19 in Canada, testing priorities and strategies are needed to prevent surges in community transmission of SARS-CoV-2. We did not consider costs associated with capacity building and existing infrastructure; nor did we include health system costs beyond testing, such as inpatient or outpatient medical costs, as most people detected would be unlikely to seek care or be detected otherwise. Dans le cadre des mesures de lutte contre la propagation du coronavirus SARS-CoV-2, We also performed other sensitivity analyses for universal testing. This has had major social and economic consequences. All of the authors revised it critically for important intellectual content, gave final approval of the version to be published and agreed to be accountable for all aspects of the work. Franck C, Fix AD, Peña CA, Strickland GT Mapping Lyme disease incidence for diagnostic and preventive decisions, Maryland. BACKGROUND: Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is largely passive, which impedes epidemic control.