Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations – a feasibility study

Introduction: SARS-CoV-2 may transmit across vaccinated cohorts during practical clinical examinations. We sought to assess the feasibility of facemask sampling (FMS) to identify individuals emitting SARS-CoV-2 during a mock PACES exam. Methods: In May 2022 we recruited participants from a mock PACE...

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Main Authors: Daniel Pan, Caroline Williams, Jonathan Decker, Eve Fletcher, Natalia Grolmusova, Paul W. Bird, Christopher A. Martin, Joshua Nazareth, Latif Rahman, Kate O'Kelly, Rakesh Panchal, Irfana Musa, Harshil Dhutia, Shirley Sze, Manish Pareek, Michael R. Barer
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Future Healthcare Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S2514664524015650
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author Daniel Pan
Caroline Williams
Jonathan Decker
Eve Fletcher
Natalia Grolmusova
Paul W. Bird
Christopher A. Martin
Joshua Nazareth
Latif Rahman
Kate O'Kelly
Rakesh Panchal
Irfana Musa
Harshil Dhutia
Shirley Sze
Manish Pareek
Michael R. Barer
author_facet Daniel Pan
Caroline Williams
Jonathan Decker
Eve Fletcher
Natalia Grolmusova
Paul W. Bird
Christopher A. Martin
Joshua Nazareth
Latif Rahman
Kate O'Kelly
Rakesh Panchal
Irfana Musa
Harshil Dhutia
Shirley Sze
Manish Pareek
Michael R. Barer
author_sort Daniel Pan
collection DOAJ
description Introduction: SARS-CoV-2 may transmit across vaccinated cohorts during practical clinical examinations. We sought to assess the feasibility of facemask sampling (FMS) to identify individuals emitting SARS-CoV-2 during a mock PACES exam. Methods: In May 2022 we recruited participants from a mock PACES examination in Leicester, UK. Following a negative lateral flow test assay, all participants wore modified facemasks able to capture exhaled virus during the assessment (FMS). A concomitant upper respiratory tract sample (URTS) was provided prior to FMS. Exposed facemasks were processed by removal and dissolution of sampling matrices fixed within the mask and cycle thresholds values quantified by RT-qPCR. Participants were asked to grade statements regarding the comfort, effort, ethics and communication when providing FMS; laboratory technicians were asked to grade key statements surrounding suitability of samples for processing. Results: 34 participants provided concomitant URTS and FMS during the examination. One participant was positive for SARS-CoV-2, with a cycle threshold value of 22.5 on URTS, but negative (no viral RNA detected) on FMS; no transmission to others was identified from this individual. Participants responded positively to statements regarding FMS describing all four domains; however, 69% of participants felt that a positive result from FMS alone was insufficient for diagnosis and that further tests were required. All but one FMS sample was suitable for processing. Discussion: FMS during PACES exams are acceptable among participants and samples provided are suitable for processing. Our results demonstrate feasibility of FMS within practical examination settings and support the further assessment of FMS as a scalable tool that can be compared with URTS to identify those who are infectious.
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spelling doaj-art-9fc2df2e849a4804a9d405db0ba88d752025-08-20T01:55:40ZengElsevierFuture Healthcare Journal2514-66452024-12-0111410017510.1016/j.fhj.2024.100175Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations – a feasibility studyDaniel Pan0Caroline Williams1Jonathan Decker2Eve Fletcher3Natalia Grolmusova4Paul W. Bird5Christopher A. Martin6Joshua Nazareth7Latif Rahman8Kate O'Kelly9Rakesh Panchal10Irfana Musa11Harshil Dhutia12Shirley Sze13Manish Pareek14Michael R. Barer15Development Centre for Population Health, University of Leicester, UK; Department of Respiratory Sciences, University of Leicester, UK; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK; NIHR Leicester Biomedical Research Centre, UK; Li Ka Shing Centre for Health Information and Discovery, University of Oxford, UK; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Sing Faculty of Medicine, University of Hong Kong, Hong Kong, China; Corresponding author at: Department of Respiratory Sciences, University of Leicester, UK.Department of Respiratory Sciences, University of Leicester, UK; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK; Department of Microbiology, University Hospitals of Leicester NHS Trust, UKDepartment of Respiratory Sciences, University of Leicester, UKDepartment of Respiratory Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, UKDepartment of Respiratory Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, UKDepartment of Respiratory Sciences, University of Leicester, UK; Department of Microbiology, University Hospitals of Leicester NHS Trust, UKDevelopment Centre for Population Health, University of Leicester, UK; Department of Respiratory Sciences, University of Leicester, UK; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK; NIHR Leicester Biomedical Research Centre, UKDevelopment Centre for Population Health, University of Leicester, UK; Department of Respiratory Sciences, University of Leicester, UK; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK; NIHR Leicester Biomedical Research Centre, UKDepartment of Acute Medicine, University Hospitals of Leicester NHS Trust, UKDepartment of Geriatric Medicine, University Hospitals of Leicester NHS Trust, UKDepartment of Respiratory Medicine, University Hospitals of Leicester NHS Trust, UKDepartment of Geriatric Medicine, University Hospitals of Leicester NHS Trust, UKDepartment of Cardiology, University Hospitals of Leicester NHS Trust, UKDepartment of Cardiology, University Hospitals of Leicester NHS Trust, UK; Department of Cardiovascular Sciences, University of Leicester, UKDevelopment Centre for Population Health, University of Leicester, UK; Department of Respiratory Sciences, University of Leicester, UK; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK; NIHR Leicester Biomedical Research Centre, UKDepartment of Respiratory Sciences, University of Leicester, UK; Department of Microbiology, University Hospitals of Leicester NHS Trust, UKIntroduction: SARS-CoV-2 may transmit across vaccinated cohorts during practical clinical examinations. We sought to assess the feasibility of facemask sampling (FMS) to identify individuals emitting SARS-CoV-2 during a mock PACES exam. Methods: In May 2022 we recruited participants from a mock PACES examination in Leicester, UK. Following a negative lateral flow test assay, all participants wore modified facemasks able to capture exhaled virus during the assessment (FMS). A concomitant upper respiratory tract sample (URTS) was provided prior to FMS. Exposed facemasks were processed by removal and dissolution of sampling matrices fixed within the mask and cycle thresholds values quantified by RT-qPCR. Participants were asked to grade statements regarding the comfort, effort, ethics and communication when providing FMS; laboratory technicians were asked to grade key statements surrounding suitability of samples for processing. Results: 34 participants provided concomitant URTS and FMS during the examination. One participant was positive for SARS-CoV-2, with a cycle threshold value of 22.5 on URTS, but negative (no viral RNA detected) on FMS; no transmission to others was identified from this individual. Participants responded positively to statements regarding FMS describing all four domains; however, 69% of participants felt that a positive result from FMS alone was insufficient for diagnosis and that further tests were required. All but one FMS sample was suitable for processing. Discussion: FMS during PACES exams are acceptable among participants and samples provided are suitable for processing. Our results demonstrate feasibility of FMS within practical examination settings and support the further assessment of FMS as a scalable tool that can be compared with URTS to identify those who are infectious.http://www.sciencedirect.com/science/article/pii/S2514664524015650SARS-CoV-2TransmissionPACESExaminationAcceptability
spellingShingle Daniel Pan
Caroline Williams
Jonathan Decker
Eve Fletcher
Natalia Grolmusova
Paul W. Bird
Christopher A. Martin
Joshua Nazareth
Latif Rahman
Kate O'Kelly
Rakesh Panchal
Irfana Musa
Harshil Dhutia
Shirley Sze
Manish Pareek
Michael R. Barer
Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations – a feasibility study
Future Healthcare Journal
SARS-CoV-2
Transmission
PACES
Examination
Acceptability
title Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations – a feasibility study
title_full Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations – a feasibility study
title_fullStr Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations – a feasibility study
title_full_unstemmed Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations – a feasibility study
title_short Implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high stakes clinical examinations – a feasibility study
title_sort implementation of facemask sampling for the detection of infectious individuals with sars cov 2 in high stakes clinical examinations a feasibility study
topic SARS-CoV-2
Transmission
PACES
Examination
Acceptability
url http://www.sciencedirect.com/science/article/pii/S2514664524015650
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