Evaluation of a novel anterior nasal swab for the detection of SARS-CoV-2.

BACKGROUND: During the course of the COVID-19 pandemic, nasopharyngeal swabs, combined throat and nose swabs and saliva samples have been evaluated for SARS-CoV-2 detection using nucleic acid amplification tests (NAT). Literature on anterior nasal swabs is limited. We investigated a novel anterior nasal swab that has been designed to standardised self-collection, maximise sample uptake and improve user comfort. We used combined throat and nose swabs and neat saliva samples as the comparators. RESULTS: The overall positive percentage agreement between the Rhinoswab™ and the combined throat and nose swab was 95.2 % at day 2 post participant recruitment and 93.3 % on day 4 post participant recruitment. This was favourable to the positive percentage agreement with saliva at the same time points. CONCLUSION: In our study the Rhinoswab™ performed equally well in comparison to a combined throat and nose swab for the laboratory detection of SARS-CoV-2 using nucleic acid amplification techniques.

State-wide genomic epidemiology investigations of COVID-19 in healthcare workers in 2020 Victoria, Australia: Qualitative thematic analysis to provide insights for future pandemic preparedness.

Background: COVID-19 has affected many healthcare workers (HCWs) globally. We performed state-wide SARS-CoV-2 genomic epidemiological investigations to identify HCW transmission dynamics and provide recommendations to optimise healthcare system preparedness for future outbreaks. Methods: Genome sequencing was attempted on all COVID-19 cases in Victoria, Australia. We combined genomic and epidemiologic data to investigate the source of HCW infections across multiple healthcare facilities (HCFs) in the state. Phylogenetic analysis and fine-scale hierarchical clustering were performed for the entire dataset including community and healthcare cases. Facilities provided standardised epidemiological data and putative transmission links. Findings: Between March-October 2020, approximately 1,240 HCW COVID-19 infection cases were identified; 765 are included here, requested for hospital investigations. Genomic sequencing was successful for 612 (80%) cases. Thirty-six investigations were undertaken across 12 HCFs. Genomic analysis revealed that multiple introductions of COVID-19 into facilities (31/36) were more common than single introductions (5/36). Major contributors to HCW acquisitions included mobility of staff and patients between wards and facilities, and characteristics and behaviours of patients that generated numerous secondary infections. Key limitations at the HCF level were identified. Interpretation: Genomic epidemiological analyses enhanced understanding of HCW infections, revealing unsuspected clusters and transmission networks. Combined analysis of all HCWs and patients in a HCF should be conducted, supported by high rates of sequencing coverage for all cases in the population. Established systems for integrated genomic epidemiological investigations in healthcare settings will improve HCW safety in future pandemics. Funding: The Victorian Government, the National Health and Medical Research Council Australia, and the Medical Research Future Fund.