AUTHOR=Kheiroddin Parastoo , Schöberl Patricia , Althammer Michael , Cibali Ezgi , Würfel Thea , Wein Hannah , Kulawik Birgit , Buntrock-Döpke Heike , Weigl Eva , Gran Silvia , Gründl Magdalena , Langguth Jana , Lampl Benedikt , Judex Guido , Niggel Jakob , Pagel Philipp , Schratzenstaller Thomas , Schneider-Brachert Wulf , Gastiger Susanne , Bodenschatz Mona , Konrad Maike , Levchuk Artem , Roth Cornelius , Schöner David , Schneebauer Florian , Rohrmanstorfer René , Dekens Marcus P. , Brandstetter Susanne , Zuber Johannes , Wallerstorfer Daniel , Burkovski Andreas , Ambrosch Andreas , Wagner Thomas , Kabesch Michael
TITLE=Results of WICOVIR Gargle Pool PCR Testing in German Schools Based on the First 100,000 Tests
JOURNAL=Frontiers in Pediatrics
VOLUME=9
YEAR=2021
URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.721518
DOI=10.3389/fped.2021.721518
ISSN=2296-2360
ABSTRACT=Background: Opening schools and keeping children safe from SARS-CoV-2 infections at the same time is urgently needed to protect children from direct and indirect consequences of the COVID-19 pandemic. To achieve this goal, a safe, efficient, and cost-effective SARS-CoV-2 testing system for schools in addition to standard hygiene measures is necessary.
Methods: We implemented the screening WICOVIR concept for schools in the southeast of Germany, which is based on gargling at home, pooling of samples in schools, and assessment of SARS-CoV-2 by pool rRT-PCR, performed decentralized in numerous participating laboratories. Depooling was performed if pools were positive, and results were transmitted with software specifically developed for the project within a day. Here, we report the results after the first 13 weeks in the project.
Findings: We developed and implemented the proof-of-concept test system within a pilot phase of 7 weeks based on almost 17,000 participants. After 6 weeks in the main phase of the project, we performed >100,000 tests in total, analyzed in 7,896 pools, identifying 19 cases in >100 participating schools. On average, positive children showed an individual CT value of 31 when identified in the pools. Up to 30 samples were pooled (mean 13) in general, based on school classes and attached school staff. All three participating laboratories detected positive samples reliably with their previously established rRT-PCR standard protocols. When self-administered antigen tests were performed concomitantly in positive cases, only one of these eight tests was positive, and when antigen tests performed after positive pool rRT-PCR results were already known were included, 3 out of 11 truly positive tests were also identified by antigen testing. After 3 weeks of repetitive WICOVIR testing twice weekly, the detection rate of positive children in that cohort decreased significantly from 0.042 to 0.012 (p = 0.008).
Interpretation: Repeated gargle pool rRT-PCR testing can be implemented quickly in schools. It is an effective, valid, and well-received test system for schools, superior to antigen tests in sensitivity, acceptance, and costs.