ArticleEClinicalMedicine2021
Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed, 67 citations in OpenAlex.
- Assessment of COVID-19 Messaging Strategies to Increase Testing for Students With Intellectual and Developmental Disabilities.The Journal of school health · 2024Trial
- Hydrogel Bead-Based Assay for the Measurement of Protein Biomarkers in Saliva.ACS measurement science au · 2026Article
- Oropouche Virus Importation in Southern Brazil and Emerging Concern Calling for Enhanced Public Health Surveillance.Journal of medical virology · 2025Article
- Enhanced testing can substantially improve defense against several types of respiratory virus pandemic.Epidemics · 2025Article
- Unintended consequences of measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review.The Cochrane database of systematic reviews · 2024Article
- Development and evaluation of three automated media pooling and molecular diagnostic systems for the detection of SARS-CoV-2.Microbiology spectrum · 2024Article
- Development and validation of cost-effective SYBR Green-based RT-qPCR and its evaluation in a sample pooling strategy for detecting SARS-CoV-2 infection in the Indonesian setting.Scientific reports · 2024Article
- Scalable solutions for global health: the SalivaDirect model.Frontiers in cellular and infection microbiology · 2024Article
- Historical trends demonstrate a pattern of increasingly frequent and severe spillover events of high-consequence zoonotic viruses.BMJ global health · 2023Article
- Building School-Academic Partnerships to Implement COVID-19 Testing in Underserved Populations.Pediatrics · 2023Article
- Saliva and wastewater surveillance for SARS-CoV-2 during school reopening amid COVID-19 pandemic in Thailand.Public health in practice (Oxford, England) · 2023Article
- Pooled RNA-extraction-free testing of saliva for the detection of SARS-CoV-2.Scientific reports · 2023Article
- Implementing the Lolli-Method and pooled RT-qPCR testing for SARS-CoV-2 surveillance in schools: a pilot project.Infection · 2023Article
- COVID-19-Related Facilitators and Barriers to In-Person Learning for Children With Intellectual and Development Disabilities.The Journal of school health · 2023Article
- A multiplexed, paired-pooled droplet digital PCR assay for detection of SARS-CoV-2 in saliva.Scientific reports · 2023Article
- A novel strategy to avoid sensitivity loss in pooled testing for SARS-CoV-2 surveillance: validation using nasopharyngeal swab and saliva samples.Frontiers in public health · 2023Article
- Accelerating the Laboratory Testing Capacity through Saliva Pooling Prior to Direct RT-qPCR for SARS-CoV-2 Detection.Diagnostics (Basel, Switzerland) · 2022Article
- Validation of RT-qPCR test for SARS-CoV-2 in saliva specimens.Journal of infection and public health · 2022Article
- Saliva-based methods for SARS-CoV-2 testing in low- and middle-income countries.Bulletin of the World Health Organization · 2022Article
- Saliva as a diagnostic specimen for SARS-CoV-2 detection: A scoping review.Oral diseases · 2022Article
Corrections and comments
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Authors and funding
43 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe negative impact of continued school closures during the height of the COVID-19 pandemic warrants the establishment of cost-effective strategies for surveillance and screening to safely reopen and monitor for potential in-school transmission. Here, we present a novel approach to increase the availability of repetitive and routine COVID-19 testing that may ultimately reduce the overall viral burden in the community.
methodsWe implemented a testing program using the SalivaClear࣪ pooled surveillance method that included students, faculty and staff from K-12 schools (student age range 5-18 years) and universities (student age range >18 years) across the country (Mirimus Clinical Labs, Brooklyn, NY). The data analysis was performed using descriptive statistics, kappa agreement, and outlier detection analysis.
findingsFrom August 27, 2020 until January 13, 2021, 253,406 saliva specimens were self-collected from students, faculty and staff from 93 K-12 schools and 18 universities. Pool sizes of up to 24 samples were tested over a 20-week period. Pooled testing did not significantly alter the sensitivity of the molecular assay in terms of both qualitative (100% detection rate on both pooled and individual samples) and quantitative (comparable cycle threshold (Ct) values between pooled and individual samples) measures. The detection of SARS-CoV-2 in saliva was comparable to the nasopharyngeal swab. Pooling samples substantially reduced the costs associated with PCR testing and allowed schools to rapidly assess transmission and adjust prevention protocols as necessary. In one instance, in-school transmission of the virus was determined within the main office and led to review and revision of heating, ventilating and air-conditioning systems.
interpretationBy establishing low-cost, weekly testing of students and faculty, pooled saliva analysis for the presence of SARS-CoV-2 enabled schools to determine whether transmission had occurred, make data-driven decisions, and adjust safety protocols. We provide strong evidence that pooled testing may be a fundamental component to the reopening of schools by minimizing the risk of in-school transmission among students and faculty.
fundingSkoll Foundation generously provided funding to Mobilizing Foundation and Mirimus for these studies.
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