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

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

Future Healthcare Journal (Dec 2024)

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

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

Affiliations

Daniel Pan: Development 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.
Caroline Williams: 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, UK
Jonathan Decker: Department of Respiratory Sciences, University of Leicester, UK
Eve Fletcher: Department of Respiratory Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, UK
Natalia Grolmusova: Department of Respiratory Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, UK
Paul W. Bird: Department of Respiratory Sciences, University of Leicester, UK; Department of Microbiology, University Hospitals of Leicester NHS Trust, UK
Christopher A. Martin: Development 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
Joshua Nazareth: Development 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
Latif Rahman: Department of Acute Medicine, University Hospitals of Leicester NHS Trust, UK
Kate O'Kelly: Department of Geriatric Medicine, University Hospitals of Leicester NHS Trust, UK
Rakesh Panchal: Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, UK
Irfana Musa: Department of Geriatric Medicine, University Hospitals of Leicester NHS Trust, UK
Harshil Dhutia: Department of Cardiology, University Hospitals of Leicester NHS Trust, UK
Shirley Sze: Department of Cardiology, University Hospitals of Leicester NHS Trust, UK; Department of Cardiovascular Sciences, University of Leicester, UK
Manish Pareek: Development 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
Michael R. Barer: Department of Respiratory Sciences, University of Leicester, UK; Department of Microbiology, University Hospitals of Leicester NHS Trust, UK

Journal volume & issue: Vol. 11, no. 4
p. 100175

Abstract

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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.

Published in Future Healthcare Journal

ISSN: 2514-6645 (Print); 2514-6653 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine
Website: https://www.sciencedirect.com/journal/future-healthcare-journal

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