A Comprehensive Covid-19 Risk Mitigation Strategy For Safe Patient Care And Staff Wellness During A Global Pandemic.

Objective: In the midst of the COVID-19 epidemic and the estimation that the vast majority of the population remains susceptible to SARS-CoV-2 infection, a comprehensive risk mitigation strategy to identify asymptomatic and pre-symptomatic carriers is key to providing safe clinical care during fertility treatment The objective of this study was to evaluate the efficiency of a combined triage protocol and molecular testing for active SARS-CoV-2 viral infection for both patients and staff from a multi-site IVF network Design: Prospective study Materials and Methods: A symptomatic triage was performed whereby all patients were contacted by phone for the presence of COVID-19 symptoms or if they had been in contact with someone suspected or confirmed to be positive for the virus Only patients determined to be at low risk for COVID-19 were allowed to enter the clinic for fertility treatment Both patients and staff were required, upon arrival at the clinic, to wear a mask, complete a symptom-based questionnaire, record body temperature, and keep a safe social distance of more than 6 feet at all times Any individual recording a fever over 100 4OF and/or two or more symptoms was instructed to stay/return home for self-quarantine Specimen collection for viral screening involved an anterior nare sampling method and storage in a FDA approved viral transport medium Viral RNA was isolated using the MagMAX™ Viral/Pathogen II (MVP II) Nucleic Acid Isolation Kit (Thermo Fisher Scientific) Molecular testing for active SARS-CoV-2 viral RNA infection was performed using the FDA emergency use authorized TaqPath™ RT-PCR COVID-19 test (Thermo Fisher Scientific) for every patient within 3-5 days prior to oocyte retrieval or an attempt to achieve a pregnancy, and for all staff bi-weekly Positive cases were reported to each respective local State Health Department Results: Of the 2,074 patients tested for COVID-19 between May and July 2020 across nine fertility clinics in the US, only 3 (0 15%) were found to be positive for SARS-CoV-2 viral RNA infection In all cases the patients were asymptomatic and passed the triage protocol PCR testing of staff bi-weekly identified 6 positive cases All but one indicated having one or two mild symptoms There were no recorded community transmissions among either patients to staff or between staff members Conclusions: A comprehensive risk mitigation strategy that includes a combined triage protocol, safe social distancing and molecular testing for active SARS-CoV-2 viral RNA infection in both patients and staff enables early detection and isolation of infected asymptomatic or pre-symptomatic individuals, thereby creating a safe environment for patient care and staff welfare during the global COVID-19 pandemic