Effectiveness and Use of RT‐PCR Point of Care Testing in a Large‐Scale COVID ‐19 Surveillance System

Rapid COVID-19 testing platforms can identify infected individuals at the point-of-care (POC), allowing immediate isolation of infected individuals and reducing the risk of transmission. While lab-based nucleic acid amplification testing (NAAT) is often considered the gold standard to detect SARS-CoV-2 in the community, results typically take 2-7 days to return, rendering POC testing a critical diagnostic tool for infection control. The National Football League (NFL) and NFL Players Association deployed a new POC testing strategy using a newly available RT-PCR rapid test during the 2020 season, and evaluated diagnostic effectiveness compared to other available devices using real-world population surveillance data.RT-PCR point-of-care test results were compared to NAAT results from same-day samples by calculation of positive and negative concordance. Sensitivity analyses were performed for three subgroups: 1) individuals symptomatic at time of positive test, 2) individuals tested during the pilot phase of rollout, and 3) individuals tested daily.Among 4,989 same-day POC/NAAT pairs, 4,957 (99.4%) were concordant, with 93.1% positive concordance and 99.6% negative concordance. Based on adjudicated case status, the false negative rate was 0.2% and false positive rate was 2.9%. In 43 instances, the immediate turnaround of results by POC allowed isolation of infected individuals one day sooner than lab-based testing. Positive/negative concordance in sensitivity analyses were relatively stable.RT-PCR point-of-care testing provided timely results that were highly concordant with lab-based NAAT in population surveillance. Expanded use of effective RT-PCR POC can enable rapid isolation of infected individuals and reduce COVID-19 infection in the community. This article is protected by copyright. All rights reserved.