2. Overview of test options
- Chan J.F.-W.
- Yip C.C.-Y.
- To K.K.-W.
- Tang T.H.-C.
- Wong S.C.-Y.
- Leung K.-H.
- et al.
3. Brief description of the test and characteristics
4. Ancillary testing options
5. Lung imaging
6. Strategic approach to testing
7. Case definitions for high performance sport
|Outcome||Risk||Risk if there is no PoC test||Risk if PoC test is implemented||Risk Difference||Relevant Risk Mitigation Strategy|
|False negative COVID-19||False negative is not able to be confirmed by the public health lab||100% of COVID cases will continue to interact with the community actively spreading the infection as a test would not have occurred.||Up to 30% of cases tested could be a false negative||Risk is lower by completing PoC testing||Patient should be isolated and retested next day if there are clinical concerns for a false negative|
|False negative that can be corrected by the public health laboratory||Could not occur as the public laboratory does not need to confirm its own result||The chances of this occurring are unknown but expected to be small with units listed in Table 1.||This should be small given the similar automated tests are used in the public hospital setting||Consider sending a proportion of negative samples to a public health laboratory for confirmation.|
|False positive COVID-19||If a positive is identified and the public health lab is unable to confirm this||Could not occur as no confirmation test is done||Unnecessary diagnosis, further investigation and isolation|
Unnecessary intensity of clinical monitoring
Stigma attached to having COVID-19
Initiating therapeutics assuming positive result
|False positive rates are expected to be small|
Treatment is currently only symptomatic treatment and isolation, no pharmacological risk currently
|Informed consent within the team prior to doing test|
Careful maintenance and cleaning of working space to limit contamination
May require additional support from team doctor/mental health professional
|False positive that can be corrected by the public health laboratory||Could not occur||Consider probability that a low positive sample degrades prior to reference laboratory testing|
Confusion and distrust in PoC test
|Discordant PoC to public health laboratory results could occur. The chances of this occurring are unknown||Reference laboratory testing is a risk mitigation strategy|
Review for sources of contamination in testing workflow
Complete additional negative quality controls
Option of re-testing same individuals 24 hours later
- •PCR testing is the only means of identifying individuals who are asymptomatic carriers of SARS-CoV-2, however the false negative rates in this period is unclear.
- •Asymptomatic patients likely account for 44–55% of SARS-CoV-2 transmissions and has significant implications for community transmission.
- •High performance/professional sport may look to allocate resources to dedicated PCR testing as a part of medical service provision to its athletes for improved time to test result or expanded indications for testing.
- •Any expanded testing framework should prioritise circumstances of elevated pre-test probability. Regular surveillance of well people may be useful in larger groups.
- •Implementing PoC PCR should only occur after due consideration of the local regulatory frameworks; capacity to manage identified cases and reporting obligations, capacity to implement appropriate quality standards, and biosafety at all stages of testing.
- •Portable PCR testing in sport is potentially useful for teams when time to test result is crucial or for teams travelling internationally where access to testing is limited.
- •Portable PCR testing in sport is likely only suitable for a subset of high performance/professional sport considering the initial and ongoing cost, requirement for a doctor with an appropriate skill set and access to sufficient personal protective equipment (PPE).
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☆Rapid response papers and have not undergone the full peer review process.