Wilmes Paul, Zimmer Jacques, Schulz Jasmin, Glod Frank, Veiber Lisa, Mombaerts Laurent, Rodrigues Bruno, Aalto Atte, Pastore Jessica, Snoeck Chantal J, Ollert Markus, Fagherazzi Guy, Mossong Joël, Goncalves Jorge, Skupin Alexander, Nehrbass Ulf
Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 7 avenue des Hauts-Fourneaux, L-4362 Esch-sur-Alzette, Luxembourg.
Department of Life Sciences and Medicine, Faculty of Science, Technology and Medicine, University of Luxembourg, 6 avenue du Swing, L-4367 Belvaux, Luxembourg.
Lancet Reg Health Eur. 2021 May;4:100056. doi: 10.1016/j.lanepe.2021.100056. Epub 2021 Feb 27.
To accompany the lifting of COVID-19 lockdown measures, Luxembourg implemented a mass screening (MS) programme. The first phase coincided with an early summer epidemic wave in 2020.
rRT-PCR-based screening for SARS-CoV-2 was performed by pooling of samples. The infrastructure allowed the testing of the entire resident and cross-border worker populations. The strategy relied on social connectivity within different activity sectors. Invitation frequencies were tactically increased in sectors and regions with higher prevalence. The results were analysed alongside contact tracing data.
The voluntary programme covered 49% of the resident and 22% of the cross-border worker populations. It identified 850 index cases with an additional 249 cases from contact tracing. Over-representation was observed in the services, hospitality and construction sectors alongside regional differences. Asymptomatic cases had a significant but lower secondary attack rate when compared to symptomatic individuals. Based on simulations using an agent-based SEIR model, the total number of expected cases would have been 42·9% (90% CI [-0·3, 96·7]) higher without MS. Mandatory participation would have resulted in a further difference of 39·7% [19·6, 59·2].
Strategic and tactical MS allows the suppression of epidemic dynamics. Asymptomatic carriers represent a significant risk for transmission. Containment of future outbreaks will depend on early testing in sectors and regions. Higher participation rates must be assured through targeted incentivisation and recurrent invitation.
This project was funded by the Luxembourg Ministries of Higher Education and Research, and Health.
为配合新冠疫情封锁措施的解除，卢森堡实施了一项大规模筛查（MS）计划。第一阶段恰逢2020年初夏的疫情高峰。
采用基于逆转录实时荧光定量聚合酶链反应（rRT-PCR）的方法对样本进行混合检测以筛查严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。该基础设施能够对全体居民和跨境工作者进行检测。该策略依赖于不同活动部门内部的社交联系。在患病率较高的部门和地区，有针对性地提高了邀请检测的频率。并结合接触者追踪数据对结果进行了分析。
该自愿计划覆盖了49%的居民和22%的跨境工作者。共发现850例索引病例，通过接触者追踪又发现了249例。在服务业、酒店业和建筑业以及不同地区观察到了病例数过多的情况。与有症状个体相比，无症状病例的二代发病率虽显著但较低。基于使用基于主体的易感-暴露-感染-康复（SEIR）模型的模拟结果，如果没有大规模筛查，预计病例总数将高出42.9%（90%置信区间[-0.3, 96.7]）。强制参与将导致进一步的差异，即高出39.7%[19.6, 59.2]。
战略性和战术性的大规模筛查能够抑制疫情动态。无症状携带者是传播的重大风险因素。未来疫情的控制将取决于在各部门和地区进行早期检测。必须通过有针对性的激励措施和反复邀请来确保更高的参与率。
该项目由卢森堡高等教育与研究部和卫生部资助。
