Yale’s pilot COVID-19 screening program has shown that the university can efficiently and effectively conduct asymptomatic testing for the novel coronavirus — and that there are currently few positive test results among individuals without symptoms in the university community, program leaders said.
A low rate of asymptomatic infection is important because people who test positive for COVID-19 without showing symptoms are potential vectors for transmitting the virus.
Yale launched the pilot program May 20. Since then, the university has tested nearly 1,500 faculty members, students, and staff — including essential workers who have been on campus throughout the pandemic and those who returned after June 1 as part of Yale’s phased laboratory reactivation plan.
The university offered voluntary testing to 5,000 employees via email. Each person was asked to fill out a questionnaire to determine whether they had COVID-19-related symptoms.
Because the pilot focused on testing people with no symptoms, Yale advised employees with symptoms to contact their primary care physician; employees without symptoms were eligible for screening.
Among all the tests, there were five positive results, yielding an overall positive rate of 0.27%.
“That’s very similar to the asymptomatic testing pilot being done at Yale New Haven Hospital,” said Dr. Madeline Wilson, chief quality officer at Yale Health and chair of the COVID-19 Testing and Tracing Committee. “It’s encouraging there are so few asymptomatic positives — but that doesn’t mean anyone should let their guard down.”
Four of the five individuals who tested positive were asymptomatic. One individual had an inconclusive result that was treated as positive with mild symptoms.
For the pilot program, individuals with no symptoms who wanted to be tested scheduled their appointment online. Yale Health staff conducted the tests — as many as 200 per day — at the Prospect-Sachem Garage. Most tests required only two minutes.
“It worked very smoothly,” Wilson said. “People liked being able to self-schedule their test, and we were able to get them the results quickly.”
Screening will remain in place as Yale prepares to welcome graduate and professional school students and a portion of the undergraduate population back to campus for the fall semester.
All undergraduate students (whether living on or off campus) will be screened upon arrival to campus and will undergo viral testing weekly throughout the semester, as will graduate and professional school students living in university dormitory-style housing. Graduate and professional students living off campus will be screened once at the start of the fall semester, with additional testing available if required by academic programs involving direct patient care or if a student has concerns about exposure.
All faculty, student-facing staff, and post-doctoral trainees who will be on campus during the fall semester will be screened at the start of the semester. Staff and post-doctoral trainees who do not interact with students will be encouraged, but not required, to be tested for COVID-19 at the start of the semester.
In the pilot program, Yale used two types of COVID-19 screening tests. The majority were nasopharyngeal swab tests, in which a swab is inserted into a nostril and used to collect a secretion sample from the back of the nose and throat. Screeners also used an anterior nasal swab test that individuals conduct themselves with supervision from Yale Health staff.
Via the digital health information site MyChart, Yale Health notified individuals about their screening results as soon as they were finalized.
Individuals who tested positive were directly contacted the same day by health care staff, who reviewed the results with them, asked them to self-isolate, notified their supervisor, and initiated a contact tracing process.
Wilson said Yale Health maintains patient privacy throughout screening and contact tracing. Contact tracers do not reveal the names of individuals who test positive, for example.
Linda Niccolai, a professor of epidemiology and director of the Connecticut Emerging Infections program at Yale, is leading the university’s contact tracing efforts. When an employee tests positive and agrees to contact tracing, a trained interviewer helps identify other people they have been physically near (within six feet) for at least 15 minutes during the previous two days.
Wilson said that, for the five positive cases detected thus far, a total of 12 contacts were identified. All individuals were considered to be low risk and none needed to be quarantined, she said.
The Yale program only seeks out contacts who, like the employees who tested positive, are part of the Yale community, she added. The university advises people who test positive to notify all non-Yale contacts of their status.
The screening program has developed a website to provide complete details for what an employee can expect — in terms of medical care, contact tracing, and privacy — in the event they test positive. In addition, Yale plans to offer testing to university employees who are identified during the contact tracing process.
“There is understandable anxiety about all of this, which is why we want to be clear and complete about what people will experience,” Wilson said. “Asymptomatic testing is an important part of building confidence as we move ahead for faculty, staff, and students. We know there is a reassuringly low number of asymptomatic positive cases on campus, and these test efforts are part of a communal effort to reduce risk.”
