Strategie zum risikostratifizierten Einsatz von Antigen-Schnelltests: Eindämmung der SARS-CoV-2-Pandemie durch die Integration von Schnelltests in das Fall- und Kontaktpersonenmanagement

Zusammenfassung

Der Einsatz von Schnelltests bietet Chancen in der Bekämpfung der SARS-CoV-2 Pandemie; jedoch müssen die Auswirkungen von falsch-positiven und falsch-negativen Testergebnissen und die Reaktion der Bevölkerung antizipiert und berücksichtigt werden, um Schaden zu vermeiden. Auch geht ein ungezielter Einsatz von Schnelltests mit hohen direkten und indirekten Kosten einher und wird bei einem ineffizienten Ressourceneinsatz begrenzte Auswirkungen auf das Pandemiegeschehen haben können. Eine risikostratifizierte Teststrategie kann bei einer direkten Verknüpfung mit dem Fall- und Kontaktpersonenmanagement des Öffentlichen Gesundheitsdienstes (ÖGD) dazu beitragen, ressourceneffizient und nachhaltig die Infektionszahlen zu senken. Die Strategie sollte eine einheitliche Kommunikationsstrategie zum Umgang mit positiven und negativen Testergebnissen, eine gezielte Ausweitung der Zugänge zu niederschwelligen Testmöglichkeiten, die Sicherstellung eines zeitnahen und kostenlosen Zugangs zu den Ergebnissen von Bestätigungstests und die Einbindung in ein übergreifendes Dokumentationssystems zur Evaluation umfassen. Im Rahmen eines risikostratifizierten Einsatzes der Schnelltests sollten alle Personen mit akuten Symptomen einer Atemwegsinfektion sowie Personengruppen mit erhöhtem Risiko für das Bestehen einer SARS-CoV-2 Infektion gezielt getestet werden um „versteckte“ Infektionsnetzwerke zu identifizieren.

Abstract

The use of rapid testing offers an opportunity to contain the SARS-CoV-2 pandemic; however, the impact of false-positive and false-negative test results and population response must be anticipated and taken into consideration to avoid or mitigate harm. Untargeted use of rapid testing is associated with high direct and indirect costs and will have limited impact on the pandemic if resources are used inefficiently. We suggest using a risk-stratified testing strategy, based on targeted testing directly integrated with the Public Health Service's case and contact tracing management. According to the proposed targeted testing strategy stratified by risk of infection, all persons with acute symptoms of a respiratory infection as well as other population groups with an elevated probability of being infected with SARS-CoV-2 infection should be specifically tested to identify “hidden” infection networks. The strategy should include a uniform communication strategy for dealing with positive and negative test results, a targeted expansion of access to low-threshold testing opportunities, ensuring timely and free access to the results of confirmatory tests, and integration into an overarching documentation system for evaluation. This integration of a risk-stratified targeted testing strategy into case and contact tracing management embedded in a comprehensive strategy can help to reduce infection rates in a resource-efficient and sustainable manner.

Schlüsselwörter

COVID-19 - Strategie - Schnelltests - Antigentest - Öffentlicher Gesundheitsdienst - Fall- und Kontaktpersonenmanagement

Key words

COVID-19 - strategy - rapid testing - antigen testing - public health service - contact tracing

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Publication History

Article published online:
08 April 2021

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