American journal of infection control · 2026
Timeliness in public health emergency response: An epidemiological assessment of a statewide severe acute respiratory syndrome coronavirus 2 testing initiative (April 2020-July 2021).
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Misterek Sophia, Carvour Martha, Portillo Elsy Barahona, Shostrom Derrick, Cummings Precious-Junia de-Winton
Аннотация
BACKGROUND: Timely diagnostic testing is essential for interrupting transmission and supporting infection prevention during public health emergencies.
METHODS: We conducted a retrospective secondary analysis of cross-sectional data from individuals tested between April 2020 and July 2021 within Test Iowa, a statewide diagnostic initiative. The primary outcome was the interval from symptom onset to testing, classified as early (≤ 4 days) or later (> 4 days) testing. Multivariable logistic regression models identified predictors of later testing, and secondary analyses summarized intervals across the testing process.
RESULTS: Among symptomatic testers, 36% were tested > 4 days after symptom onset. Later testing was associated with age ≥ 50 years, known exposure (aOR = 1.31, 95% CI = 1.28-1.33), and moderate (aOR = 1.13, 95% CI = 1.11-1.16) or severe symptoms (aOR = 1.46, 95% CI = 1.32-1.61). Early testing was more common among healthcare workers (aOR = 0.93, 95% CI = 0.91-0.94) and individuals reporting systemic symptoms (aOR = 0.91, 95% CI = 0.88-0.93). The longest delays occurred between scheduling initiation and testing, while laboratory turn-around time remained stable.
DISCUSSION: Findings indicate that testing delays primarily occured in the early stages of the testing pathway, particularly among high-risk groups.
CONCLUSIONS: Improving scheduling pathways and access to testing sites may enhance diagnostic timeliness and strengthen infection control capacity in future emergencies.
METHODS: We conducted a retrospective secondary analysis of cross-sectional data from individuals tested between April 2020 and July 2021 within Test Iowa, a statewide diagnostic initiative. The primary outcome was the interval from symptom onset to testing, classified as early (≤ 4 days) or later (> 4 days) testing. Multivariable logistic regression models identified predictors of later testing, and secondary analyses summarized intervals across the testing process.
RESULTS: Among symptomatic testers, 36% were tested > 4 days after symptom onset. Later testing was associated with age ≥ 50 years, known exposure (aOR = 1.31, 95% CI = 1.28-1.33), and moderate (aOR = 1.13, 95% CI = 1.11-1.16) or severe symptoms (aOR = 1.46, 95% CI = 1.32-1.61). Early testing was more common among healthcare workers (aOR = 0.93, 95% CI = 0.91-0.94) and individuals reporting systemic symptoms (aOR = 0.91, 95% CI = 0.88-0.93). The longest delays occurred between scheduling initiation and testing, while laboratory turn-around time remained stable.
DISCUSSION: Findings indicate that testing delays primarily occured in the early stages of the testing pathway, particularly among high-risk groups.
CONCLUSIONS: Improving scheduling pathways and access to testing sites may enhance diagnostic timeliness and strengthen infection control capacity in future emergencies.