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During the coronavirus disease 2019 (COVID-19) pandemic, regular sampling has been unable to keep up with the rapidly changing situation, leading to an increased focus on self-sampling. To evaluate the health and economic effects of self-sampling, we conducted a descriptive analysis of residents who used self-sampling based on data from SoundAI Health. Results revealed that self-sampling was widely accepted among residents of all ages, ranging from 22 days to 116 years old. Of the 650,452 (71.9%) residents, the time from self-sampling to result-reporting was less than one day. Self-sampling was found to save a great deal of manpower and medical resources compared to regular sampling. The practice in Fengtai showed that self-sampling could help the public effectively and economically confront the pandemic, with characteristics of general applicability, equivalent effectiveness, and low cost. In the future, self-sampling can be implemented to introduce prevention and control measures for large-scale epidemics.
Nucleic acid testing is an important measure for detecting patients, diagnosing infection, and preventing and controlling transmission. However, with the rapid spread of the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), regular sampling needs to be optimized. On November 11, 2022, China introduced the Notice on Further Optimizing the Prevention and Control Measures of COVID-19 in a Scientific and Precise Manner, providing 20 detailed measures for improving prevention and control measures of COVID-19 (1). In accordance with the “20 Measures,” some places explored self-sampling to identify people with COVID-19. Fengtai, as a representative of areas conducting pilot projects on SARS-CoV-2 nucleic acid self-sampling in China, provided a standardized procedure for self-sampling (2). After face-to-face or online (self-sampling videos) training, representative residents of each household obtained sampling materials from communities, completed family members and sampling information in SoundAI Health, and finished the process of self-sampling, returning the samples to communities in time (3). Samples were sent to a third-party organization for testing, and residents could get their results through SoundAI Health at any time. To ensure the quality of self-sampling, staff in communities organized various types of training for residents and checked the samples carefully, and SoundAI Health sent notifications in case of any abnormal situation occurring during an operation (4).
In this study, a total of 890,952 community residents in Fengtai underwent self-sampling from November 24 to November 30, 2022. Registered information (after anonymous processing) from SoundAI Health, a widely used WeChat program for COVID-19 related health services in China, such as booking vaccines, querying nucleic-acid testing results, and reporting antigen self-testing results, was analyzed. Descriptive analysis was used to assess the effectiveness of self-sampling, including age, region and time distribution. Age was divided into groups of 10 years, and time was divided into 5 groups (<12 hours, 12–23 hours, 24–35 hours, 36–47 hours, and ≥48 hours). Mean±standard deviation was used to describe continuous age, and frequency and percentage were applied to describe categorical variables. All data analyses were performed in R software (4.0.3; R Core Team, Vienna, Austria).
The age of 890,952 self-sampling residents ranged from 22 days to 116 years old, with a mean of 41.72±18.31 years old. The majority of residents were between 30–39 (21.2%, 188,697) and 40–49 (19.2%, 171,008) years old (Table 1). The number of self-sampling participants increased rapidly from 1,112 in Lize Financial and Business District to 100,355 in Nanyuan Street, covering all streets of Fengtai. After initiating self-sampling, the number of participants increased rapidly from 24,604 on November 24 to 114,572 on November 26, and then remained above 150,000 per day (Figure 1). The time from self-sampling to sample-collecting was mainly within 24 hours (94.9%), particularly within 12 hours (60.0%). The time from self-sampling to result-reporting was mainly <24 hours (66.6%), with residents with time over 48 hours only accounting for 3.4% (Table 1). A total of 289,017 sampling tubes were used; 94.7% of tubes contained 5 or fewer samples for each tube, i.e. “5 Mixed in 1” (Figure 2). During the same period, the daily self-sampling size was 127,279 (890,952 in a week), and the average size of regular sampling at each station was 2,568 per day (5). According to the Guidelines for Normal Nucleic Acid Testing in Beijing, there are 3–5 staff for sampling, information registering, and security at each station. Self-sampling could save numerous manpower and medical resources compared with regular sampling, as it requires fewer staff and stations. The positive rate of self-sampling was 181.49 per 100,000 population, higher than regular sampling (85.71 per 100,000 population).
Characteristic Number Percentage
(%)Age group (years) 0–9 56,891 6.4 10–19 55,132 6.2 20–29 100,172 11.2 30–39 188,697 21.2 40–49 171,008 19.2 50–59 165,294 18.6 60 and above 153,758 17.3 Street name Wangzuo Town 9,812 1.1 Shiliuzhuang 4,328 0.5 Liuliqiao 8,138 0.9 Lize Financial Business District 1,112 0.1 Xiluoyuan 17,170 1.9 Yungang 10,467 1.2 Dahongmen 11,363 1.3 Qingta 13,520 1.5 Fangzhuang 14,355 1.6 Fengtai Science and Technology Park 9,960 1.1 Donggaodi 17,735 2.0 Taipingqiao 18,451 2.1 Wanping 23,346 2.6 Wulidian 24,311 2.7 Changxindian 32,632 3.7 Heyi 33,760 3.8 Huaxiang 33,961 3.8 Yuquanying 36,082 4.0 Youanmen 37,752 4.2 Chengshousi 43,013 4.8 Lugouqiao 48,136 5.4 Majiabao 50,830 5.7 Xincun 51,750 5.8 Kandan 57,957 6.5 Dongtiejiangying 80,734 9.1 Fengtai 99,922 11.2 Nanyuan 100,355 11.3 Time from self-sampling to sample-collecting (hours) <12 534,394 60.0 12–23 311,050 34.9 24–35 24,104 2.7 36–47 13,979 1.6 ≥48 7,425 0.8 Time from self-sampling to result-reporting (hours) <12 47,355 5.3 12–23 593,097 66.6 24–35 178,810 20.1 36–47 41,574 4.7 ≥48 30,116 3.4 Table 1. Characteristics of 890,952 community residents with SARS-CoV-2 nucleic acid self-sampling in Fengtai District, Beijing, November 2022.
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