Feasibility and effectiveness of daily temperature screening to detect COVID-19 in a prospective cohort at a large public university

Shelley N. Facente, Lauren A. Hunter, Laura J. Packel, Yi Li, Anna Harte, Guy Nicolette, Shana McDevitt, Maya Petersen, Arthur L. Reingold

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: Many persons with active SARS-CoV-2 infection experience mild or no symptoms, presenting barriers to COVID-19 prevention. Regular temperature screening is nonetheless used in some settings, including university campuses, to reduce transmission potential. We evaluated the potential impact of this strategy using a prospective university-affiliated cohort. Methods: Between June and August 2020, 2912 participants were enrolled and tested for SARS-CoV-2 by PCR at least once (median: 3, range: 1–9). Participants reported temperature and symptoms daily via electronic survey using a previously owned or study-provided thermometer. We assessed feasibility and acceptability of daily temperature monitoring, calculated sensitivity and specificity of various fever-based strategies for restricting campus access to reduce transmission, and estimated the association between measured temperature and SARS-CoV-2 test positivity using a longitudinal binomial mixed model. Results: Most participants (70.2%) did not initially have a thermometer for taking their temperature daily. Across 5481 total person months, the average daily completion rate of temperature values was 61.6% (median: 67.6%, IQR: 41.8–86.2%). Sensitivity for SARS-CoV-2 ranged from 0% (95% CI 0–9.7%) to 40.5% (95% CI 25.6–56.7%) across all strategies for self-report of possible COVID-19 symptoms on day of specimen collection, with corresponding specificity of 99.9% (95% CI 99.8–100%) to 95.3% (95% CI 94.7–95.9%). An increase of 0.1 °F in individual mean body temperature on the same day as specimen collection was associated with 1.11 increased odds of SARS-CoV-2 positivity (95% CI 1.06–1.17). Conclusions: Our study is the first, to our knowledge, that examines the feasibility, acceptability, and effectiveness of daily temperature screening in a prospective cohort during an infectious disease outbreak, and the only study to assess these strategies in a university population. Daily temperature monitoring was feasible and acceptable; however, the majority of potentially infectious individuals were not detected by temperature monitoring, suggesting that temperature screening is insufficient as a primary means of detection to reduce transmission of SARS-CoV-2.

Original languageEnglish (US)
Article number1693
JournalBMC Public Health
Volume21
Issue number1
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • COVID-19
  • Detection
  • Fever
  • SARS-CoV-2
  • Screening
  • Temperature monitoring
  • Thermometer

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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