On the impact of mass screening for SARS-CoV-2 through self-testing in Greece

Samuel Gilmour; Spyros Sapounas; Kimon Drakopoulos; Patrick Jaillet; Gkikas Magiorkinis; Nikolaos Trichakis

doi:10.3389/fpubh.2024.1352238

On the impact of mass screening for SARS-CoV-2 through self-testing in Greece

Front Public Health. 2024 Mar 6:12:1352238. doi: 10.3389/fpubh.2024.1352238. eCollection 2024.

Authors

Samuel Gilmour¹, Spyros Sapounas², Kimon Drakopoulos³, Patrick Jaillet¹, Gkikas Magiorkinis⁴, Nikolaos Trichakis¹

Affiliations

¹ Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, United States.
² National Public Health Organisation, Athens, Greece.
³ Department of Data Sciences and Operations, Marshall School of Business, University of Southern California, Los Angeles, CA, United States.
⁴ Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Abstract

Background: Screening programs that pre-emptively and routinely test population groups for disease at a massive scale were first implemented during the COVID-19 pandemic in a handful of countries. One of these countries was Greece, which implemented a mass self-testing program during 2021. In contrast to most other non-pharmaceutical interventions (NPIs), mass self-testing programs are particularly attractive for their relatively small financial and social burden, and it is therefore important to understand their effectiveness to inform policy makers and public health officials responding to future pandemics. This study aimed to estimate the number of deaths and hospitalizations averted by the program implemented in Greece and evaluate the impact of several operational decisions.

Methods: Granular data from the mass self-testing program deployed by the Greek government between April and December 2021 were obtained. The data were used to fit a novel compartmental model that was developed to describe the dynamics of the COVID-19 pandemic in Greece in the presence of self-testing. The fitted model provided estimates on the effectiveness of the program in averting deaths and hospitalizations. Sensitivity analyses were used to evaluate the impact of operational decisions, including the scale of the program, targeting of sub-populations, and sensitivity (i.e., true positive rate) of tests.

Results: Conservative estimates show that the program reduced the reproduction number by 4%, hospitalizations by 25%, and deaths by 20%, translating into approximately 20,000 averted hospitalizations and 2,000 averted deaths in Greece between April and December 2021.

Conclusion: Mass self-testing programs are efficient NPIs with minimal social and financial burden; therefore, they are invaluable tools to be considered in pandemic preparedness and response.

Keywords: COVID-19 testing; compartmental models; epidemic modelling; mass screening; non-pharmaceutical interventions.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / diagnosis
COVID-19* / epidemiology
Greece / epidemiology
Humans
Mass Screening
Pandemics / prevention & control
SARS-CoV-2*
Self-Testing

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. We gratefully acknowledge funding from SYN-ENOSIS, the Greek Shipowners’ Social Welfare Company.