"As capacity for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) diagnostics has expanded, both with assay types (nucleic acid amplification tests, NAATs, antigen tests, and serology) and specimen collection options (nasopharyngeal, NP; oropharyngeal, OP; saliva; mid-turbinate, MT; anterior nares, AN), interest in the use of routine, serial screening of asymptomatic individuals in a variety of settings has expanded. Notably, the use of asymptomatic surveillance in higher education and professional and nonprofessional athletics has become commonplace, but transmission in these settings has also been linked to lapses in implementation of basic infection prevention practices such as masking and physical distancing. Given the considerable interest in asymptomatic surveillance in areas outside of healthcare, the question of the utility of routine screening among healthcare
personnel (HCP) in acute-care facilities has been raised. In this focused review, we describe the reported risk of acquisition of infection after HCP exposures to occultly infected patients,
the risk acquisition of infection by patients exposed to occultly infected HCP, and the prevalence of asymptomatic infection among HCP in settings where screening has been implemented. We also assess the potential role or routine surveillance of asymptomatic HCP to reduce the risk of nosocomial transmission from HCP-to-HCP and HCP-to-patient. We report on the early experience of acute-care facilities that have offered screening of asymptomatic HCP outside confirmed exposures, and we conclude with considerations for facilities considering offering screening, either “on demand” or as part of routine surveillance.
