Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Sarwat Chaudhry

Abstract

Mass screening has been shown to be more efficient in identifying infections in correctional facilities compared to symptom-based screening, but little is known about the impact of systematic mass screening on timely isolation of infectious cases over the course of the entire pandemic. Between March 2020 and May 2023, the Connecticut Department of Correction (CT DOC) performed a multifaceted SARS-CoV-2 testing strategy for its incarcerated population, which included RT-PCR for mass screening, as well as rapid antigen testing for contact tracing, symptom-based screening, and other miscellaneous reasons. Testing data reveals that mass screening identified 48% of all positive results, whereas contact tracing and symptom-based screening captured 31% and 1%, respectively. In order to ascertain the impact of mass screening on SARS-CoV-2 detection and transmission, resident housing data was used to approximate the movement of individuals into isolation after testing positive for SARS-CoV-2. Through a linear difference-in-difference model, mass screening is estimated to have prevented 877 exposure-days to susceptible cell- and cellblock-mates for each index case who tested positive. This evaluation suggests that a systematic mass screening program is compatible with timely identification and isolation of infectious cases, with some operational limitations to controlling a respiratory pandemic within a vulnerable congregate setting.

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This is an Open Access Thesis.

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