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Objective: To compare the concordance and acceptability of saliva testing with standard‐of‐care oropharyngeal and bilateral deep nasal swab testing for severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) in children and in general practice. Design: Prospective multicentre diagnostic validation study. Setting: Royal Children's Hospital, and two general practices (cohealth, West Melbourne; Cirqit Health, Altona North) in Melbourne, July–October 2020. Participants: 1050 people who provided paired saliva and oropharyngeal‐nasal swabs for SARS‐CoV‐2 testing. Main outcome measures: Numbers of cases in which SARS‐CoV‐2 was detected in either specimen type by real‐time polymerase chain reaction; concordance of results for paired specimens; positive percent agreement (PPA) for virus detection, by specimen type. Results: SARS‐CoV‐2 was detected in 54 of 1050 people with assessable specimens (5%), including 19 cases (35%) in which both specimens were positive. The overall PPA was 72% (95% CI, 58–84%) for saliva and 63% (95% CI, 49–76%) for oropharyngeal‐nasal swabs. For the 35 positive specimens from people aged 10 years or more, PPA was 86% (95% CI, 70–95%) for saliva and 63% (95% CI, 45–79%) for oropharyngeal‐nasal swabs. Adding saliva testing to standard‐of‐care oropharyngeal‐nasal swab testing increased overall case detection by 59% (95% CI, 29–95%). Providing saliva was preferred to an oropharyngeal‐nasal swab by most participants (75%), including 141 of 153 children under 10 years of age (92%). Conclusion: In children over 10 years of age and adults, saliva testing alone may be suitable for SARS‐CoV‐2 detection, while for children under 10, saliva testing may be suitable as an adjunct to oropharyngeal‐nasal swab testing for increasing case detection. [ABSTRACT FROM AUTHOR]

Objectives: To design and evaluate 3D‐printed nasal swabs for collection of samples for SARS‐CoV‐2 testing. Design: An iterative design process was employed. Laboratory evaluation included in vitro assessment of mock nasopharyngeal samples spiked with two different concentrations of gamma‐irradiated SARS‐CoV‐2. A prospective clinical study compared SARS‐CoV‐2 and human cellular material recovery by 3D‐printed swabs and standard nasopharyngeal swabs. Setting, participants: Royal Melbourne Hospital, May 2020. Participants in the clinical evaluation were 50 hospital staff members attending a COVID‐19 screening clinic and two inpatients with laboratory‐confirmed COVID‐19. Intervention: In the clinical evaluation, a flocked nasopharyngeal swab sample was collected with the Copan ESwab and a mid‐nasal sample from the other nostril was collected with the 3D‐printed swab. Results: In the laboratory evaluation, qualitative agreement with regard to SARS‐CoV‐2 detection in mock samples collected with 3D‐printed swabs and two standard swabs was complete. In the clinical evaluation, qualitative agreement with regard to RNase P detection (a surrogate measure of adequate collection of human cellular material) in samples collected from 50 hospital staff members with standard and 3D‐printed swabs was complete. Qualitative agreement with regard to SARS‐CoV‐2 detection in three pairs of 3D‐printed mid‐nasal and standard swab samples from two inpatients with laboratory‐confirmed SARS‐CoV‐2 was also complete. Conclusions: Using 3D‐printed swabs to collect nasal samples for SARS‐CoV‐2 testing is feasible, acceptable to patients and health carers, and convenient. [ABSTRACT FROM AUTHOR]

During this period, our laboratory at Royal Melbourne Hospital performed 15 358 SARS-CoV-2 RT-PCR tests from 12 569 unique persons, using published methods3 (Box 1); 12 215 tests (80%) were for people who attended health services for SARS-CoV-2 testing, and 3143 (20%) for symptomatic or asymptomatic health care workers. Limited clinical value of early repeat RT-PCR testing for SARS-CoV-2 Keywords: COVID-19; Diagnosis; Respiratory tract infections; Infectious diseases EN COVID-19 Diagnosis Respiratory tract infections Infectious diseases 42 43 2 07/06/21 20210701 NES 210701 The analytic performance of the gold standard diagnostic test for severe acute respiratory syndrome coronavirus (SARS-CoV-2), reverse transcription polymerase chain reaction (RT-PCR), has been described.1 However, data on its clinical performance, which may be affected by pre-analytical factors - such as stage of illness, anatomic sample site, and sample collection - are more limited.2 We therefore assessed the frequency and characteristics of discordant repeat SARS-CoV-2 RT-PCR results between 1 June and 21 July 2020, during the second wave of coronavirus disease 2019 (COVID-19) in Melbourne. [Extracted from the article]

2 * Hot wards are wards dedicated to managing patients with confirmed or suspected COVID-19. 3 † COVID-19 wards are wards where patients with confirmed or suspected COVID-19 were managed. Keywords: COVID-19; Infectious diseases; Respiratory tract infections; Infection control EN COVID-19 Infectious diseases Respiratory tract infections Infection control 101 101 1 03/12/21 20210215 NES 210215 The response to the largest institutional outbreak of COVID-19 in health care workers in Australia to date needed to be multidimensional In many countries, high rates of health care workers with coronavirus disease 2019 (COVID-19) have been associated with inadequate personal protective equipment (PPE), exposure to large numbers of patients with COVID-19, worker fatigue, and limited access to diagnostic testing.1-3 In Australia, during the initial phase of the epidemic, infections in health care workers were largely attributable to international travel, corroborated by genomically distinct severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lineages.4,5 At the Royal Melbourne Hospital, we observed a marked increase in staff infections during July and August 2020, concurrent with a statewide surge in COVID-19 cases. As increasing numbers of staff infections were recognised, the density of patients on the COVID-19 wards was reduced by closing beds in shared rooms and moving each patient to a single room where possible. The ICU had between zero and ten concurrent patients with COVID-19 over the period (median, 7; interquartile range [IQR], 5.0-8.0), with four ICU staff acquiring COVID-19. [Extracted from the article]