Objectives: The COVID-19 pandemic has had a profound impact on population health, with the prevalence and severity of the
illness being higher in cancer patients due to their immunosuppressive state. Cancer clinics should consider routine staff and
patient testing as people infected with COVID-19 may have very mild or no symptoms while they can still transmit the virus to
others, acting as super spreaders. The study aim is to assess the prevalence of SARS-CoV-2 in asymptomatic healthcare workers
and patients and the impact of preventative measures in a UK private oncology provider.
Study design: Asymptomatic staff and patients enter a prospective screening program, the SARS-CoV-2 Antigen Testing
Program (COVID-ATP), consisting of the nationally approved real time Polymerase-Chain-Reaction (RT-PCR) nasopharyngeal
swab test looking for SARS-CoV-2 viral RNA. The program runs April to December 2020 and covers the period of the 1st
lockdown, the summer period of viral remission and the second wave in autumn/winter 2020. Here we present our preliminary
results between April and October 2020.
Methods: Asymptomatic staff working across 14 centres are tested weekly and cancer patients are tested at specific intervals
depending on their treatment plan. The COVID-ATP testing program is complemented by staff and patient adherence to infection
prevention control (IPC) procedures, social distancing, clinic spacing, virtual clinics, intense cleaning routines and appropriate
Personal Protective Equipment (PPE) use.
Results: 204 healthcare workers and 21 patients are tested on average each week. The prevalence of asymptomatic staff infection
was 0.8% shortly after the first lockdown in April/May 2020, reduced to 0% between June/July 2020, increased to 1% in August/
September and was 0.8% in September/October 2020. Two asymptomatic patients tested positive on routine testing, towards the
end of the 1st lockdown.
Conclusion: This is the first longitudinal study in a UK private healthcare group, who applied a systematic testing program
to assess the prevalence of asymptomatic COVID-19 in healthcare workers and patients. The prevalence of asymptomatic
COVID-19 in staff is similar to the community prevalence in England at the time of testing and the temporal prevalence reflects
the community prevalence trends. The protective measures taken within centres and the self-isolation of staff testing positive,
resulted in lack of viral spread.
COVID-19 RT-PCR; Infection Prevention Control; SARS-CoV-2
ATP : Antigen Testing Program; COVID-ATP : SARS-CoV-2 Antigen Testing Program (COVID-ATP); IPC : Infection Prevention Control;
MDT : Multidisciplinary Team; NHS : National Health Service; PPE : Personal Protective Equipment; RT-PCR : real time polymerase