Heather Pedersen

Background Evidence of long-term impacts of COVID-19 related public health restrictions on digital sexually transmitted and blood borne infection (STBBI) testing utilization is limited. We assessed these impacts on GetCheckedOnline (a digital testing resource for STBBIs) relative to all STBBI tests in British Columbia (BC). Methods Interrupted time series analyses were conducted using GetCheckedOnline program data comparing monthly test episodes (STBBI tests per requisition) among BC residents, stratified by BC region, testers’ sociodemographic and sexual risk profiles, for the pre-pandemic (March 2018-February 2020) and pandemic periods (March 2020-October 2021). Trends in GetCheckedOnline testing per 100 STBBI tests in BC regions with GetCheckedOnline were analysed. Each outcome was modelled using segmented generalized least squared regression. Results Overall, 17,215 and 22,646 test episodes were conducted in the pre-pandemic and pandemic periods. Monthly GetCheckedOnline test episodes reduced immediately after restrictions. By October 2021(end of pandemic period), monthly GetCheckedOnline testing increased 21.24 test episodes per million BC residents (95%CI: -11.88, 54.84) and GetCheckedOnline tests per 100 tests in corresponding BC regions increased 1.10 (95%CI: 0.02, 2.17) above baseline trends. After initial increases among users at higher STBBI risk (symptomatic testers/testers reporting sexual contacts with STBBIs), testing decreased below baseline trends later in the pandemic, while monthly GetCheckedOnline testing increased among people ≥40 years, men who have sex with men, racialized minorities, and first-time testers via GetCheckedOnline. Conclusions Sustained increases in utilization of digital STBBI testing during the pandemic suggest fundamental changes in STBBI testing in BC, highlighting the need for accessible and appropriate digital testing, especially for those most affected by STBBIs.

Background: We assessed the performance, stability, and user acceptability of swab-independent self-collected saliva and saline mouth rinse/gargle sample types for the molecular detection of SARS-CoV-2 in adults and school-aged children. Methods: Outpatients who had recently been diagnosed with COVID-19 or were presenting with suspected COVID-19 were asked to have a nasopharyngeal swab collected and provide at least one self-collected sample type. A portion of participants were also asked about sample acceptability. Samples underwent molecular testing using multiple assays. Saline mouth rinse/gargle and saliva samples were tested daily at time zero, day one, and day 2 to assess nucleic acid stability at room temperature. Results: 50 participants (aged 4 to 71 years) were included; of these, 40 had at least one positive sample and were included in the primary sample yield analysis. Saline mouth rinse/gargle samples had a sensitivity of 98% (39/40) while saliva samples had a sensitivity of 79% (26/33). Both saline mouth rinse/gargle and saliva samples showed stable viral RNA detection after 2 days of room temperature storage. Mouth rinse/gargle samples had the highest (mean 4.9) and HCW-collected NP swabs had the lowest acceptability scores (mean 3.1). Conclusion: Saline mouth rinse/gargle samples demonstrated the highest combined user acceptability ratings and analytical performance when compared with saliva and HCW collected NP swabs. This sample type is a promising swab-independent option, particularly for outpatient self-collection in adults and school aged children.