Analysis of Higher Education Athletic Department COVID-19 Testing: A Comparison of Screening Versus Testing-Based Protocols.

Abstract

Objective: To determine efficacy of screening-based versus testing COVID-19 management protocols.

Design: Retrospective analysis.

Setting: Athletic departments of a National Association of Intercollegiate Athletics (NAIA) and National Collegiate Athletic Association (NCAA) Division I institution.

Patients: All student-athletes (n = 303 and 437) and staff (n = 34 and 291) within the NAIA and NCAA athletic departments. Total cohort (n = 1065).

Interventions: The authors analyzed the independent variables of screening and testing rates.

Main outcome measures: Dependent variables of positive rates, percent positive rates, competition missed, and cost were analyzed.

Results: The screening-based protocol (n = 20 798) generated 139 tests and a percent positive rate of 10.07% for student-athletes. Half of the staff (17 of 34) also had positive results. Protocol costs were $45,038 and 29 games were missed among all teams. The testing-based protocol did not screen but tested student-athletes 14 837 times, which resulted in 158 positives (P < 0.00001) and a percent positive rate of 1.06%. Only 14.37% (43 of 291) of staff tested positive (P < 0.00001). Protocol costs were $1,616 570 and 43 games were missed among all teams.

Conclusions: The testing-based protocol protected student-athletes and staff better than the screening-based protocol, but at >35 times the cost. Neither protocol resulted in severe infections necessitating hospitalizations, and fewer games were missed in the screening-based protocol. Because institutions have different levels of financial support, varied but viable protocols are needed.