Agreement Between SARS-CoV-2 PCR Test Results Using Nasopharyngeal and Mid-Turbinate Specimens Among Asymptomatic Working-Age Adults.

OBJECTIVE: The aim of this study was to determine whether mid-turbinate specimens reliably detect active infection in asymptomatic adults undergoing regular COVID-19 PCR testing. METHODS: Qualitative agreement between 2481 paired nasopharyngeal and mid-turbinate PCR results was assessed. Mean cycle threshold values for each positive result were evaluated as an indicator of active infection. RESULTS: Overall agreement between nasopharyngeal and mid-turbinate tests was 98.4%. Positive percent agreement was 37.2%, and negative percent agreement was ~100%. Test pairs with lower cycle thresholds (≤30 and ≤25) reached 67% and 100% positive percent agreement, respectively. CONCLUSIONS: SARS-CoV-2 infections with high viral loads were detected regardless of specimen type. Mid-turbinate swabs reduced staff discomfort and may decrease repeated positive test results weeks or months after initial infection. Discordant pairs generally had high cycle threshold values (>30) indicating low viral load and little risk of transmitting COVID-19.

The Shell Disability Management Program: a five-year evaluation of the impact on absenteeism and return-on-investment.

OBJECTIVE: To evaluate the impact of the Shell Disability Management Program (DMP) on U.S. manufacturing employee absenteeism. METHODS: We estimated absence episodes and days lost per employee from 2004 to 2008 compared to pre-program values in 2002, and productivity gains from transitional duty (TD). RESULTS: Between 2002 and 2008, absence episodes/100 employees decreased from 37.4 to 25.7 among hourly workers but increased from 9.7 to 13.1 among staff employees. Days lost per employee decreased from 7.4 to 5.2 for hourly employees and were virtually unchanged for staff employees. TD resulted in 6042 days saved in 2006 and 11,438 days in 2008, with direct cost savings of more than $4.1 million from 2006 to 2008. CONCLUSIONS: The Shell DMP emphasizes absence tracking, timely return-to-work, and facilitation of TD. Absenteeism decreased significantly after DMP implementation, particularly among hourly employees, with an estimated 2.4:1 return-on-investment.