Strategies for testing: costs and human resource requirements

To inform implementation of active testing strategies, we developed a conceptual framework for testing that consisted of 6 stages, which was used for each of the 5 groups: 1) scheduling, 2) sampling, 3) test transport, 4) laboratory RT-PCR analysis, 5) communication of results and 6) acting on results (e.g., contact tracing). Through discussion with public health officials and laboratory managers in Quebec, we estimated human resource requirements for each stage of each strategy. Full details of how each strategy would be conducted are shown in Appendix 1. In brief, we estimated the number of health care professionals, clerical and laboratory personnel required per day (1 d was 8 h; we considered part-time staff) for each strategy. We assumed sampling could be done at existing sampling centres by nurses or onsite by mobile teams. Mobile teams would visit health care facilities with ≥ 5 employees, essential businesses with ≥ 20 employees, and all schools; all others (including contacts) would be referred to existing sampling centres. We employed a microcosting approach for all recurrent costs (2020 Canadian dollars), using a health system perspective. These included costs of materials (e.g., personal protective equipment [PPE], nasopharyngeal swabs, reagents), personnel and transportation. We obtained costs from nationally representative sources. We did not include capital costs of scaling capacity (e.g., equipment, training) or existing infrastructure.