Document text
Principal Investigator: AKSHAY SOOD
Organization: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
Fiscal Year: 2021
Award: $958,041
Funding agency: National Institute of General Medical Sciences
ABSTRACT
There are limited studies on the spread of SARS–CoV-2 infection in rural essential workers. This gap-in-knowledge must
be addressed to develop and implement novel pandemic strategies to keep open rural essential workplaces, such as coal
mines. The long-term goal of the study is to mitigate the spread of the pandemic in miners, a population of high-risk, rural
essential workers who are susceptible and vulnerable to COVID-19, and who are predominantly racial/ethnic minorities in
New Mexico (NM). The study objective is to provide proof-of-principle for frequent point-of-care molecular testing as a
workplace surveillance tool to monitor and prevent the spread of SARS-CoV-2 infection in this unique population. The
central hypothesis is that frequent workplace molecular surveillance is an effective method to reduce SARS-CoV-2 infection
and discover novel host risk factors. The site of molecular surveillance (intervention site) will be a surface mine in McKinley
County, NM, located just outside the Navajo Nation, comprised of 66% minority miners. Miners at the intervention site will
provide nasal swabs every alternate work shift, which will be analyzed with the Abbott ID Now™ COVID-19 test, i.e., the
‘index’ test. The control mine located at Campbell County, Wyoming, has similar mine characteristics as the intervention
mine. The rationale for this study is to establish the suitability of longitudinal molecular surveillance to prevent and control
SARS–CoV-2 infection in this unique population by completing the following aims. Specific Aim 1: To determine the
acceptance rate to frequent point-of-care molecular workplace surveillance among miners. Hypothesis 1: Miners will have
a cumulative acceptance rate of frequent testing at ≥85%, with the added objective of exploring difference in acceptance by
miner characteristics. Specific Aim 2: To determine the ability to detect the presence of SARS-CoV-2 by point-of-care
molecular workplace surveillance in a real-world setting of miners. Hypothesis 2: The sensitivity of the index test in a real-
world study setting is a) comparable to that described by others in controlled settings, and b) positively associated with viral
load in upper respiratory specimens. Specific Aim 3: To determine the effectiveness and implementation costs of frequent
point-of-care molecular workplace surveillance on reducing incident infection rates of SARS-CoV-2. Hypothesis 3A:
Frequent point-of-care molecular testing over six months in the intervention mine will result in lower incident seropositivity
rates compared to the control mine. Hypothesis 3B: Frequent point-of-care molecular surveillance in the intervention mine
is cost-effective compared to the control mine. Specific Aim 4: To determine novel predictive host factors associated with
incident SARS-CoV-2 infection in miners. Hypothesis 4: Miners with incident infection demonstrate less frequent use of
cloth face coverings outside the workplace, greater mine dust exposure intensity, presence of dust-related lung disease, and
racial/ethnic minority status than those not infected. Successful completion of the study will establish the acceptability and
effectiveness of the proposed surveillance in work settings where common occupational mitigation strategies are not
possible. Findings from this study will provide broad-reaching implications for novel pandemic strategies to keep rural
essential workplaces open. By working with the NIH RADx-UP Coordinating and Data Collection Center, this study will
provide crucial data for subsequent studies of vaccine interventions in rural minority essential workers.
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