Evaluating the implementation of a saliva-based screening program for detection of COVID-19


The COVID-19 pandemic caused tremendous suffering, mortality, and economic disturbance worldwide. To safely reopen businesses and schools, institutions needed to develop approaches to rapidly identify COVID-19 cases and manage their spread while balancing program effectiveness, feasibility, costs, and scalability.


In partnership with colleagues from across the University of Pennsylvania and Penn Medicine, we developed a bi-weekly asymptomatic screening program called Covid SAFE (Screening Assessment for Exposure) that leveraged a saliva-based test developed by Penn Medicine scientists. The test produced results rapidly and used internally developed reagents to avoid potential supply chain shortages.

Covid SAFE remotely enrolled participants, enacted automated bidirectional text message communications, managed symptom monitoring, and automatically reported test results. We implemented the program as a research study to allow for experimentation and learning in real-time. During the rollout, we leveraged insights from behavioral economics to test different recruitment strategies and measured components of the program, such as long-term test adherence.


By January 2021, approximately 4,000 members of the Penn Medicine community had enrolled in Covid SAFE, and over 24,000 tests had been conducted.

The program provided confidence that mitigation measures were working, enabling faculty, staff, and students to feel safe on campus. Participants reported high satisfaction, with more than 90 percent stating that the saliva test was easy, not painful, and felt safe to complete. And retention rates were impressive, with fewer than 50 people unenrolling from the program during its tenure.

Due to an increase in the vaccinated population and a decline in COVID-19 cases in Philadelphia, the Covid SAFE surveillance testing program was closed in June 2021. Insights gathered during the design and implementation of this program – such as the fact that opt-out framed recruitment messaging increased enrollment into the program and the overall test completion rate - can inform other health promotion efforts needed to address the COVID-19 pandemic.


Penn Medicine, Rapid Assay Task Force, Way to Health


Penn Medicine