COVID-19 testing in outbreak free care homes: What are the public health benefits?

Green, R, Tulloch, J S P, Tunnah, C, Coffey, E, Lawrenson, K, Fox, A, Mason, J, Barnett, R, Constantine, A, Shepherd, W, Ashton, M, Beadsworth, M B J, Vivancos, R, Hall, I, Walker, Naomi ORCID: https://orcid.org/0000-0002-3345-7694 and Ghebrehewet, S (2021) 'COVID-19 testing in outbreak free care homes: What are the public health benefits?'. Journal of Hospital Infection, Vol 111, pp. 89-95.

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Abstract

BACKGROUND
COVID-19 care home outbreaks represent a significant proportion of COVID-19 morbidity and mortality in the UK. National testing initially focused on symptomatic care home residents, before extending to asymptomatic cohorts.

AIM
The aim was to describe the epidemiology and transmission of COVID-19 in outbreak free care homes.

METHODS
A two-point prevalence survey of COVID-19, in 34 Liverpool care homes, was performed in April and May 2020. Changes in prevalence were analysed. Associations between care home characteristics, reported infection, prevention and control interventions, and COVID-19 status were described and analysed.

FINDINGS
No resident developed COVID-19 symptoms during the study. There was no significant difference between: the number of care homes containing at least one test positive resident between the first (17.6%, 95%CI 6.8-34.5) and second round (14.7%, 95%CI 5.0-31.1) of testing (p>0.99); and the number of residents testing positive between the first (2.1%, 95%CI 1.2-3.4) and second round (1.0%, 95%CI 0.5-2.1) of testing (p=0.11). Care homes providing nursing care (RR 7.99, 95%CI 1.1-57.3) and employing agency staff (RR 8.4, 95%CI 1.2-60.8) were more likely to contain test positive residents. Closing residents shared space was not associated with residents testing positive (RR 2.63, 95%CI 0.4-18.5).

CONCLUSIONS
Asymptomatic COVID-19 care homes showed no evidence of disease transmission or development of outbreaks; suggesting that current infection prevention and control measures are effective in preventing transmission. Repeat testing at 2-3 weeks had limited or no public health benefits over regular daily monitoring of staff and residents for symptoms. These results should inform policies calling for regular testing of asymptomatic residents.

Item Type:	Article
Subjects:	WA Public Health > WA 105 Epidemiology WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 505 Viral respiratory tract infections WX Hospitals and Other Health Facilities > WX 100 General works WX Hospitals and Other Health Facilities > WX 28.61 Hospices and hospice care programs (General coverage)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.jhin.2020.12.024
Depositing User:	Julie Franco
Date Deposited:	19 Jan 2021 13:02
Last Modified:	04 Jun 2021 09:47
URI:	https://archive.lstmed.ac.uk/id/eprint/16700

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