SARS-CoV-2 in Nursing Homes after 3 Months of Serial, Facilitywide Point Prevalence Testing, Connecticut, USA

Ehrlich, Hanna Y.; Harizaj, Adora; Campbell, Lauren; Colt, McKenzie; Yuan, Karen; Rabatsky‐Ehr, Therese; Weinberger, Daniel M; Leung, Vivian; Niccolai, Linda M.; Parikh, Sunil

doi:10.3201/eid2705.204936

Cited by 14 publications

(22 citation statements)

References 23 publications

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“…Many NHs that successfully mitigated an outbreak with facility‐wide testing were supported by the local hospital, laboratory, or public health services. 10 , 13 , 33 , 34 Other studies have shown that a cohort ward or being able to isolate positive residents and having enough staff was key facilitators to mitigating an outbreak. 10 , 13 , 34 , 35 This is in agreement with our findings.…”

Section: Discussionmentioning

confidence: 99%

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Implementation of a national testing policy in Dutch nursing homes during SARS‐CoV‐2 outbreaks

Besselaar

Spaargaren

Smalbrugge

et al. 2022

J American Geriatrics Society

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Background: To evaluate how a national policy of testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) regardless of symptoms was implemented during outbreaks in Dutch nursing homes in the second wave of the pandemic and to explore barriers and facilitators to serial testing. Methods:We conducted a mixed-method study of nursing homes in the Netherlands with a SARS-CoV-2 outbreak after 15 September 2020. Direct care staff and management from 355 healthcare organizations were invited to participate in a digital survey. A total of 74 out of 355 (20.9%) healthcare organizations participated and provided information about 117 nursing homes. We conducted 26 in-depth interviews on the outbreak and the testing strategy used. We also conducted four focus group meetings involving managers, physicians, nurses, and certified health assistants. Recordings were transcribed and data were thematically analyzed. Results: One hundred and four nursing homes (89%) tested residents regardless of their symptoms during the outbreak, and 85 nursing homes (73%) tested the staff regardless of their symptoms. However, interviews showed testing was sometimes implemented during later stages of the outbreak and was not always followed up with serial testing. Barriers to serial testing regardless of symptoms were lack of knowledge of local leaders with decisional making authority, lack of a cohort ward or skilled staff, and insufficient collaboration with laboratories or local public health services. Important facilitators to serial testing were staff willingness to undergo testing and the availability of polymerase chain reaction (PCR) tests. Conclusions: Serial testing regardless of symptoms was only partially implemented. The response rate of 21% of nursing home organizations gives a risk of selection bias. Barriers to testing need to be addressed. A national implementation policy that promotes collaboration between public health

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Section: Discussionmentioning

confidence: 99%

“…8 Multiple NHs were able to keep outbreaks under control with serial testing of residents and staff. 9 , 10 , 11 , 12 , 13 , 14 , 15 …”

Section: Introductionmentioning

confidence: 99%

Implementation of a national testing policy in Dutch nursing homes during SARS‐CoV‐2 outbreaks

Besselaar

Spaargaren

Smalbrugge

et al. 2022

J American Geriatrics Society

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“…There was also a significant increase in COVID-19 deaths occurring at Hospitals (72.3% to 80.8%) and Homes (6.3% to 8.8%) during the Delta variant surge compared to the prior surge. The reduced deaths rates in the Care Homes during the Delta variant surge are probably due to multiple interventions, first of which is the infection control and protective measures implemented in the Care Homes with the lessons learned from previous surges [9][10][11][12][13][14] . The greater adoption of COVID-19 vaccination among the Care Home residents and immunity from previous SARS-CoV2 infections are also potential contributary factors for reduced deaths during the Delta variant surge in Care Homes which need further study 17,[27][28][29] .…”

Section: Discussionmentioning

confidence: 99%

“…During the COVID-19 global pandemic caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), Care Homes and long-term care facilities (LTCFs) worldwide plunged into crisis which resulted in 25-50% of total COVID-19 deaths in various countries during the early part of the pandemic [1][2][3][4][5][6] . Numerous preventive measures were taken all over the world to reduce the COVID-19 infections among the Care Home residents and to improve the outcomes [7][8][9][10][11][12][13][14][15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Changing dynamics of COVID-19 deaths during the SARS-CoV2 B.1.617.2 (Delta variant) outbreak in England and Wales: Reduced COVID-19 deaths among the Care Home residents

Emani

Reddy²,

Emani

et al. 2022

Preprint

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Objectives Care Homes faced crisis during the SARS-CoV2 pandemic with increased mortality and various corrective interventions were undertaken. The impact of current SARS-CoV2 B.1.617.2 (Delta variant) outbreak on COVID-19 deaths in Care Homes is not completely known. Design Observational study Setting and Participants We included nationwide data of deaths from all causes and COVID-19 in England and Wales during March 7, 2020-November 26, 2021. Methods Impact of COVID-19 deaths in Care Homes, Hospital and Homes relative to total deaths from all causes was investigated. Results During March 7-August 28,2020; 15,414 (29.8%) of the 51,740 COVID-19 deaths occurred in Care Homes. During August 29, 2020-May 28, 2021, there were significant decrease in COVID-19 deaths in Care Homes ([19.2%]; RR 0.64; 95%CI 0.63-0.65;p<0.0001], which significantly declined further ([8.9%]; RR 0.46; 95%CI 0.43-0.48;p<0.0001) during May 29-November 26, 2021. During the March 7-August 28, 2020; 20.0% (15,514/76,906) of all Care Home deaths were caused by COVID-19, which significantly declined to 18.5% (RR 0.92; 95%CI 0.90-0.93; p<0.0001) during August 29, 2020-May 28, 2021 and declined further to 2.5% (RR 0.13; 95% CI 0.12-0.14;p<0.0001) during May 29-November 26, 2021. Increased percentages of COVID-19 deaths occurred in Hospitals ([72.3%]; RR 1.14; 95% CI 1.1-1.15;p<0.0001) and Homes ([6.3%]; RR 1.33; 95% CI 1.27-1.40; p<0.0001) during August 29, 2020-May 28, 2021 and further increases in the Hospitals ([80.8%]; RR 1.11; 95% CI 1.10-1.12; p<0.0001) and Homes ([8.8%]; RR 1.39; 95% CI 1.31-1.47; p<0.0001) during May 29-November 26, 2021. Conclusions and Implications There was a significantly lower number of COVID-19 deaths occurred in Care Homes and a significantly lower number of Care Homes deaths caused by COVID-19 during the Delta variant surge in England and Wales than the prior surges. Care Home residents are at highest risk for mortality, continuous monitoring and research on COVID-19 preventive interventions are essential.

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“…Previous studies have observed that congregate settings with increased testing rates also have increased incidence rates. 55 , 56 , 57 Other research has shown the ability of serial testing to halt outbreaks in these settings. 58 Our findings contribute to the literature in showing the continuum of this association by comparing settings with low testing rates to those with high testing rates.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Testing and Case Rates and Social Contact Among Residential College Students in Connecticut During the 2020-2021 Academic Year

et al. 2021

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Key Points Question What is the association between COVID-19 testing and case rates on residential college campuses? Findings In this cohort study of 18 Connecticut colleges and universities, infrequent COVID-19 testing of residential students was not associated with decreased transmission, whereas testing of residential students twice per week was associated with decreased transmission during the 2020-2021 academic year. Meaning Findings suggest that twice-weekly COVID-19 testing of residential students may serve as an effective infection mitigation strategy at colleges and universities.

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SARS-CoV-2 in Nursing Homes after 3 Months of Serial, Facilitywide Point Prevalence Testing, Connecticut, USA

Cited by 14 publications

References 23 publications

Implementation of a national testing policy in Dutch nursing homes during SARS‐CoV‐2 outbreaks

Implementation of a national testing policy in Dutch nursing homes during SARS‐CoV‐2 outbreaks

Changing dynamics of COVID-19 deaths during the SARS-CoV2 B.1.617.2 (Delta variant) outbreak in England and Wales: Reduced COVID-19 deaths among the Care Home residents

COVID-19 Testing and Case Rates and Social Contact Among Residential College Students in Connecticut During the 2020-2021 Academic Year

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