Efficacy of COVID-19 outbreak management in a skilled nursing facility based on serial testing for early detection and control

Garibaldi, Pedro Manoel Marques; Ferreira, Nilson; Moraes, Glenda R.; Moura, José Carlos de; Espósito, Danillo Lucas Alves; Volpe, Gustavo Jardim; Calado, Rodrigo T.; Fonseca, Benedito Antônio Lopes da; Borges, Marcos C.

doi:10.1016/j.bjid.2021.101570

Cited by 15 publications

(17 citation statements)

References 19 publications

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“…Our finding that staff at site A had high preexisting seroprevalence (>40%) prior to intensive monitoring suggests this facility experienced a prior outbreak and had a level of immunity that limited spread of the virus from the two positive staff members ( 45 ). It is possible that other control measures and policies instituted at the time of monitoring, such as negative pressure isolation space ( 46 ), surveillance and monitoring systems, quarantine of positive staff ( 40 , 47 – 49 ), environmental cleaning ( 50 , 51 ), and other measures ( 52 ) additionally contributed to protection against outbreaks. It is notable that at both sites, seroprevalence reached a maximum of 40% during the study period, suggesting this might correspond to a level of naturally acquired immunity when coupled with other preventative measures.…”

Section: Discussionmentioning

confidence: 99%

Durable Antibody Responses in Staff at Two Long-Term Care Facilities, during and Post SARS-CoV-2 Outbreaks

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Durable Antibody Responses in Staff at Two Long-Term Care Facilities, during and Post SARS-CoV-2 Outbreaks

et al. 2021

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“…Early in the COVID-19 pandemic, in many facilities, only individuals with COVID-like symptoms were tested, due to limited testing resources. However, several studies show that screening symptomatic cases only is not enough to control outbreaks [33,16,17]. Starting in March 2020, the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) offered various COVID-19 surveillance testing strategies to hospitals, nursing homes, schools, and other facilities, as the pandemic progressed.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Apart from suggestions provided by the government, managers and researchers in various facilities developed their own surveillance testing strategies, combined with contact interventions, based on the facility's contact patterns and healthcare resources. In LTCs for example, the strategies include daily individual health screening via surveys or front desk checks [3,16], daily temperature and oxygen level checks [33], serological anti-body checks [31], and reverse transcription-polymerase chain reaction (RT-PCR) tests.…”

Section: Literature Reviewmentioning

confidence: 99%

Surveillance Testing for Rapid Detection of Outbreaks in Facilities

Ding,

Agrawal,

Cao

et al. 2021

Preprint

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This paper develops an agent-based disease spread model on a contact network in an effort to guide efforts at surveillance testing in small to moderate facilities such as nursing homes and meat-packing plants. The model employs Monte Carlo simulations of viral spread sample paths in the contact network. The original motivation was to detect COVID-19 outbreaks quickly in such facilities, but the model can be applied to any communicable disease. In particular, the model provides guidance on how many test to administer each day and on the importance of the testing order among staff or workers.

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“…A further recommendation was for asymptomatic healthcare personnel to be tested after exposure to a SARS‐CoV‐2‐positive individual and to self‐isolate for 14 days following the exposure 8 . Multiple NHs were able to keep outbreaks under control with serial testing of residents and staff 9–15 …”

Section: Introductionmentioning

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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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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Efficacy of COVID-19 outbreak management in a skilled nursing facility based on serial testing for early detection and control

Cited by 15 publications

References 19 publications

Durable Antibody Responses in Staff at Two Long-Term Care Facilities, during and Post SARS-CoV-2 Outbreaks

Durable Antibody Responses in Staff at Two Long-Term Care Facilities, during and Post SARS-CoV-2 Outbreaks

Surveillance Testing for Rapid Detection of Outbreaks in Facilities

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

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