Lessons From Mass-Testing for Coronavirus Disease 2019 in Long-Term Care Facilities for the Elderly in San Francisco

Louie, Janice K.; Scott, Hyman; DuBois, Amie; Sturtz, Natalya; Lu, Wendy; Stoltey, Juliet; Masinde, Godfred; Cohen, Stéphanie; Sachdev, Darpun; Philip, Susan; Bobba, Naveena; Aragón, Tomás; Robin, Allen-Contreras; Sabrina, Alonso; Nicole, Copeland; Adam, Corona; Lee, George; Kaylene, Lemen; Ongpin, Melissa; Watson, Lisa; Sheilah, Zarate

doi:10.1093/cid/ciaa1020

Cited by 47 publications

(66 citation statements)

References 5 publications

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“…Geographically we report evidence from eleven countries, the majority (20 studies) are from USA [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] and UK. [36][37][38][39][40] We report evidence from Canada, [41][42][43] France, 44,45 Hong Kong, 46,47 Belgium, 48 Germany, 49 Ireland, 50 Japan, 51 Korea, 52 and Spain 53 (Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Twenty studies report the nature of LTCFs related with outbreaks and transmission of COVID-19 infection (Table 2; 16,23,28,29,31,33,[35][36][37][38][39][41][42][43][45][46][47][50][51][52] ). Thirty studies (Table 3a; [17][18][19][20][21][22][23][24][25][26][27][28][29][32][33][34][37][38][39][40][41][42][43][45][46][47][48][49][50]53 ) report evidence of measures to ...…”

Section: Infection Control Measuresmentioning

confidence: 99%

“…A variety of infection control measures are described (Tables 1 and 3a-c) including: mass testing/point-prevalence testing (22 studies; 17,[19][20][21][22][25][26][27][28][29][30][32][33][34]38,39,44,45,[48][49][50]53 ), use of personal protective equipment (10 studies; 17,18,20,25,28,29,32,45,47,49 ), screening of residents, staff, or visitors for symptoms (8 studies; [18][19][20]23,25,27,29,32 ), restrictions on visitor entry (10 studies; [18][19][20]25,27,29,32,45,49,…”

Section: Infection Control Measuresmentioning

confidence: 99%

“…Morbidity and mortality results from included studies are presented for residents (Table 3a), staff (Table 3b), and visitors (Table 3c). Prevalence of COVID-19 infection was reported in 29 studies, including prevalence in residents (27 studies; [17][18][19][20][21][22][23][24][25][26][27][28][29][32][33][34]38,39,41,43,[45][46][47][48][49][50]53 ) and staff (22 studies; 17,[19][20][21][22]24,[26][27][28][29][30]32,34,38,39,[44][45][46][47][48]…”

Section: Morbidity and Mortalitymentioning

confidence: 99%

“…21 One study reported 16 COVID-19 positive visitor cases, 28 while a study which examined SARS infection following an outbreak in a Hong Kong facility reported 3 positive visitor cases. 47 The symptom status (symptomatic/presymptomatic/asymptomatic, typical/atypical symptoms) of participants was reported in 16 studies, with resident and staff symptom status reported in 15 [17][18][19]21,22,[25][26][27]29,32,33,45,48,50,53 and 13 studies, [19][20][21][22]26,27,29,32,44,45,48,50,53 respectively. No studies reported symptom status of visitors.…”

Section: Morbidity and Mortalitymentioning

confidence: 99%

See 4 more Smart Citations

A rapid systematic review of measures to protect older people in long term care facilities from COVID-19

Frazer

Mitchell

Stokes

et al. 2020

Preprint

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The global COVID-19 pandemic produced large-scale health and economic complications. Older people and those with comorbidities are particularly vulnerable to this virus, with nursing homes and long term care facilities experiencing significant morbidity and mortality associated with COVID-19 outbreaks. The aim of this rapid systematic review was to investigate measures implemented in long term care facilities to reduce transmission of COVID-19 and their effect on morbidity and mortality of residents, staff, and visitors. Databases (including MedRXiv pre-published repository) were systematically searched to identify studies reporting assessment of interventions to reduce transmission of COVID-19 in nursing homes among residents, staff, or visitors. Outcome measures include facility characteristics, morbidity data, case fatalities, and transmission rates. Due to study quality and heterogeneity, no meta-analysis was conducted. The search yielded 1414 articles, with 38 studies included. Reported interventions include mass testing, use of personal protective equipment, symptom screening, visitor restrictions, hand hygiene and droplet/contact precautions, and resident cohorting. Prevalence rates ranged from 1.2-85.4% in residents and 0.6-62.6% in staff. Mortality rates ranged from 5.3-55.3% in residents. Novel evidence in this review details the impact of facility size, availability of staff and practices of operating between multiple facilities, and for-profit status of facilities as factors contributing to the size and number of COVID-19 outbreaks. No causative relationships can be determined; however, this review provides evidence of interventions that reduce transmission of COVID-19 in long term care facilities.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Infection Control Measuresmentioning

confidence: 99%

Section: Infection Control Measuresmentioning

confidence: 99%

Section: Morbidity and Mortalitymentioning

confidence: 99%

Section: Morbidity and Mortalitymentioning

confidence: 99%

See 3 more Smart Citations

A rapid systematic review of measures to protect older people in long term care facilities from COVID-19

Frazer

Mitchell

Stokes

et al. 2020

Preprint

View full text Add to dashboard Cite

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Outcomes of Contact Tracing in San Francisco, California—Test and Trace During Shelter-in-Place

et al. 2021

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Older age has consistently been associated with higher mortality in patients with coronavirus disease 2019 (COVID-19). 1,2 Unfortunately, as shown by Cunningham et al 3 in this issue of JAMA Internal Medicine, COVID-19 does not spare young people. Using a national all-payer hospital database, the investigators identified 3222 nonpregnant adults aged 18 to 34 years who were admitted to US hospitals for COVID-19. Morbidity was substantial: 21% required intensive care, and 2.7% died. Mortality was higher among those who had obesity, hypertension, and male sex, as has been noted in general adult populations.Combined with what we know about the greater risk of older persons, what does this study tell us about COVID-19 and young adults? First, while young adults are much less likely than older persons to become seriously ill, if they reach the point of hospitalization, their risks are substantial. Second, obesity, hypertension, and male sex put patients of all ages at greater risk. As obesity and hypertension are preventable and treatable conditions, reducing the risk of serious COVID 19 illness should be added to the already long list of reasons to increase medical and public health efforts in young adults to promote healthful diets and increased exercise. Finally, the article by Cunningham et al 3 establishes that COVID-19 is a life-threatening disease in people of all ages and that social distancing, facial coverings, and other approaches to prevent transmission are as important in young adults as in older persons.

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Surveillance testing reveals a significant proportion of hospitalized patients with SARS-CoV-2 are asymptomatic

Arnold

Bishop

Oppy

et al. 2021

American Journal of Infection Control

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Background: The proportion of positive patients admitted to acute-care hospitals for reasons other than coronavirus disease-19 (COVID-19) is unknown. These patients potentially put other patients and healthcare workers at risk of infection. Objective: The objective of this study was to define the proportion of asymptomatic patients admitted with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Secondary objectives were to define the positivity rate, reasons for admission, and the geographic distribution in the region. Methods: Universal surveillance testing for SARS-CoV-2 was performed on patients admitted to this hospital over a 12-week period from April 9, 2020 to July 1, 2020. Positive patients were categorized as either symptomatic or asymptomatic as defined by the 11 criteria per the Centers for Disease Control and Prevention. The positivity rate, proportion with and without symptoms, reasons for admission, and geographic distribution in the region were recorded. Results: The positivity rate ranged from 0.8% to 6.2%. The proportion of asymptomatic patients with SARS-CoV-2 was 37%. Asymptomatic patients primarily presented to the hospital because of either trauma or labor. Some clusters in the region were identified of both symptomatic and asymptomatic patients. Conclusions: The proportion of asymptomatic patients admitted with SARS-CoV-2 was significant. Identifying and isolating asymptomatic patients likely prevented exposure and development of hospital-acquired COVID-19 cases among healthcare workers and other patients, supporting the universal surveillance of all admitted patients.

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Lessons From Mass-Testing for Coronavirus Disease 2019 in Long-Term Care Facilities for the Elderly in San Francisco

Cited by 47 publications

References 5 publications

A rapid systematic review of measures to protect older people in long term care facilities from COVID-19

A rapid systematic review of measures to protect older people in long term care facilities from COVID-19

Outcomes of Contact Tracing in San Francisco, California—Test and Trace During Shelter-in-Place

Surveillance testing reveals a significant proportion of hospitalized patients with SARS-CoV-2 are asymptomatic

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