Regular COVID-19 Screenings Among Nursing Home Workers Safeguarded Residents, Extended Lives
Frequent COVID-19 Surveillance Testing in Nursing Homes Saves Lives, Study Finds
A new study published in the New England Journal of Medicine has revealed that nursing homes with more frequent staff surveillance testing experienced lower rates of COVID-19 infections and deaths among residents.
The study, led by Brian McGarry, found that frequent testing was particularly effective before the availability of vaccines. According to McGarry, surveillance testing is a crucial part of any infectious disease response.
Before vaccines were available, nursing home residents and staff were among the most vulnerable populations, with high infection rates and mortality due to close contact and shared living spaces. Regular surveillance testing helped identify asymptomatic and pre-symptomatic infections, which was critical to preventing outbreaks in these settings.
The primary source of data for this study was the Centers for Medicare and Medicaid Services (CMS) COVID-19 Nursing Home Database, a mandatory federal repository containing information submitted weekly by skilled nursing facilities on COVID testing routines, cases, and deaths.
The researchers separated their analysis into three timeframes: pre-COVID vaccine availability, post-vaccine but before the omicron wave, and during the omicron wave. During the pre-vaccine period, faster test turnaround time for lab-processed COVID tests was associated with fewer resident deaths.
The study did not find a strong association between surveillance testing and cases or deaths during the omicron wave, possibly due to reduced vaccine efficacy against infections during this period. However, frequent surveillance testing was associated with fewer resident cases but no difference in deaths, consistent with the reduction in vaccine efficacy for preventing COVID infections, but not in preventing hospitalizations and deaths.
For nursing homes that predominantly used lab-processed COVID tests, faster test turnaround time was associated with fewer resident deaths. Rapid COVID tests became widely available in nursing homes due to the federal government's decision to prioritize these facilities for distribution by August 2020.
Had all facilities performed an additional test per staff member per week during the pre-vaccine phase, an estimated 30 percent of resident cases and 26 percent of resident COVID deaths could have been prevented.
The U.S. nursing home industry consists of 1.7 million staff and over 4 million short and long stay residents. Despite representing only 2% of the U.S. population, nursing home residents accounted for 20% of COVID deaths through the end of 2021.
In conclusion, the study's findings suggest that frequent COVID-19 surveillance testing could have significantly reduced COVID cases and deaths among nursing home residents, particularly during the pre-vaccine phase of the pandemic. The study underscores the importance of regular testing as part of a broader infection prevention strategy in vulnerable populations.
[1] Centers for Disease Control and Prevention (CDC). (2020). Interim Guidance for Implementing the Shared Healthcare Decision-Making Model for Nursing Home Residents During the COVID-19 Pandemic. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html
[2] Centers for Medicare & Medicaid Services (CMS). (2020). Nursing Home COVID-19 Data Reporting Requirements. Retrieved from https://www.cms.gov/files/document/nursing-home-covid-19-data-reporting-requirements.pdf
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