Delays can have devastating consequences, as even an undetected infection can cause a large-scale epidemic silently but temporarily.
This article was published thursday, November 12, 2020 on Kaiser Health News.
By Jordan Rau and Lauren Weber and Rachana Pradhan
Care centers still take days to suffer the effects of the COVID-19 test, as many avoid the Trump administration’s central strategy of restricting the spread of the virus among elderly and ill-health Americans.
In late summer, federal officials began distributing millions of antigenic tests at the point of service to nursing homes, which can be performed on site and report the presence or absence of the virus within minutes. Human Services is expected to submit approximately 23 million immediate tests.
But as of October 25, 38% of the country’s approximately 15,000 nursing homes had still used a point-of-care test, according to KHN’s investigation into nursing home records.
The figures recommend a basic word war between the Trump administration, public fitness officials and nursing home directors about how productive it is to control this population and how to strike the right balance between speed and accuracy. Many nursing homes still basically send samples to labs a type of verification that is considered more reliable, but that can take days to provide results.
As a result, in 29% of the approximately 13,000 services that provided their speed control to the government, the effects on citizens took an average of 3 days or more, according to the analysis. Only 17% of nursing homes said their average response time was less than one day, and the rest tended to have effects in a day or two. Waiting times for the effects of staff member controls were similar.
These delays can have devastating consequences, as even an undetected infection can cause a large-scale epidemic silently but temporarily. This is a specific fear as winter arrives and the pandemic records infections.
Meanwhile, coronavirus continues to paint in institutions. Care homes have reported more than 262,000 infections and 59,000 deaths since the government began collecting data in May. Even without previously estimating the number of COVID-19 citizens, reported nursing home deaths account for more than a quarter of all COVID-19 deaths in the United States to date.
In the week ending October 25, the most known recent era, a third of qualified nursing services reported a new suspected coronavirus infection from a resident or member.
Many public health and nursing facilities have constant reservations about immediate verification. They are believed to be less accurate than the dearest sent to laboratories, known as polymerase chain reaction, or PCR, which verify and identify the genetic appearance of the virus however, it takes days. And their brands say that immediate verification is designed for others with symptoms and not for the detection of a general population.
In early November, the Food and Drug Administration warned of false positive effects, in which a user who is inflamed, related to an immediate type of COVID test, is wrongly told, and suggested that providers follow the recommendations of the Centers for Disease Control and Prevention for use in nursing homes. False negatives are also a cause for concern, as other people who don’t know they are inflamed would possibly accidentally spread the virus.
HHS bought millions of quick checks for distribution to nursing homes, as the federal government imposed new mandates on establishments to review them at least once a month. Routine verification increases up to twice a week for homes in spaces with the highest infection rates. State health insurance
Leaders in several states, including Nevada, Vermont, and Illinois, must prohibit antigen testing at retirement homes or restrict their use.
“I think the hardest component was testing at other institutions,” said David Grabowski, a professor of fitness policy at Harvard Medical School. Instead, he said, “the main obstacles to immediate testing appear to be a lack of recommendation on when and how to use the evidence, along with considerations of its accuracy. “
Dr. Michael Wasserman, beyond the president of the California Long-Term Care Medicine Association, said the national effort is chaotic and inadequate.
The federal government “just entrusts things to nursing homes and then says, “Hey, it’s up to you, go ahead,” he said. “And then, when things fall apart, “We’re not to blame. “
Care homes that do not accept immediate testing as true have to take over from laboratory testing. It costs Stuart Almer, president and CEO of Gurwin Jewish Nursing $125,000 a week
“We settle for the tests,” Almer said, “but how are we going to keep working and pay for it?”
Goodwin House in Virginia, which includes professional nursing services and assisted living services, had conducted more than 9,500 tests for COVID-19 by the end of October, said Joshua Bagley, an administrator. Only a hundred of them were antigen tests. ” Most of our attention still focuses on PCR testing,” Bagley said.
Considerations from state fitness officials were perhaps more evident in Nevada, where in early October the state banned antigen testing in nursing homes. HHS said the order was illegal and revoked within days.
“There is no better test,” Said Admiral Brett Giroir, a senior HHS official leading the Trump administration’s COVID testing efforts, in a call with reporters on November 9. For example, Said Giroir, a threat of PCR testing is that it can provide a positive diagnosis when a user is no longer “truly contagious”.
While there have been widespread accuracy issues with antigen testing, some tests that the administration distributes nationally have accuracy comparable to laboratory testing, he said.
Other state responses were not as competitive as Nevada’s, however, they expressed concern about how to use the devices, if any.
Vermont recommends using antigen tests after known exposure to COVID, but says they should not be used to diagnose asymptomatic people.
Ohio was first and foremost reluctant to implement them after Republican Gov. Mike DeWine’s false positive result of an antigenic device, testing has been passed, said Peter Van Runkle, executive director of the Ohio Health Care Association, which represents qualified nursing centers. in the state.
Some nursing homes say the use of antigenic controls has made a monumental difference. In Humanson, Kansas, Wesley Towers Retirement Community used both types of controls, however, it was Abbott’s BinaxNOW antigen control that detected his first two asymptomatic people with COVID-19, said Gretchen Sapp, vice president of fitness at Wesley Towers.
“We are more convinced that ours does not really have COVID or that they are absent and do not disclose to residents. And that’s incredibly useful,” Sapp said.
A total of 1,150 families told the federal government that they did not have enough materials for point-of-care testing for all workers, according to KHN’s analysis. Care homes can temporarily pass millions of tests per month or more common tests, depending on the tip of COVID-19 in the region.
White House spokesman Michael Bars said the administration is “on hand with our state and our local partners” and “doing more than ever for the health and protection of high-risk equipment of maximum age vulnerable to the virus. “
Janet Snipes, executive director of the Holly Heights Care Center in Denver, said antigen verification has been helpful in evaluating staff members despite some false positive results. A check used on a member of the clergy that a resident had summoned.
“We couldn’t have let him in, but we had to do the antigen test,” he said. “With the most vulnerable citizens we serve, we expect more antigen testing, more trial periods, more testing of any kind. “
Jordan Rau: jrau@kff. org, @JordanRau
Lauren Weber: LaurenW@kff. org, @LaurenWeberHP
Rachana Pradhan: rpradhan@kff. org, @rachanadixit
“The main obstacles to the use of immediate testing appear to be a lack of recommendations on when and how to use the tests, along with considerations of their accuracy. “Professor David Grabowski, Harvard School of Medicine.
Kaiser Health News is a national fitness policy news service that is part of the non-component foundation of the Henry J Family Circle. Kaiser.
The figures recommend a basic word war between the Trump administration, state fitness officials, and retirement home managers on the most productive way to control this population.
Many nursing services still send samples primarily to laboratories, a type of verification that is considered more reliable, but can take days to provide results.
As a result, in 29% of the approximately 13,000 establishments that brought their speed to the government, the effects on citizens took on average 3 days or more.
Only 17% of nursing homes reported that their average response time was less than a day, and the rest tended to take effect within a day or two.
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