According to a retrospective cohort study, higher rates of SARS-CoV-2 testing among skilled nursing facilities were associated with lower rates of COVID-19 cases and deaths among residents.
From more than 13,000 services studied between 2020 and 2022, there were 519. 7 COVID cases consistent with one hundred possible outbreaks among high-assessment service citizens, to 591. 2 cases among low-rated service citizens, Brian E reported. McGarry, PT, PhD, of the University of Rochester in New York, and colleagues.
Deaths also decreased at high testing centers, with 42. 7 deaths consistent with one hundred prospective outbreaks with 49. 8 deaths at low testing centers, they noted in the New England Journal of Medicine.
“We found that more surveillance testing of staff members in nurse practitioners was linked to clinically meaningful discounts on COVID-19 cases and deaths among citizens,” McGarry and his team wrote. “Enhanced surveillance testing was also linked to more COVID-19 cases among potential staff outbreaks, findings that were consistent with protecting citizens through increased COVID-19 detection among staff members. “
Although nursing homes and qualified citizens make up less than 2% of the U. S. population, they are not allowed to live in the U. S. population. In the U. S. , McGarry and his team pointed to a Kaiser Family Foundation report from February 2022 that showed this population accounted for 20% of COVID deaths at the end of 2021.
“The federal government has advised that the verification of the COVID-19 regimen of asymptomatic personnel be carried out up to twice a week in qualified nursing facilities in areas of maximum transmission of SARS-CoV-2, this practice was difficult to achieve in the maximum of services before 2021 due to verification and staff shortages, chain of origin issues and slow response times for verification results,” they wrote.
When the effects of common testing were analyzed at 3 other times, before vaccine availability, before Omicron and Omicron, common staff testing was most effective in the era before vaccines became available.
During this consistent period, high and low testing services recorded 759. 9 cases and 1060. 2 cases, equivalent to 100 possible outbreaks, respectively, and 125. 2 and 166. 8 deaths.
In the pre-Omicron period, case-death rates were similar between facilities with high and low testing, and the Omicron wave, instances decreased in facilities with high tests, but mortality rates were similar.
It should be noted that greater discounts on COVID cases and deaths were noted when verification effects were delivered quickly. When average response times were 2 days or less, there were 41. 6 resident deaths consistent with one hundred possible outbreaks compared to 59. 1 when effects were returned 3 days or more after testing.
“It is possible that detection occurred earlier in the course of the disease, disrupting potential viral chains of transmission,” McGarry and colleagues suggested.
While there is no difference between point-of-care (POC) and non-POC tests, the researchers noted that “using POC tests avoids delays in lab response times. “
In addition, “during the study consistent with the period, the use of non-POC tests was associated with only modest discounts in the number of cases and no relief in deaths,” they added. “Because POC tests are less expensive than non-POC tests ($5 vs. $100 consistent with testing), common testing would possibly be more financially feasible with POC testing. “
For this study, McGarry and his team included 13,424 professional nursing homes and assessed staff testing volumes over weeks without COVID cases compared to other professional nursing services in the same county, as well as COVID cases and deaths among potential citizen outbreaks. which were explained as the occurrence of a case after 2 weeks without a case.
High-end services fell in the 90th percentile of check volume, and low-level services fell in the 10th percentile.
McGarry and colleagues noted that because of the design of the observational study, causality was determined. Moreover, unmeasured confusion could have been a driving force behind the differences between upper and lower verification facilities.
Ingrid Hein is infectious disease editor for MedPage Today. She has been a medical journalist for more than a decade. Follow
McGarry disclosed any conflicts of interest. One co-author said he consulted with Greylock McKinnon Associates.