1. Mass testing after a single suspected or confirmed case of COVID-19 in London care homes, April-May 2020: implications for policy and practice.
- Author
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Tang S, Sanchez Perez M, Saavedra-Campos M, Paranthaman K, Myers R, Fok J, Crawley-Boevey E, Dun-Campbell K, Janarthanan R, Fernandez E, Vusirikala A, Patel B, Ma T, Amin-Chowdhury Z, Shetty N, Zambon M, Bell A, Wynne-Evans E, Chow Y, and Ladhani S
- Subjects
- Aged, Aged, 80 and over, COVID-19 epidemiology, COVID-19 transmission, COVID-19 Nucleic Acid Testing, COVID-19 Testing, England, Female, Humans, Infection Control, London epidemiology, Long-Term Care, Male, Pandemics, Policy, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2 genetics, Whole Genome Sequencing, COVID-19 diagnosis, Mass Screening statistics & numerical data, SARS-CoV-2 isolation & purification
- Abstract
Introduction: Previous investigations have identified high rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among residents and staff in care homes reporting an outbreak of coronavirus disease 2019 (COVID-19). We investigated care homes reporting a single suspected or confirmed case to assess whether early mass testing might reduce risk of transmission during the peak of the pandemic in London., Methods: Between 18 and 27 April 2020, residents and staff in care homes reporting a single case of COVID-19 to Public Health England had a nasal swab to test for SARS-CoV-2 infection by reverse transcription polymerase chain reaction and subsequent whole-genome sequencing. Residents and staff in two care homes were re-tested 8 days later., Results: Four care homes were investigated. SARS-CoV-2 positivity was 20% (65/333) overall, ranging between 3 and 59%. Among residents, positivity ranged between 3 and 76% compared with 3 and 40% in staff. Half of the SARS-CoV-2-positive residents (23/46, 50%) and 63% of staff (12/19) reported symptoms within 14 days before or after testing. Repeat testing 8 days later in two care homes with the highest infection rates identified only two new cases. Genomic analysis demonstrated a small number of introduction of the virus into care homes, and distinct clusters within three of the care homes., Conclusions: We found extensive but variable rates of SARS-CoV-2 infection among residents and staff in care homes reporting a single case of COVID-19. Although routine whole-home testing has now been adopted into practice, care homes must remain vigilant and should be encouraged to report a single suspected case, which should trigger appropriate outbreak control measures., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
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