Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May:111:89-95.
doi: 10.1016/j.jhin.2020.12.024. Epub 2021 Jan 13.

COVID-19 testing in outbreak-free care homes: what are the public health benefits?

R Green  1 , J S P Tulloch  2 , C Tunnah  3 , E Coffey  3 , K Lawrenson  3 , A Fox  4 , J Mason  5 , R Barnett  6 , A Constantine  5 , W Shepherd  1 , M Ashton  3 , M B J Beadsworth  5 , R Vivancos  1 , I Hall  7 , N Walker  8 , S Ghebrehewet  9
Affiliations

COVID-19 testing in outbreak-free care homes: what are the public health benefits?

R Green et al. J Hosp Infect. 2021 May.

Abstract

Background: COVID-19 care home outbreaks represent a significant proportion of COVID-19 morbidity and mortality in the UK. National testing initially focused on symptomatic care home residents, before extending to asymptomatic cohorts.

Aim: The aim was to describe the epidemiology and transmission of COVID-19 in outbreak free care homes.

Methods: A two-point prevalence survey of COVID-19, in 34 Liverpool care homes, was performed in April and May 2020. Changes in prevalence were analysed. Associations between care home characteristics, reported infection, prevention and control interventions, and COVID-19 status were described and analysed.

Findings: No resident developed COVID-19 symptoms during the study. There was no significant difference between: the number of care homes containing at least one test positive resident between the first (17.6%, 95% confidence interval (CI) 6.8-34.5) and second round (14.7%, 95% CI 5.0-31.1) of testing (p>0.99); and the number of residents testing positive between the first (2.1%, 95% CI 1.2-3.4) and second round (1.0%, 95% CI 0.5-2.1) of testing (P=0.11). Care homes providing nursing care (risk ratio (RR) 7.99, 95% CI 1.1-57.3) and employing agency staff (RR 8.4, 95% CI 1.2-60.8) were more likely to contain test positive residents. Closing residents shared space was not associated with residents testing positive (RR 2.63, 95% CI 0.4-18.5).

Conclusions: Asymptomatic COVID-19 care homes showed no evidence of disease transmission or development of outbreaks; suggesting that current infection prevention and control measures are effective in preventing transmission. Repeat testing at two to three weeks had limited or no public health benefits over regular daily monitoring of staff and residents for symptoms. These results should inform policies calling for regular testing of asymptomatic residents.

Keywords: COVID-19; COVID-19 testing; Care home; Health protection; Infection prevention and control; SARS-CoV-2.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram detailing resident test results through both rounds of swabbing.
Figure 2
Figure 2
Flow diagram detailing care home test results through both rounds of swabbing.
Figure 3
Figure 3
The number of test-positive asymptomatic COVID-19 cases per care home.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Office for National Statistics. Deaths registered weekly in England and Wales, provisional: week ending 15 May 2020. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/... [last accessed August 2020].
    1. Burki T. England and Wales see 20000 excess deaths in care homes. Lancet. 2020;395(10237):1602. - PMC - PubMed
    1. Du R.-H., Liang L.-R., Yang C.-Q., Wang W., Cao T.-Z., Guo G.-Y. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Resp J. 2020;55(5):2000524. - PMC - PubMed
    1. Gordon A.L., Franklin M., Bradshaw L., Logan P., Elliott R., Gladman J.R. Health status of UK care home residents: a cohort study. Age Ageing. 2014;43(1):97–103. - PMC - PubMed
    1. Shah A., Harries A., Cleary P., McGivern M., Ghebrehewet S. Use of prophylactic antivirals and care home characteristics associated with influenza in care homes with confirmed outbreaks. Public Health. 2019;177:48–56. - PubMed