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. 2022 Aug;41(8):1802-1811.
doi: 10.1177/07334648221093050. Epub 2022 May 11.

Low-Threshold Testing for SARS-CoV-2 (COVID-19) in Long-Term Care Facilities Early in the First Pandemic Wave, the Twente Region, the Netherlands: A Possible Factor in Reducing Morbidity and Mortality

Felix Geeraedts  1 , Mariska Luttje  2 , Jan Visschedijk  2 , Monique van Hattem  3 , Henk-Jan Hasper  4 , Roy Kohnen  5 , Rene Loman  6 , Rudi de Goede  7 , Desiré Jansen  8 , Dorine Hess  1 , Nashwan Al Naiemi  1
Affiliations

Low-Threshold Testing for SARS-CoV-2 (COVID-19) in Long-Term Care Facilities Early in the First Pandemic Wave, the Twente Region, the Netherlands: A Possible Factor in Reducing Morbidity and Mortality

Felix Geeraedts et al. J Appl Gerontol. 2022 Aug.

Abstract

During the first wave of the COVID-19 pandemic, there was a shortage of SARS-CoV-2 diagnostic tests, and testing patients with mild symptoms (low-threshold testing) was not recommended in the Netherlands. Despite these guidelines, to protect those who were most at risk, low-threshold testing was advocated and offered to the majority of long-term care institutions in the Twente region. In this manner, 144 healthcare workers and 96 residents tested SARS-CoV-2-positive and were isolated before the same service was provided nationwide by public health services. Strikingly, excess mortality rate in the Twente region 1 month after the introduction of this strategy was found to be 62%-89% lower than that in neighboring regions, which may be explained by this divergent testing strategy. In an emerging pandemic, early implementation of a liberal testing policy may be more effective than restricted testing in settings with a high death rate.

Keywords: COVID-19; SARS-CoV-2 diagnostic testing; decision making; home and community-based care and services; long-term care; mortality; pandemic.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The first pandemic wave in the Twente region. Numbers of SARS-CoV-2-positive cases per day for the Twente region, starting from the firstly identified case on March 3 (blue line), with the 7-day average given (black line). The red box presents the time period in which low-threshold testing in regionally long-term care institutions was performed before similar testing became available by public health services.
Figure 2.
Figure 2.
Regional differences in COVID-19-related deaths and excess deaths. The regions for which the percentages of COVID-19-related deaths (CD) per inhabitant and percentages of excess deaths (ED) are given (see also the text) are depicted in shades of gray. Dotted lines represent the boundaries of the Dutch provinces (insert).
See this image and copyright information in PMC

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