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. 2024 Feb 17;78(2):439-444.
doi: 10.1093/cid/ciad424.

In Support of Universal Admission Testing for SARS-CoV-2 During Significant Community Transmission

Chanu Rhee  1   2 , Michael Klompas  1   2 , Theodore R Pak  1   3 , Julia R Köhler  4
Affiliations

In Support of Universal Admission Testing for SARS-CoV-2 During Significant Community Transmission

Chanu Rhee et al. Clin Infect Dis. .

Abstract

Many hospitals have stopped or are considering stopping universal admission testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We discuss reasons why admission testing should still be part of a layered system to prevent hospital-acquired SARS-CoV-2 infections during times of significant community transmission. These include the morbidity of SARS-CoV-2 in vulnerable patients, the predominant contribution of presymptomatic and asymptomatic people to transmission, the high rate of transmission between patients in shared rooms, and data suggesting surveillance testing is associated with fewer nosocomial infections. Preferences of diverse patient populations, particularly the hardest-hit communities, should be surveyed and used to inform prevention measures. Hospitals' ethical responsibility to protect patients from serious infections should predominate over concerns about costs, labor, and inconvenience. We call for more rigorous data on the incidence and morbidity of nosocomial SARS-CoV-2 infections and more research to help determine when to start, stop, and restart universal admission testing and other prevention measures.

Keywords: COVID-19; asymptomatic screening; infection control; non-maleficence; nosocomial SARS-CoV-2.

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Conflict of interest statement

Potential conflicts of interest . C. R. reports royalties from UpToDate, Inc, for chapters related to procalcitonin use; consulting fees from Cytovale related to sepsis diagnostics; and payments from the Infectious Diseases Society of America for his role as an associate editor for Clinical Infectious Diseases. M. K. reports institutional grants from the Agency for Healthcare Research and Quality and royalties from UpToDate, Inc, for chapters related to hospital-acquired pneumonia. C. R. and M. K. report funding from the Centers for Disease Control and Prevention (CDC) to conduct research on infection prevention and control. T. R. P. reports funding from a training grant from the National Institute of Allergy and Infectious Diseases (NIAID). J. R. K. reports research grants from NIAID (R01 and R33); a service grant from the National Library of Medicine (G08 “Bridging Neglect” of Chagas Disease). All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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