ABSTRACT
Context: COVID-19 is especially dangerous to older adults living in residential care. Objective: To evaluate the usefulness of a nurse-led Enhanced Care Home Team (ECHT) SARS-CoV-2 testing strategy to identify resident cases early, identify typical illness presentation residents, and correctly attribute cause of death in care home settings in Norfolk, UK. Method: Residents and staff received nose and throat swab tests (7 April to 29 June 2020). Resident test results were linked with symptoms on days 0–14 after test and mortality to 13 July 2020. The data collected were used to evaluate service performance. Findings: Residents (n = 521) and staff (estimated n = 340) in 44 care homes were tested in the ECHT service. SARS-CoV-2 positivity was identified in 103 residents in 14 homes and 49 staff in 7 homes. Of 103 SARS-CoV-2+ residents, just 37 had what were understood to be typical COVID-19 symptom(s). Among 51 residents without symptoms when initially tested, 13 (25%) developed symptoms within 14 days. Many SARS-CoV-2+ residents lacked typical symptoms but presented rather as ‘generally unwell’ (n = 16). Of 39 resident deaths during the monitoring period, 20 (51%) were initially attributed to SARS-CoV-2, all of whom tested SARS-CoV-2+. One deceased person not initially attributed to SARS-CoV-2 tested positive through a different monitoring programme. Of all staff tests, 9% were positive. Implications: A locally designed and integrated joint nursing and social care team approach successfully identified asymptomatic and pre-symptomatic SARS-CoV-2+ residents and staff. Being ‘generally unwell’ was common amongst symptomatic residents and indicated SARS-CoV-2 infection in older people in the absence of more ‘typical’ symptoms. The service supported correct attribution of cause of death. © 2022 The Author(s).
ABSTRACT
BACKGROUND: There is a high prevalence of COVID-19 in university-age students, who are returning to campuses. There is little evidence regarding the feasibility of universal, asymptomatic testing to help control outbreaks in this population. This study aimed to pilot mass COVID-19 testing on a university research park, to assess the feasibility and acceptability of scaling up testing to all staff and students. METHODS: This was a cross-sectional feasibility study on a university research park in the East of England. All staff and students (5625) were eligible to participate. All participants were offered four PCR swabs, which they self-administered over two weeks. Outcome measures included uptake, drop-out rate, positivity rates, participant acceptability measures, laboratory processing measures, data collection and management measures. RESULTS: 798 (76%) of 1053 who registered provided at least one swab; 687 (86%) provided all four; 792 (99%) of 798 who submitted at least one swab had all negative results and 6 participants had one inconclusive result. There were no positive results. 458 (57%) of 798 participants responded to a post-testing survey, demonstrating a mean acceptability score of 4.51/5, with five being the most positive. CONCLUSIONS: Repeated self-testing for COVID-19 using PCR is feasible and acceptable to a university population.