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Oxford University Press - PMC COVID-19 Collection logoLink to Oxford University Press - PMC COVID-19 Collection
. 2021 Feb 23:afab054. doi: 10.1093/ageing/afab054

Mass testing after a single suspected or confirmed case of COVID-19 in London care homes, April–May 2020: implications for policy and practice

Suzanne Tang 1,, Marina Sanchez Perez 2, Maria Saavedra-Campos 3, Karthik Paranthaman 4, Richard Myers 5, Jonathan Fok 6, Emma Crawley-Boevey 7, Kate Dun-Campbell 8, Roshni Janarthanan 9, Elena Fernandez 10, Amoolya Vusirikala 11, Bharat Patel 12, Thomas Ma 13, Zahin Amin-Chowdhury 14, Nandini Shetty 15, Maria Zambon 16, Anita Bell 17, Edward Wynne-Evans 18,19, Yimmy Chow 20, Shamez Ladhani 21,22
PMCID: PMC7929429  PMID: 33620453

Abstract

Introduction: Previous investigations have identified high rates of SARS-CoV-2 infection among residents and staff in care homes reporting an outbreak of 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 18–27 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 RT-PCR and subsequent whole genome sequencing. Residents and staff in two care homes were re-tested eight days later.

Results: Four care homes were investigated. SARS-CoV-2 positivity was 20% (65/333) overall, ranging between 3–59%. Among residents, positivity ranged between 3–76% compared to 3–40% 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 introductions 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. While 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.

Keywords: SARS-CoV-2, COVID-19, care home, long-term care facility, mass testing, older people


Articles from Age and Ageing are provided here courtesy of Oxford University Press

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