Testing for SARS-CoV-2 infection in care home residents and staff in English care homes: A service evaluation

Brainard, Julii, Aldus, Clare, Smith, Emma, Dunham, Sharon, Hunter, Paul, Steel, Nicholas and Everden, Paul (2022) Testing for SARS-CoV-2 infection in care home residents and staff in English care homes: A service evaluation. Journal of Long-Term Care, 2022. pp. 154-162. ISSN 2516-9122

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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 seven 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. 9% of all staff tests 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.

Item Type:	Article
Uncontrolled Keywords:	covid-19,care homes,nursing,public health,service evaluation,social care,health(social science),health professions (miscellaneous) ,/dk/atira/pure/subjectarea/asjc/3300/3306
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Medicine and Health Sciences > School of Health Sciences University of East Anglia Research Groups/Centres > Theme - ClimateUEA
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Social Sciences > Research Centres > Water Security Research Centre Faculty of Medicine and Health Sciences > Research Centres > Population Health
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	23 Mar 2022 15:30
Last Modified:	06 Feb 2025 10:29
URI:	https://ueaeprints.uea.ac.uk/id/eprint/84242
DOI:	10.31389/jltc.99

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