Does Universal Testing for COVID-19 Work for Everyone?
Does Universal Testing for COVID-19 Work for Everyone?
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DOI：
10.1016/j.jamda.2020.08.013
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发表时间：
2020-11-01
影响因子：
7.6
通讯作者：
Jump, Robin L. P.
中科院分区：
文献类型：
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作者：
Dumyati, Ghinwa;Gaur, Swati;Jump, Robin L. P.
2019年冠状病毒病（COVID-19）大流行对养老院居民的影响尤其严重，居民个人的健康状况和社区生活环境都导致了发病率和死亡率的增加。预防COVID-19感染的传播需要多管齐下，包括早期识别受感染的居民和医护人员，遵守感染防控措施，将受感染的居民聚集在一起，以及受感染的工作人员休假。应对养老院居民COVID-19感染的策略因严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）检测的可用性、将检测纳入更广泛的监测工作，以及利用检测结果通过识别无症状和症状前感染来帮助减轻COVID-19的传播而有所不同。我们回顾了可用于诊断COVID-19感染的检测方法、普遍检测对养老院工作人员和居民的影响、检测结果的解释、重复检测的问题，以及将检测结果纳入COVID-19大流行长期应对措施的一部分。我们建议采用一种结构化的方法对居民和工作人员进行全设施检测，并在检测能力有限的情况下提供替代方案，强调接触者追踪。拥有强有力的居民和工作人员筛查方案、对新病例进行接触者追踪并继续对感染防控措施保持警惕的养老院，可以通过深思熟虑地使用基于症状和风险的检测策略，更好地为其居民和工作人员服务。由爱思唯尔公司代表AMDA（急性和长期护理医学协会）出版。
The Coronavirus disease 2019 (COVID-19) pandemic has been especially devastating among nursing home residents, with both the health circumstances of individual residents as well as communal living settings contributing to increased morbidity and mortality. Preventing the spread of COVID-19 infection requires a multipronged approach that includes early identification of infected residents and health care personnel, compliance with infection prevention and control measures, cohorting infected residents, and furlough of infected staff. Strategies to address COVID-19 infections among nursing home residents vary based on the availability for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests, the incorporation of tests into broader surveillance efforts, and using results to help mitigate the spread of COVID-19 by identifying asymptomatic and presymptomatic infections. We review the tests available to diagnose COVID-19 infections, the implications of universal testing for nursing home staff and residents, interpretation of test results, issues around repeat testing, and incorporation of test results as part of a long-term response to the COVID-19 pandemic. We propose a structured approach for facility-wide testing of residents and staff and provide alternatives if testing capacity is limited, emphasizing contact tracing. Nursing homes with strong screening protocols for residents and staff, that engage in contact tracing for new cases, and that continue to remain vigilant about infection prevent and control practices, may better serve their residents and staff by thoughtful use of symptom- and risk-based testing strategies. Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.