May 26, 2020

expert reaction to preprint paper on COVID-19 testing in four London care homes, documenting clinical features and outcomes

A preprint, an unpublished study posted on medRxiv, looked at COVID-19 testing in four London care homes, and documented clinical features and outcomes.

Dr Henglien Lisa Chen, a lecturer in social work and social care at the University of Sussex, said:

“Screening and testing is one of the essential COVID-19 infection control strategies. 

“The study’s findings echo some of the best practice currently being carried out around the globe such as the daily practice of screening care home staff, visitors and residents in Taiwan where no care home residents have been reported to be infected to date.

“To be effective, what constitutes screening needs to be clearly defined with a clear protocol established for care homes to follow.

“When to use testing is also crucial because testing is not cheap.

“The crucial time for testing is when there is a single case at a home. Every member of staff and resident should then be tested with results returned swiftly, ideally within 24 hours, and strategies need to be put in place while awaiting results.

“In a global example of best practice in Taiwan, non-infected residents are assisted by the local authority in a temporary transfer to other care institutions so the whole care home can be deep-cleaned.”

Dr Michael Head, Senior Research Fellow in Global Health at the University of Southampton, said:

“This is a small but useful study, covering COVID-19 outbreak response in care homes. The study highlights an example of the scale of COVID-19 infection and excess death in care homes, which underpins the national UK picture.

“Alongside the death toll in the residents, it is important to note that across the four care homes covered, there were hundreds of staff, some of whom were agency staff and many of whom will work across more than one site. There are huge implications for transmission between care homes (and also hospitals), and the increased levels of employee sickness shows the difficulties in operating with safe levels of staffing.

“Care homes and also domiciliary care are hugely difficult and complex places for infection control, not least because these are quite literally people’s place of residence, and thus distinct from a hospital ward. The unusual clinical presentations and asymptomatic cases found by the researchers show the difficulties in early diagnosis, which is vital in vulnerable populations such as these. They have been a neglected population for far too long.”

*”SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes” is a preprint by Neil Graham et al. on medRxiv and was uploaded on Tuesday 26 May

All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19

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