Evidence to support the need for visitor restrictions to stay in place?
A London School of Economics and Political Science analysis of COVID-19 cases in aged care staff and residents in other countries has shown that most did not exhibit symptoms at the time of testing – raising questions over whether the same would apply to visitors.
In Belgium, analysis of the 13,544 COVID-19 tests carried out in care homes since 10 April shows 13% of staff were positive – with 73% asymptomatic at the time.
20% of residents were positive – with 69% asymptomatic when tested.
As we have already covered, a study by the Centers for Disease Control and Prevention in the United States found symptom-based screening in long-term care facilities could fail to identify around 50% of residents with COVID-19.
The author, Adelina Comas-Herrera, an Assistant Professorial Research Fellow at the Care Policy and Evaluation Centre (CPEC), says ideally all aged care home residents and staff should be tested regularly, irrespective of whether they display the “typical symptoms”.
Ms Comas-Herrera also notes that the latest guidance on managing COVID-19 in care homes from the British Geriatrics Society says while Public Health England says that COVID-19 should be suspected in any resident with a new continuous cough and/or high temperature (at least 37.8°C), aged care residents may also present with non-respiratory tract symptoms, such as new onset/worsening confusion or diarrhoea.
“Care home staff, with detailed knowledge of residents, are well-placed to intuitively recognise these subtle signs (‘soft signs’) of deterioration,” she said.
The Research Fellow also stressed that countries which appear to have had relative success in preventing and containing COVID-19 outbreaks in care homes, such as Singapore and South Korea, have very strict processes to isolate and test all aged care home residents and staff who not only have symptoms, but who may had contact with people who have COVID-19.
She suggested reducing occupancy in aged care homes may make it easier for operators to physically isolate residents and implement measures such as “zoning” the home.