Detection of SARS-CoV-2 in an independent and assisted living community for older adults in Seattle, Washington

Detection of SARS-CoV-2 in an independent and assisted living community for older adults in Seattle, Washington. Spencer EA, Heneghan C.

https://www.cebm.net/study/detection-of-sars-cov-2-in-an-independent-and-assisted-living-community-for-older-adults-in-seattle-washington/

Published on July 27, 2020

Reference Roxby AC, Greninger AL, Hatfield KM, et al. Detection of SARS-CoV-2 among residents and staff members of an independent and assisted living community for older adults — Seattle, Washington, 2020. MMWR Morb Mortal Wkly Rep 2020;69:416–418. DOI: http://dx.doi.org/10.15585/mmwr.mm6914e2
Study type
Country USA
Setting Seniors’ housing community
Funding Details Non Reported
Transmission mode Close contact, person to person
Exposures

Bottom Line

Symptom-based screening might not identify SARS-CoV-2 infections in independent and assisted living facility residents.

Evidence Summary

Following identification of two COVID-19 cases in a Seattle independent and assisted living facility, stringent preventive measures were implemented. Testing of all residents and staff members was performed.

Mean age of residents was 86 years (range 69 to 102 years); mean age of staff members was 40 years (range 16 to 70 years).

In testing round 1: 142 residents and staff members were tested. Three of 80 residents (3.8%) and two of 62 staff members (3.2%) had positive test results. None of the residents with positive tests reported symptoms at the time of testing; however, one reported resolved mild cough and loose stool during the preceding 14 days. During this round, symptoms were reported by 42% of residents and 25% of staff members who had negative test results for SARS-CoV-2.

In testing round 2: one additional positive test result was reported for an asymptomatic resident who had negative test results on the first round.

What did they do?

The study describes the occurrence and symptomology of COVID-19 within a senior independent and assisted living community in Seattle, USA. In this housing community, the residents do not require skilled nursing services, and do not live as closely together as do residents in skilled nursing facilities. Between 5th and 9th March 2020, two residents were hospitalized with confirmed COVID-19 infection.

On 6th March, social distancing and other preventive measures were implemented in the housing community. Two rounds of SARS-CoV-2 testing were conducted seven days apart, using nasopharyngeal swabs and real-time RT-PCR. 

Round 1: 10th March. Physical distancing and other preventive measures had been in effect for >72 hours. All residents and staff members were tested for SARS-CoV-2, and asked to complete a questionnaire about their symptoms during the preceding 14 days.

Round 2: 17th March. All residents were tested again. Staff members were not retested.

Study reliability

This was a study with very few events (cases) and needs replication.  As in numerous retrospective studies, recall bias may have affected participants’ reporting of symptoms here.

Clearly defined setting Demographic characteristics described Follow-up length was sufficient Transmission outcomes assessed Main biases are taken into consideration
Yes Yes Yes Yes No

What else should I consider?

Few cases were identified and the authors propose this may be due to well enforced physical distancing procedures combined with little contact with healthcare providers.

About the authors

Carl Heneghan

Carl Heneghan

Carl is Professor of EBM & Director of CEBM at the University of Oxford. He is also a GP and tweets @carlheneghan. He has an active interest in discovering the truth behind health research findings

Elizabeth Spencer

Elizabeth Spencer

Dr Elizabeth Spencer; MMedSci, PhD. Epidemiologist, Nuffield Department for Primary Care Health Sciences, University of Oxford.