Efficacy of COVID-19 outbreak management in a skilled nursing facility based on serial testing for early detection and control

Braz J Infect Dis. Mar-Apr 2021;25(2):101570. doi: 10.1016/j.bjid.2021.101570. Epub 2021 Mar 23.


SARS-CoV-2 has a high risk of outbreak in long-term skilled nursing facilities (SNF). Coronavirus disease (COVID-19) has high mortality rates among the elderly with chronic health conditions. Following identification of COVID-19 index case in a SNF, serial point-prevalence was implemented with reverse transcription-polymerase chain reaction (RT-PCR) and immunochromatographic assays. Active surveillance and early isolation of infected patients were implemented. Out of 23 SNF residents and 26 healthcare workers (HCW), 18 (78%) and 12 (46%) tested positive for SARS-CoV-2, respectively. High proportion (38%) of positive patients were asymptomatic and RT-PCR was positive up to six days before symptoms. Five (21.74%) residents were hospitalized with COVID-19, and 2 (9%) died; only 1 (4%) HCW needed to be hospitalized and no staff members died. Active surveillance helped COVID-19 control and management in a SNF. Testing symptomatic individuals only may fail to identify and isolate all persons contributing to transmission. In high-risk elderly, only symptoms screening may not be enough for outbreak control.

Keywords: 2019 novel coronavirus disease; COVID-19; Long-term care facilities; Outbreak; SARS-CoV-2; Skilled nursing facility.

MeSH terms

  • Aged
  • COVID-19*
  • Disease Outbreaks
  • Humans
  • Mass Screening
  • SARS-CoV-2
  • Skilled Nursing Facilities*