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Public Health

Point Prevalence Testing of Residents for SARS-CoV-2 in a Subset of Connecticut Nursing Homes

Educational Objective
To understand how point prevalence testing is utilizing to treat residents for COVID-19

1 Credit CME

JAMA

Published Online: August 10, 2020

Research Letter

Article Information and Disclosures

Sunil Parikh, MD, MPH¹;

Kevin O’Laughlin, MD²;

Hanna Y. Ehrlich, MPhil¹;

Lauren Campbell, BS¹;

Adora Harizaj, MPH³;

Amanda Durante, PhD³;

Vivian Leung, MD³

Author Affiliations

¹Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
²Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
³Connecticut Department of Public Health, Hartford

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The first case of coronavirus disease 2019 (COVID-19) in Connecticut was reported in a nursing home (NH) on March 15, 2020. Within the next 2 months, 80.0% of Connecticut’s 215 NHs reported at least 1 case of COVID-19, accounting for 61.6% of COVID-19 deaths in the state.¹ Residents were initially tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) only if symptomatic, as per recommendations from the Centers for Disease Control and Prevention. In early May, NHs were prioritized and selected for point prevalence surveys to provide a baseline for residents not previously identified as infected. We describe the results of these surveys in a targeted subset of Connecticut NHs between May 2 and 19, 2020.

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Article Information

Corresponding Author: Sunil Parikh, MD, MPH, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT 06520 (sunil.parikh@yale.edu).

Accepted for Publication: July 24, 2020.

Published Online: August 10, 2020. doi:10.1001/jama.2020.14984

Author Contributions: Drs Parikh and Leung had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Parikh and O’Laughlin contributed equally to this work.

Concept and design: Parikh, O’Laughlin, Ehrlich, Leung.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Parikh, O’Laughlin, Ehrlich, Harizaj.

Critical revision of the manuscript for important intellectual content: Parikh, O’Laughlin, Ehrlich, Campbell, Durante, Leung.

Statistical analysis: Parikh, Ehrlich.

Administrative, technical, or material support: O’Laughlin, Ehrlich, Campbell, Harizaj, Durante, Leung.

Supervision: Parikh, Leung.

Conflict of Interest Disclosures: None reported.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Additional Contributions: We thank the Connecticut Department of Public Health team including Barbara Cass, RN; Anu Paranandi, DO, MPH; Erin Grogan, RN, MS; Naissa Piverger, MPH; Meghan Maloney, MPH; Ellen Neuhaus, MD; Surjit Sethuraman; Kim Hriceniak, RNC, BSN; Kristin Soto, MPH; and Terry Rabatsky-Ehr, MS, MPH, for building and maintaining a nursing home surveillance system for coronavirus disease 2019. We thank Ben Gagne and members of the Connecticut National Guard for assisting in the deployment of point prevalence survey test kits. We thank Linda Niccolai, PhD, and team from the Yale School of Public Health for assistance with developing and executing the nursing home surveillance system. No individuals listed received compensation for their contributions to this work.

References

Connecticut Department of Public Health. COVID-19 daily DPH reports library. Updated July 31, 2020. Accessed June 10, 2020. https://data.ct.gov/Health-and-Human-Services/COVID-19-Daily-DPH-Reports-Library/bqve-e8um

Bigelow BF , Tang O , Barshick B , et al. Outcomes of universal COVID-19 testing following detection of incident cases in 11 long-term care facilities. JAMA Intern Med. Published online July 14, 2020. doi:10.1001/jamainternmed.2020.3738 PubMed Google Scholar

Feaster M , Goh YY . High proportion of asymptomatic SARS-CoV-2 infections in 9 long-term care facilities, Pasadena, California, USA, April 2020. Emerg Infect Dis. 2020;26(10). doi:10.3201/eid2610.202694 PubMed Google Scholar

Sanchez GV , Biedron C , Fink LR , et al. Initial and repeated point prevalence surveys to inform SARS-CoV-2 infection prevention in 26 skilled nursing facilities: Detroit, Michigan, March-May 2020. MMWR Morb Mortal Wkly Rep. 2020;69(27):882-886. doi:10.15585/mmwr.mm6927e1 PubMed Google Scholar Crossref

Richardson S , Hirsch JS , Narasimhan M , et al; Northwell COVID-19 Research Consortium. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-2059. doi:10.1001/jama.2020.6775 PubMed Google Scholar Crossref

Centers for Disease Control and Prevention. Testing guidelines for nursing homes: interim SARS-CoV-2 testing guidelines for nursing home residents and healthcare personnel. Updated July 21, 2020. Accessed July 15, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-testing.html

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.