Testing residents in independent/assisted living communities is a better strategy for identifying potential cases of COVID-19 than screening symptoms.
In March 2020, public health surveillance of staff and residents was conducted on site at an assisted and independent living residence for older adults in Seattle, WA, after exposure to 2 residents who were hospitalized with COVID-19.
According to a May 21 article in JAMA Internal Medicine, all 80 residents and 62 staff members received a COVID-19 test. Eighty residents and 57 staff members completed a questionnaire documenting their existing health conditions and assessing their COVID-19 symptoms.
Residents: SARS-CoV-2 was detected in 3 residents, all of whom reported feeling well and in their usual state of health on the day of testing. On day 7, 1 additional asymptomatic resident, a woman in her 80s who had negative screening results the week prior, had SARS-CoV-2 detected.
On day 21, all of these residents continued to exhibit their usual state of health, and no new cases of COVID-19 were found among residents.
Overall, 63 of 80 residents (79%) had at least 1 serious chronic medical condition and 33 (41%) reported symptoms including cough, dizziness, headache, and diarrhea.
Staff: SARS-CoV-2 was detected in 2 symptomatic female staff. One staff person worked in dining services and 1 was a health aide. The symptoms reported by these staff were headache for 10 days, and body aches, headache, and cough for 5 days. The staff member with 5 days of symptoms had not worked while ill.
Of 57 staff who completed a questionnaire, 16 (28%) reported symptoms including malaise, sore throat, and body aches.
“We showed that early surveillance after exposure to cases may identify asymptomatic residents infected with SARS-CoV-2,” the authors concluded. “Screening for typical symptoms of COVID-19 may be inadequate in this population to identify infected persons. Also, symptom screening would have incorrectly identified as possibly infected many residents without COVID-19 because more than 40% reported 1 or more potential COVID-19 symptoms.”