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Silent Shedders

Published on May 19th, 2020

McKnight’s had another article showing the nursing home industry begging for more tests to keep residents and caregivers safe.  Asymptomatic carriers, or “silent shedders,” are responsible for much of the introduction of the novel coronavirus in nursing homes, said Vince Mor, Ph.D., a Brown University researcher with decades of experience. He currently is analyzing outbreaks and prevalence among Genesis HealthCare facilities.  COVID-19’s ability to hide in plain sight will continue to crush expectations of halting its spread unless more and quicker testing at nursing homes sweeps the country.

“There are lots of documented cases where people are shedding virus asymptomatically for four or five days before they become symptomatic. And in many cases, the younger people never become symptomatic,” Mor told attendees at an Alliance for Health Policy webinar on Friday.

Further, he said there is “lots” of anecdotal evidence suggesting positive cases in nursing homes that then become no longer positive, “just like a teenager: They get the disease, it didn’t affect them and then it went on, but they were shedding virus in that time. They were a silent shedder in that sense. The only hope we have is for testing.”

Genesis Chief Medical Officer Richard Feifer, M.D., confirmed that about half of all COVID-19 cases are asymptomatic, and the case fatality rate is about 20%. While test turnaround times have improved from as long as 11 days to 24 to 48 hours, Feifer added, supplies and services are still woefully lacking. That could lead to quicker and more efficient cohorting, experts point out. Instead, nursing home residents — and workers especially — are left to often unwittingly share the virus, sometimes at multiple facilities.

“Swabs and testing are still inadequate in many states,” he said. “What we really need urgently is point-of-care rapid testing. For the virus, not the antibody.”

 

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