It’s widely agreed that prompt, methodical, ongoing testing of residents and staff is the key to making nursing homes safer, but a White House recommendation for states to test all residents within two weeks failed to produce desired results.
Maggie Flynn at Skilled Nursing News had a great article about the current issues with testing nursing home workers. She explains that one of the primary factors in the spread of COVID-19 in skilled nursing facilities is the workforce — specifically staff members in a facility who are infected with the virus while not showing any symptoms of illness. Regardless of whether or not those infected do begin to show symptoms, they can still pass on the virus, rendering symptom screenings — such as testing for fever and checking for cough or shortness of breath — ineffective in keeping it from getting inside a SNF. That makes widespread testing of staffers and residents paramount.
And while guidance on reopening nursing homes from the Centers for Medicare & Medicaid Services (CMS) recommends that SNFs have the capacity to test staff once a week, the lack of funds and test kits make that impossible. As COVID-19 began to spread across the country, the shortage of testing was a major concern. It still remains a problem. As more and more states set mandates for nursing home resident and staff tests, that will mean exponentially increasing the tests provided.
A federal watchdog report last month found a “persistent” pattern of infection control problems in nursing homes even before the coronavirus. The Government Accountability Office said that about 40% of the nursing homes inspected in each of the past two years were cited for problems with infection control and prevention.
The efforts of states highlight how the call to “test, test, test,” which has become a mantra of sorts since the pandemic began gathering steam in the U.S., can be implemented — and how the reality of supplies and risk and time affect those strategies.
While the impulse to test every resident is a typical part of the medical mentality of testing — diagnosing and treating — the fact remains that testing is hard to obtain and there is no treatment for COVID-19. Early identification of COVID-19-positives before they show symptoms can reduce the number of new positive cases.