• Guillermo V Sanchez, Caitlin Biedron, Lauren R Fink, Kelly M Hatfield, Jordan Micah F Polistico, Monica P Meyer, Rebecca S Noe, Casey E Copen, Amanda K Lyons, Gonzalo Gonzalez, Keith Kiama, Mark Lebednick, Bonnie K Czander, Amen Agbonze, Aimee R Surma, Avnish Sandhu, Valerie H Mika, Tyler Prentiss, John Zervos, Donia A Dalal, Amber M Vasquez, Sujan C Reddy, John Jernigan, Paul E Kilgore, Marcus J Zervos, Teena Chopra, Carla P Bezold, and Najibah K Rehman.
• MMWR Morb. Mortal. Wkly. Rep. 2020 Jul 10; 69 (27): 882-886.

AbstractSkilled nursing facilities (SNFs) are focal points of the coronavirus disease 2019 (COVID-19) pandemic, and asymptomatic infections with SARS-CoV-2, the virus that causes COVID-19, among SNF residents and health care personnel have been described (1-3). Repeated point prevalence surveys (serial testing of all residents and health care personnel at a health care facility irrespective of symptoms) have been used to identify asymptomatic infections and have reduced SARS-CoV-2 transmission during SNF outbreaks (1,3). During March 2020, the Detroit Health Department and area hospitals detected a sharp increase in COVID-19 diagnoses, hospitalizations, and associated deaths among SNF residents. The Detroit Health Department collaborated with local government, academic, and health care system partners and a CDC field team to rapidly expand SARS-CoV-2 testing and implement infection prevention and control (IPC) activities in all Detroit-area SNFs. During March 7-May 8, among 2,773 residents of 26 Detroit SNFs, 1,207 laboratory-confirmed cases of COVID-19 were identified during three periods: before (March 7-April 7) and after two point prevalence surveys (April 8-25 and April 30-May 8): the overall attack rate was 44%. Within 21 days of receiving their first positive test results, 446 (37%) of 1,207 COVID-19 patients were hospitalized, and 287 (24%) died. Among facilities participating in both surveys (n = 12), the percentage of positive test results declined from 35% to 18%. Repeated point prevalence surveys in SNFs identified asymptomatic COVID-19 cases, informed cohorting and IPC practices aimed at reducing transmission, and guided prioritization of health department resources for facilities experiencing high levels of SARS-CoV-2 transmission. With the increased availability of SARS-CoV-2 testing, repeated point prevalence surveys and enhanced and expanded IPC support should be standard tools for interrupting and preventing COVID-19 outbreaks in SNFs.

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