More than half of vulnerable elderly people infected with coronavirus at US nursing homes have no symptoms, a new study has found.
Long-term care facilities residents account for more than 40 percent of coronavirus fatalities in the US, according to a New York Times analysis. As a result, some homes have established universal testing.
Johns Hopkins University researchers identified hundreds more covid-positive residents at long-term care facilities which collectively had 153 confirmed diagnoses.
Of the additional cases, 55 percent had no symptoms, a clear signal that screening or isolating only those with symptoms of coronavirus is not enough – especially in nursing homes where the virus can spread like wildfire among vulnerable, elderly people.
More than 50% of long-term care home residents who tested positive for coronavirus in Maryland had no symptoms at the time of testing, a new study found. Pictured: a nursing home resident in New York is wheeled to an ambulance after showing signs of coronavirus
The research team looked at 11 long-term care facilities in Maryland that initiated universal testing for residents after cases were identified within their walls.
Initially, the 11 homes had a collective 153 cases.
The other cumulative 893 residents were also tested and 354 were positive for the virus, but less than half of them had symptoms.
But being asymptomatic at the time of their positive tests did not mean that those residents were safe from getting severely ill.
In fact, within two weeks, 20 of the 154 people who were asymptomatic at the time they tested positive had to be hospitalized.
Seven of those patients were dead 14 days after testing positive.
It’s an astoundingly short timeline between infection and death, but there was a silver lining to the mortality-related findings of the study, which was published in JAMA Internal Medicine on Tuesday.
Those seven patients who died represented less than 20 percent of the cases identified within seven of the 11 care homes (follow-up data on the remaining four facilities was not available).
That makes the odds of fatality in facilities with universal testing considerably lower than the national rate in such homes, where about a third of patients who catch coronavirus are estimated to die, according to the Center for Medicare & Medicaid Services.
New York Governor Andrew Cuomo (right) has come under fire for a March executive order requiring nursing homes to allow coronavirus patients to be discharged to their care after becoming ‘stable’ at hospitals
According to an analysis by The New York Times, at least 296,000 long-term care facility residents and staff members have been infected with coronavirus and 55,000 have died in the US.
How these infections occur and the handling of these patients has become a subject of controversy, particularly in New York.
In March, Governor Andrew Cuomo issued a policy that prohibited nursing homes from turning away covid-positive patients who were ‘stable’ after being discharged from hospitals.
Last week, the governor’s health department published a report that claimed people allowed into or back into nursing homes after testing positive or being hospitalized for coronavirus were not a significant driver of the nearly 6,500 deaths in the state’s long-term care facilities.
The state’s health department instead blamed the devastating outbreaks in such facilities on transmissions from staff members who unwittingly brought the virus into these homes.
The report was met with skepticism and scrutiny and, on Monday, Governor Cuomo altered the March policy so that hospitalized coronavirus patients must test negative for the virus before they can be discharged to long-term care homes.
Regardless, the authors of the new study argue that outbreaks will still be very possible in nursing homes until testing is universal within them.
In New York, Governor Cuomo signed an executive order in May that required all staff members in long-term care facilities to be tested for COVID-19 at least twice a week – but no such universal testing requirement is in place for residents.
‘Long-term care facilities have emerged as “hot spots” for SARS-CoV-2 infection and mortality globally,’ the Johns Hopkins researchers wrote.
‘Using symptom-based testing alone to identify positive residents is not adequate to assess case burden and inform outbreak-control efforts in these settings.
‘Additional testing resources are urgently needed to identify the true burden of COVID-19 and curb transmission in long-term care settings.’