Lessons learned in preventing COVID-19 within a skilled nursing facility during the early pandemic.
Theresa Watts, Marilyn Tucker, Chelsey Gray and 3 others
PMID 34624696WHAT IT FOUND
In one skilled nursing facility, two residents had positive PCR tests but no symptoms, no known exposure, and repeat tests were negative.
The authors suggest these were likely false positives. The paper describes infection control efforts but cannot show whether they prevented spread.
Key findings
01Two residents were confirmed cases by PCR but were asymptomatic, had no known exposure, had repeat tests that were negative, and their close contacts also tested negative.
02The study could not measure whether the infection control interventions actually prevented spread.
03During months when protective equipment and testing were in short supply, residents and staff had higher odds of being counted as a case.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study could not measure whether any of the infection control steps actually prevented spread. Data came from internal documents that may have had errors in dates, interventions, or staff illness records. Testing was not available in the facility until May, so early suspected cases were never confirmed or ruled out by PCR. Visitors were not tracked, even though they are part of the facility community. This is one facility in one rural county, so the findings may not apply to other settings. The number of confirmed cases was very small, so the statistical models had wide uncertainty and low explanatory power.
Declared interests
The authors declared no competing financial or personal interests.
The easy way to misread this
Do not read the low case counts or the described protective measures as evidence that this facility's infection control programme worked. The authors state plainly that they could not assess effectiveness, and the two confirmed resident cases were likely false positives. This paper describes what one facility did during an emergency, not what has been shown to prevent spread.