PAGING CAPTAIN OBVIOUS – Experts Tell Hospitals: Stop Testing New Admissions For COVID

A panel of infectious disease experts is urging hospitals to stop testing new admissions for COVID.

In a new study, 12 experts affiliated with the Society for Healthcare Epidemiology of America (SHEA), argued that when hospitals employ masking and proper ventilation, testing for the virus can have deleterious effects, including “delays in patient placement” and “postponement of necessary procedures.”

The study was published in published in Cambridge University Press’ Infection Control & Hospital Epidemiology.

“The use of asymptomatic screening is a unique yet resource-intensive tool that arguably has been overused,” the articles executive summary reads. “Although it is imperative to prevent healthcare-associated spread of respiratory pathogens, we must critically assess interventions that, when added upon core layers of infection prevention, may not attain the intended impact and may have unintended consequences for patients and HCP.”

The experts also said that there could be a time for mass testing, but that it was not always necessary.

“Admission screening may be beneficial during times of increased virus transmission in some settings where other layers of controls are limited (eg, behavioral health, congregate care, or shared patient rooms), but widespread routine use of admission asymptomatic screening is not recommended over strengthening other infection prevention controls,” they explained.

The authors delineated the methods to reduce spreading the virus in hospitals.“Key interventions that are important to reduce the risk of respiratory virus spread in healthcare facilities include patient symptom screening, avoidance of HCP presenteeism, optimization of ventilation, environmental cleaning, hand hygiene, source control with masking, isolation of suspect and confirmed infected patients, and vaccination of patients and HCP,” the said.

“In the setting of these layered hierarchies of control, the added benefit of asymptomatic screening is uncertain,” they concluded.

The panel did allow that pre-admission screenings for patients at risk of developing a serious form of COVID, such as organ transplant and cancer patients, should be utilized.

“The small benefits that could come from asymptomatic testing at this stage in the pandemic are over ridden by potential harms from delays in procedures, delays in patient transfers, and strains on laboratory capacity and personnel,” Dr Thomas Talbot, an epidemiologist at Vanderbilt University stated.

In a May 2022 study, the Cook County, Illinois Department of Emergency Medicine examined the effect of universal screening of patients with a behavior health problem between March 1, 2020, and December 31, 2020 and found that routine asymptomatic Covid testing made patients spend an average of 7.3 more hours in the emergency room.