HealthDay News — Rapid and widespread transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur in skilled nursing facilities, according to a study published online in the New England Journal of Medicine.

Melissa M. Arons, RN, from the US Centers for Disease Control and Prevention COVID-19 Emergency Response in Atlanta, and colleagues conducted 2 serial point-prevalence surveys one week apart among residents of a skilled nursing facility. Assenting residents of the facility underwent nasopharyngeal and oropharyngeal testing for SARS-CoV-2; symptoms present in the previous 14 days were recorded. Asymptomatic residents who tested positive were reassessed after seven days.

The researchers found that 57 of 89 residents (64%) tested positive for SARS-CoV-2 23 days after the first positive test result in a resident at the skilled nursing facility. Forty-eight of 76 residents (63%) who participated in point-prevalence surveys tested positive. More than half (56%) of these 48 residents were asymptomatic at the time of testing; 24 of the 27 subsequently developed symptoms. The median real-time reverse-transcriptase polymerase chain reaction cycle threshold value was 23.1 in samples from these 24 presymptomatic residents; viable virus was recovered from 17 residents. Eleven of the 57 residents with SARS-CoV-2 infection had been hospitalized as of April 3, and 15 had died (26% mortality).

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“Our data suggest that symptom-based strategies for identifying residents with SARS-CoV-2 are insufficient for preventing transmission in skilled nursing facilities,” the authors write. “Once SARS-CoV-2 has been introduced, additional strategies should be implemented to prevent further transmission.”

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