Help or hindrance? Lessons learnt from asymptomatic COVID-19 testing of newly admitted hospital inpatients.

Help or hindrance? Lessons learnt from asymptomatic COVID-19 testing of newly admitted hospital inpatients.

Claire Hynes¹, Caroline Bartolo^2,3, Mary Butters¹, Alison McKenzie¹, Daniel O’Brien^2,4, ,

¹Infection Prevention Service Barwon Health, Geelong, Victoria, Australia
²Department of Infectious Diseases Barwon Health, Geelong, Victoria, Australia
³Geelong Clinical School, Deakin University, Geelong, Victoria, Australia
⁴Department of Infectious Diseases, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
Background
In March 2023 the Barwon South West region saw an 18.7% increase in reported COVID-19 cases with increased COVID-19 exposures and staff absenteeism observed at Barwon Health. Concerned that COVID-19 incursions were occurring from asymptomatic patients not identified on admission rapid antigen testing (RAT) due to its reduced sensitivity compared to PCR, Barwon Health implemented COVID-19 PCR testing of all asymptomatic admissions.

Methods
All patients admitted to Barwon Health from home, the Emergency Department and other facilities, without symptoms of COVID-19, were tested with COVID-19 PCR. Tests were sent to the Barwon Health pathology service provider. Identified positive cases and their close contacts were isolated. Contacts were tested regularly with positive cases followed for development of symptoms.

Results
2105 COVID-19 PCR tests were performed over 6 weeks. Turnaround time (TAT) of COVID-19 PCR results ranged from <24- 60 hours due to various factors. 22 asymptomatic COVID-19 positive cases were identified (0.01%), with 11 admitted into shared rooms. Contact tracing identified 31 close contacts, with no transmission observed despite delays of often >24 hours of contact before PCR results were received. Three positive cases developed symptoms during admission.

Conclusion
Despite delays in obtaining results and isolating cases, transmission of COVID-19 was not observed. This project demonstrated that in asymptomatic and presymptomatic COVID-19, risk of transmission in shared rooms was low. As COVID-19 PCR testing did not offer additional benefits but utilized more resources than RAT, a change in hospital policy to RAT testing for all newly admitted inpatients was enacted.

Biography

Mary Butters is a Clinical Nurse Consultant in the Infection Prevention Service at Barwon Health. Mary has an extensive clinical background and Post Graduate qualifications in Public Health.

Claire has 24 years’ experience as a Registered Nurse with a background in Intensive Care and has Post Graduate qualifications in both Intensive Care and Infection Prevention. Her current role is Clinical Nurse Consultant in Infection Prevention Services at Barwon Health.