Long-term care facilities with a preventive COVID-19 testing strategy experienced far fewer infections compared with facilities that conducted tests in response to illness, according to a county-wide study published Thursday by the Centers of Disease Control and Prevention.

Investigators tracked COVID-19 infections in 28 Fulton County, Georgia, facilities this spring, including skilled nursing, memory care and assisted living communities. Baseline prevalence was determined with a four-week follow-up. Participants in the “prevention” group were those that tested proactively — before infections were identified. The “response” group began testing following a confirmed case.

Although most facilities had at least one case of COVID-19, significantly more infections were found in the 15 facilities with a response testing strategy. The high initial prevalence of cases in residents (28%) and staff members (7.4%) suggested that the infection already had spread by the time the first case was identified. On follow-up, a total of 42% of residents and 12% of staff members were infected overall. 

This was compared with significantly lower case counts in the 13 facilities with a prevention strategy. These operations had initial counts of 0.5% resident cases and 1% staff cases, and follow-up totals of 1.5% and 2%, respectively.

The findings suggest that proactive testing of long-term care facility residents and staff members might prevent large COVID-19 outbreaks, concluded Carson T. Telford from Emory University and the Fulton County Board of Health in Atlanta. The key is early identification and timely infection prevention and control response, he wrote.

During March and May, long-term care facility residents accounted for more than 50% of deaths tied to COVID-19 in Fulton County, although they represented less than 1% of the population, the researchers reported.

The study was published in the CDC’s Morbidity and Mortality Weekly Report.