Low-Threshold Testing for SARS-CoV-2 (COVID-19) in Long-Term Care Facilities Early in the First Pandemic Wave, the Twente Region, the Netherlands: A Possible Factor in Reducing Morbidity and Mortality

• Published in: Journal of applied gerontology Vol. 41; no. 8; pp. 1802 - 1811
• Main Authors: Geeraedts, Felix, Luttje, Mariska, Visschedijk, Jan, van Hattem, Monique, Hasper, Henk-Jan, Kohnen, Roy, Loman, Rene, de Goede, Rudi, Jansen, Desiré, Hess, Dorine, al Naiemi, Nashwan
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.08.2022; SAGE PUBLICATIONS, INC
• Subjects: COVID-19; COVID-19 Research; Health services; Long term health care; Medical diagnosis; Morbidity; Mortality rates; Pandemics; Physicians; Public health; Regions; Severe acute respiratory syndrome; COVID-19; decision making; long-term care; mortality; pandemic; home and community-based care and services; SARS-CoV-2 diagnostic testing
• ISSN: 0733-4648; 1552-4523
• DOI: 10.1177/07334648221093050

During the first wave of the COVID-19 pandemic, there was a shortage of SARS-CoV-2 diagnostic tests, and testing patients with mild symptoms (low-threshold testing) was not recommended in the Netherlands. Despite these guidelines, to protect those who were most at risk, low-threshold testing was advocated and offered to the majority of long-term care institutions in the Twente region. In this manner, 144 healthcare workers and 96 residents tested SARS-CoV-2-positive and were isolated before the same service was provided nationwide by public health services. Strikingly, excess mortality rate in the Twente region 1 month after the introduction of this strategy was found to be 62%–89% lower than that in neighboring regions, which may be explained by this divergent testing strategy. In an emerging pandemic, early implementation of a liberal testing policy may be more effective than restricted testing in settings with a high death rate.